Abstract
BackgroundMethamphetamine use and harms are rising rapidly. Management of patients with methamphetamine use disorder (MUD) and problematic methamphetamine use (PMU) is challenging, with no clearly established best approach; both psychosocial and pharmacologic interventions have been described. Furthermore, given the diversity of individuals that use methamphetamines, there is a need to assess evidence for treatments for subgroups including youths; gay, bisexual, and other men who have sex with men; individuals with mental health comorbidities; and individuals in correction services. Establishing awareness of the messages regarding treatment from recent clinical practice guidelines (CPG) in the field is also of value.The first study objective will be to establish a greater understanding of the methods, populations, and findings of controlled studies for psychosocial and pharmacologic treatments for MUD and PMU. Investigation of this information can help establish the potential for advanced syntheses of the evidence (such as network meta-analysis) to compare therapies for this condition and to identify gaps related to key populations where more primary research is needed. Summarizing the recommendations regarding treatment of MUD/PMU from recent CPGs and systematic reviews will be an important secondary objective.MethodsA scoping review will be performed. Using the OVID platform, MEDLINE, Embase, PsycINFO, and relevant Cochrane databases from EBM Reviews will be searched (from databases’ inception onwards). Eligibility criteria will include individuals described as having MUD or PMU, with designs of interest including randomized trials, non-randomized trials, and controlled cohort studies with three or more months of follow-up; systematic reviews and CPGs will also be sought. Two reviewers (with support from automation tools) will independently screen all citations, full-text articles, and chart data. Different approaches to handling and summarizing the data will be implemented for each type of study design. Tables and graphics will be used to map evidence sources and identify evidence gaps.DiscussionThis research will enhance awareness of evidence addressing the effects of psychosocial and pharmacologic interventions for MUD/PMU overall and in sub-populations, both in terms of recent CPGs/reviews and primary studies; inspection of the latter will also help establish the feasibility of future syntheses to compare treatments, such as network meta-analysis.Systematic review protocol registrationOpen Science Framework (https://osf.io/9wy8p)
Highlights
Methamphetamine use and harms are rising rapidly
This research will enhance awareness of evidence addressing the effects of psychosocial and pharmacologic interventions for methamphetamine use disorder (MUD)/problematic methamphetamine use (PMU) overall and in sub-populations, both in terms of recent clinical practice guidelines (CPG)/reviews and primary studies; inspection of the latter will help establish the feasibility of future syntheses to compare treatments, such as network meta-analysis
The current review will seek to address these limitations by means of a focused synthesis of treatments for MUD/PMU as well as by incorporating evidence for special populations in order to establish evidence for nuances of treatment
Summary
Methamphetamine use and harms are rising rapidly. Management of patients with methamphetamine use disorder (MUD) and problematic methamphetamine use (PMU) is challenging, with no clearly established best approach; both psychosocial and pharmacologic interventions have been described. Regular consumption is associated with many negative health consequences including a significant rise in the risk of adverse mental health symptoms (e.g., psychosis, paranoia, depression, insomnia, and cognitive impairment [8,9,10,11]), increased likelihood of risky behaviors (e.g., illicit drug consumption, criminal behaviors, and sexual behaviors with increased risk of sexually transmitted infections [12,13,14,15,16,17,18,19]), and other physiologic effects (e.g., “meth mouth” [20, 21]; brain abnormalities such as reductions in whitematter integrity and hippocampal volumes, cardiovascular problems, hyperthermia, seizures [6, 22,23,24]), infections (e.g., human immunodeficiency virus, hepatitis, methicillin-resistant Staphylococcus aureus), endocarditis [25, 26], and risk of death from overdose [1, 27]
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