Why do we need a medication to treat methamphetamine addiction?

Hello. Dr. Heinzerling here for UCLA SARx. If you've visited this blog before you know that we are working on developing a medication to treat methamphetamine addiction. Currently, there are no medications approved to treat methamphetamine addiction (there are medications approved for opioid and alcohol addiction and look for more on these in an upcoming post). The mainstay of treatment for methamphetamine addiction at the moment is behavioral therapy.

There are two types of  behavioral therapy that have been tested and are effective for methamphetamine addiction. The first is cognitive behavioral therapy (CBT), which is standard drug counseling that aims to provide the patient with the skills they need to resist their triggers to use drugs. The other is contingency management (CM), where patients receive immediate reinforcement for positive behavior, i.e. if they provide a urine sample that is negative for methamphetamine they get a reward (often a gift card). Research studies confirm that both CBT and CM work for methamphetamine addiction, but they are not close to 100% effective. In a UCLA SARx study (in collaboration with Drs. Andy Dean and Edythe London at UCLA) we found that about one-third (33%) achieved success with behavioral therapy which we defined as being in treatment and abstinent from methamphetamine at the end of a 12 week treatment episode. Even more importantly, for the most severely addicted patients, those who were daily or near-daily methamphetamine users, the success rate with behavioral therapy was only around 5-10%.

While CBT and CM are important treatments, it is clear that we need something additional to boost the success rates. The approach we are using to developing medications starts with CBT and CM treatment and adds a medication on top to see if we can get better success rates with the combination of a medication and behavioral therapy. Early research suggests the medication bupropion (aka Wellbutrin or Zyban) may boost success rates in some methamphetamine users but it is not clear yet who. As a result, we are currently doing a study where people who want to quit methamphetamine receive CBT and bupropion to try to determine if it does work and if so for who. In particular we are interested in looking at whether a patient's genetic make-up may influence whether he/she responds to treatment for methamphetamine addiction. If you would like more info on this study or are interested in potentially participating, call 866-449-UCLA or visit the Clinical Trials portion of the website. Thanks for visiting and as always feel free to comment via our Twitter feed (@UCLASARx).

Related posts:

• Is there a pill that can cure addiction?
• Our Treatment Philosophy

Tags: bupropion, cognitive behavioral therapy, contingency management, counseling, crystal meth, medication, methamphetamine