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 / Methamphetamine Use Disorder

How We Treat Methamphetamine Use Disorder

Is there any evidence to support MAT for methamphetamine use disorder?

In a 12-week study published in the New England Journal of Medicine (Jan 2021), 13.6% of patients who took both bupropion and naltrexone stopped using meth, compared with 2.5% who took a placebo. This is the highest success rate shown in any previous study.

The treatment combines two medications: naltrexone, commonly used to treat alcohol and opioid dependence, and bupropion, an antidepressant. These medications have not been FDA-approved to treat methamphetamine use disorder, but a recent New England Journal of Medicine (Jan 2021) study, and other medical literature, supports their use for this purpose.

The combination of naltrexone and bupropion is strictly for isolated methamphetamine use disorder. If you are using meth and opioids together, we will develop a personalized treatment plan for you that may include buprenorphine (Suboxone). We have successfully treated many patients with poly-substance use disorder and can help you too.

Patients will meet with an addiction medicine provider regularly for 6 months to a year or longer before safely tapering off the medication. If patients are using both meth and opioids, their treatment plan will include buprenorphine. 

We perform regular urine drug testing to help us tailor and adjust your treatment plan. It's important for our providers to know what substances are in your system to ensure your safety and offer you the most appropriate medical and behavioral treatment. Please be prepared to provide a urine sample during your scheduled appointments. Blood is drawn, typically on your second visit, to identify and make you aware of any undiagnosed health conditions that may interfere with your treatment plan. We test for things like liver function, kidney function, STIs, HIV, and Hepatitis B & C. We share the results with you and will refer you to primary or specialty care if follow up treatment is needed.

Naltrexone-bupropion is not approved for use in people under the age 18. Younger adolescents in need of treatment should be referrred to a clinician or program specializing in adolescent addiction.

Studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of naltrexone and bupropion combination in older adults. However, elderly patients may be more sensitive to the effects of this medicine and are more likely to have age-related kidney problems. This may require extra caution and an adjustment in dosing for patients receiving this medicine.

Unfortunately, naltrexone-bupropion is not recommended for use during pregnancy as it may harm the fetus.

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