Methamphetamine — a.k.a. speed — is a big problem, more so now that we’re under the COVID-19 cloud.
Overdoses from opioids seem to take center stage, but meth is always behind the scenes and just as bad. Until now, there has been no treatment for addiction to it.
But a new study funded by the National Institutes of Health holds promise for treatment. A combination of two medications — oral bupropion and injectable naltrexone, a drug used to treat opioid addiction — appear to be safe in treating meth addiction.
That, combined with cognitive therapy, just might get some meth heads out of their buzz. Let’s dive into the data.
The study took place over a two-year period starting in 2017 and included 400 adults ages 18 to 65 with severe meth use. All wanted to reduce or stop their drug use.
They were randomly assigned to a placebo group or a drug treatment group, which received long-acting injectable naltrexone, a drug used for opioid addiction, with daily bupropion, a commonly used antidepressant used for ADD and tobacco addiction. In the control group, only 3% did better, but in the treatment group it jumped to nearly 17% who improved.
Nearly one out of five in the treatment group stopped their meth use. They had fewer drug cravings and better improvement in their lives, as measured by questionnaires, and how they functioned. Nearly all of them tolerated the medication, with many of them continuing the bupropion after the study was over.
Long-term meth use cause changes in the brain seen on MRI scans. This potent stimulant, like other addictive drugs, hijacks the reward system of the brain. It disrupts dopamine, oxytocin and serotonin, the three internal brain transmitters that naturally set up our brain’s reward system.
When you’re a child and your mom says “good job,” those three neuro hormones kick into action, giving you the glow that makes you feel good. Just think of one of those times in your life when you felt good — even that memory gives you a warm feeling right now.
If you close your eyes and go to one of those places in your memory, this triple play reward system acts in your brain to remind you of that good time.
When you’re on meth, those systems including the receptors that activate that system, have been saturated by the drug. Your brain is pushed up to 120 mph, so the normal reward system can’t do its job.
Getting off the stuff can be terribly difficult. It might seem easy to follow the Nancy Reagan slogan, “Just say no.” But if you do get hooked, what to do?
My spin: In this time of COVID-19, not to mention all the other things going on in our society, it’s easy to forget we are still in the middle of a drug abuse epidemic. And I don’t mean marijuana, which is more like alcohol than it is like opioids or meth.
This new drug combination gives hope to meth addicts to help them quit the buzz.
Dear Doc: What’s your opinion about remdesivir and convalescent plasma as treatments of COVID-19. Do they work? Should anyone take them to keep from getting COVID? Love your show and your columns. — H.J., from Sun Prairie
Dear H.J.: First off, as preventive measures, that’s a big no. The only thing we know about prevention of coronavirus spread is social distancing, masking, washing your hands and staying away from indoor activities with groups. That’s it.
Remdesivir shortens hospitalization for those who are acutely ill. It’s not as good a drug as we initially thought at the beginning of the pandemic, but when it is combined with dexamethasone, an inexpensive generic steroid on the market for several decades, it seems to do the trick for the seriously ill.
Now let’s look at convalescent plasma. This is a 100-year-old technology that was used before antibiotics and immunizations to treat diphtheria, whooping cough and influenza, during the 1918 pandemic. It does seem to help, especially in the early phases of COVID-19 infection.
A recent study from the New England Journal of Medicine showed that high titer plasma therapy did reduce the death rate in seriously ill COVID patients. The “titer” measure in blood serum indicates the level of antibodies.
My spin: There is lots of COVID convalescent plasma around, but the problem is getting it into people. You have to go to a transfusion site, which takes time and personnel. It works best when it’s given during the early stage of the disease, when you’re sick but not too sick.
But at least this offers some positive news regarding the terrible scourge we’ve been facing. Stay well.
This column provides general health information. Always consult your personal health care provider about concerns. No ongoing relationship of any sort is implied or offered by Dr. Paster to people submitting questions. Any opinions expressed by Dr. Paster in his columns are personal and are not meant to represent or reflect the views of SSM Health.