Treatment of methamphetamine use disorders: An update

UCLA Integrated Substance Abuse Programs, 11050 Santa Monica Boulevard, Suite 100, Los Angeles, CA 90025, USA.
Journal of Substance Abuse Treatment (Impact Factor: 3.14). 10/2002; 23(2):145-50. DOI: 10.1016/S0740-5472(02)00256-8
Source: PubMed


Methamphetamine (MA) is a major public health and criminal justice problem in much of the Western and Midwestern US, and its use seems to be increasing east of the Mississippi River. MA use can produce significant psychiatric and medical consequences, including psychosis, dependence, overdose, and death. Cognitive behavioral therapy and contingency management are among the most promising approaches for treatment of MA abuse and dependence. A multisite study evaluating the Matrix Model of outpatient treatment will soon be completed to provide data on this manualized approach. An ambitious program of pharmacotherapy development research is currently being sponsored by the National Institute on Drug Abuse (NIDA) in geographic areas significantly affected by MA use. The development of treatments for MA-related problems is particularly critical for a number of user groups including MA users who experience persistent psychosis, pregnant women and women with children, gay and bisexual men, and MA users involved in the criminal justice system.

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    • "et al. 2013). Effective medications have yet to be devel-25 oped to treat MA dependence; therefore, psychosocial and behavioral treatments continue to make up principal treatment strategies (Rawson, Gonzales, and Brethen 2002). Although MA users have a variety of options for psychosocial treatment regimens, group cognitive behavioral therapy 30 (CBT) has been shown to improve outcomes (Keoleian et al. 2013). "
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    ABSTRACT: In this research, the possible neuropsychological predictors of relapse and dropout of group cognitive behavioral therapy (CBT) for methamphetamine (MA) users were explored. Participants were 42 MA users sentenced by the judicial system to take part in an out-patient relapse prevention program for MA abuse and dependence that employs a CBT model once a week over the course of 12 weeks. Baseline neuropsychological functions were evaluated with the Conners' Continuous Performance Test, Wisconsin Card Sorting Test, Iowa Gambling Task, and Barratt Impulsiveness Scale. All participants had to submit to urine drug tests every week. Of the 42 participants, 69.0% had a MA positive urine screening result at least once throughout the program (relapse), while 40.5% dropped out of the treatment program prior to its completion. Short duration of MA abstinence at baseline and poor attention predicted relapse. Predictors of dropout included being unmarried and having risky decision making. Findings may be helpful for clinicians, who can screen for the aforementioned risk factors and provide strategies for high-risk patients to help prevent relapse and dropout among MA users in treatment programs.
    Journal of psychoactive drugs 08/2015; 47(4):1-8. DOI:10.1080/02791072.2015.1071447 · 1.10 Impact Factor
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    • "Acute doses of MET were also shown to produce social isolation in monkeys (Crowley et al., 1974), rats (Shinba et al., 1996), and mice (Sokolov et al., 2004). Disruptions in social behavior and social withdrawal are known also in human MET users (Davidson et al., 2001; Rawson et al., 2002). Still, such effects were shown only in timid mice in our study. "
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    ABSTRACT: The aim of the present study was to compare the behavioral effects of modafinil, an atypical psychostimulatory acting and cognitive-function improving drug, with the effects of the psychostimulants methamphetamine (MET) and MDMA (3,4-methylenedioxymethamphetamine, or "ecstasy") in a model of mouse agonistic behavior. This model enables the observation of ethologically well-defined sociable, timid, aggressive, and locomotor behavioral acts and postures. Singly-housed male mice (isolates) were separated into 4 groups. The observations were performed in 4 sessions, 1 week apart. In each interaction, singly-housed mice were paired with non-aggressive group-housed partners for 4 min in a neutral environment. The isolates received, in a Latin square design, either a) a vehicle or modafinil at doses 2.0, 10.0, or 50.0 mg/kg; or b) a vehicle or MET at doses 1.0, 5.0, or 10.0 mg/kg; or c) a vehicle or MDMA at doses 2.5, 10.0, or 30.0 mg/kg. The isolates were categorized as timid or aggressive according to their behavior in the control interaction (vehicle pre-treatment). Elements of locomotor, sociable, aggressive, and timid behavior were evaluated (one-way ANOVA). In the aggressive mice, no change in the sum of aggressive behavior was measured following modafinil administration, while both methamphetamine and MDMA produced dose-dependent inhibition of aggression (p<0.01). The substantial difference in the tested drug effects on agonistic behavior was an increased occurrence of sociable acts (p<0.01) accompanied by a simultaneous increase of timid acts (p<0.01) recorded after MDMA, but not after modafinil or methamphetamine administration. In the timid mice, at least some doses of modafinil decreased timidity (p<0.01) and increased aggression (p<0.01) with no effect on sociability. Administration of MDMA increased timid activities (p<0.01). Both MDMA and MET decreased sociability (p<0.01).
    Pharmacology Biochemistry and Behavior 05/2012; 102(2):215-23. DOI:10.1016/j.pbb.2012.04.013 · 2.78 Impact Factor
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    • "Methamphetamine (Meth) is a highly addictive drug of abuse, and addiction to Meth has increased to epidemic proportions worldwide (Cretzmeyer et al. 2003 ; Rawson et al. 2002). Chronic Meth users show psychotic signs such as hallucinations and delusions, which are indistinguishable from paranoid schizophrenia (Sato et al. 1983 ; Srisurapanont et al. 2003 ; Yui et al. 2002). "
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    ABSTRACT: Galantamine, a drug used to treat Alzheimer's disease, inhibits acetylcholinesterase (AChE) and allosterically modulates nicotinic acetylcholine receptors (nAChRs) resulting in stimulation of catecholamine neurotransmission. In this study, we investigated whether galantamine exerts cognitive-improving effects through the allosteric modulation of nAChRs in an animal model of methamphetamine (Meth) psychosis. The mice treated with Meth (1 mg/kg.d) for 7 d showed memory impairment in a novel object recognition test. Galantamine (3 mg/kg) ameliorated the memory impairment, and it increased the extracellular dopamine release in the prefrontal cortex (PFC) of Meth-treated mice. Donepezil, an AChE inhibitor (1 mg/kg) increased the extracellular ACh release in the PFC, whereas it had no effect on the memory impairment in Meth-treated mice. The nAChR antagonist, mecamylamine, and dopamine D1 receptor antagonist, SCH 23390, blocked the ameliorating effect of galantamine on Meth-induced memory impairment, whereas the muscarinic AChR antagonist, scopolamine, had no effect. The effects of galantamine on extracellular dopamine release were also antagonized by mecamylamine. Galantamine attenuated the defect of the novelty-induced activation of extracellular signal-regulated kinase 1/2 (ERK1/2). The ameliorating effect of galantamine on recognition memory in Meth-treated mice was negated by microinjection of an ERK inhibitor, PD98059, into the PFC. These results suggest that the ameliorating effect of galantamine on Meth-induced memory impairment is associated with indirect activation of dopamine D1 receptor-ERK1/2 following augmentation with dopaminergic neurotransmission in the PFC through the allosteric activation of nAChRs. Galantamine could be a useful therapeutic agent for treating cognitive deficits in schizophrenia/Meth psychosis, as well as Alzheimer's disease.
    The International Journal of Neuropsychopharmacology 03/2010; 13(10):1343-54. DOI:10.1017/S1461145710000222 · 4.01 Impact Factor
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