Treatment Of Methamphetamine Dependence Research Articles

A New Protocol of Methamphetamine Dependence Treatment with Taper-Up-Off Treatment of Opium Tincture, a New Hope to Cure the Methamphetamine Addiction

Methamphetamine is a neurotoxic drug and highly addictive stimulant, which causes a significant psychological dependence in use disorder and potential brain damage even in the first use disorder. Despite decades of research, no approved pharmacotherapy is available for methamphetamine (METH) use disorder, and behavioral therapies are faced with a great lack of long-term recovery and a high rate of relapse. Opium tincture is air-dried Papaver somniferum latex, formulated for oral administration. The present study aimed to evaluate the effectiveness of the new protocol for taper up-off method of opium tincture used for treatment of methamphetamine addiction in Iran, for more than 10 years. In the present study, the effectiveness of the Opium tincture taper-up-off treatment method for methamphetamine dependence called “Dezhakam step time (DST) for methamphetamine” was assessed. We used data collected via the “Congress 60” a nongovernmental organization in Iran, dedicated to addiction treatment with the DST method, from Jan 2018 until December 2020. We evaluated the treatment safety, success, and relapse rate in methamphetamine dependents treated in the “Congress 60” organization with the DST for methamphetamine method. All subjects were tested using Urine drug monitoring for both opioid and methamphetamine use after the treatment period and during the next two years as a follow-up. Findings revealed 89 percent of successful treatments for methamphetamine dependence and only 11 percent of substance abuse relapses in two years follow up. Also, less than one percent of the subjects that finished the treatment program abused opioids in two years follow up. Findings suggest the safety and effectiveness of the Opium tincture taper-up-off method in the treatment of methamphetamine dependence. The findings of the study may help to a better understanding of a safe potential novel method for methamphetamine dependence treatment and its effects on psychological dependence on psychostimulants.

Adenosine receptor stimulation inhibits methamphetamine-associated cue seeking.

Methamphetamine (METH) is a psychostimulant drug that remains a popular and threatening drug of abuse with high abuse liability. There is no established pharmacotherapy to treat METH dependence, but evidence suggests that stimulation of adenosine receptors reduces the reinforcing properties of METH and could be a potential pharmacological target. This study examines the effects of adenosine receptor subtype stimulation on METH seeking using both a cue-induced reinstatement and cue-craving model of relapse. Male and female rats were trained to self-administer METH during daily 2-h sessions. Cue-induced reinstatement of METH seeking was evaluated after extinction training. A systemic pretreatment of an adenosine A1 receptor (A1R) or A2A receptor (A2AR) agonist was administered prior to an extinction or cue session to evaluate the effects of adenosine receptor subtype stimulation on METH seeking. The effects of a systemic pretreatment of A1R or A2AR agonists were also evaluated in a cue-craving model where the cued-seeking test was conducted after 21 days of forced home-cage abstinence without extinction training. Cue-induced reinstatement was reduced in both male and female rats that received A1R or A2AR agonist pretreatments. Similarly, an A1R or A2AR agonist pretreatment also inhibited cue craving in both male and female rats. Stimulation of either adenosine A1R or A2AR subtypes inhibits METH-seeking behavior elicited by METH-associated cues. These effects may be attributed to the ability of A1R and A2AR stimulation to disrupt cue-induced dopamine and glutamate signaling throughout the brain.

Treatment outcome, cognitive function, and psychopathology in methamphetamine users compared to other substance users.

BACKGROUNDThe rising number of people using methamphetamine leads to an increasing need for treatment options for this patient group. Evidence-based research on the efficacy of treatment programs for methamphetamine users is limited. Due to specific characteristics of methamphetamine users, the question arises whether established treatment methods for individuals using other substances can be effective for the treatment of methamphetamine dependence as well. We hypothesize that there are significant differences between the two groups that may affect the effectiveness of treatment and worsen the prognosis of treatment outcomes for methamphetamine users compared to consumers of other substances.AIMTo investigate potential differences in cognitive functioning and psychopathology between methamphetamine users and other substance users and possible correlations with treatment outcomes.METHODSA total of 110 subjects were recruited for an observational, longitudinal study from a German inpatient addiction treatment center: 55 patients with methamphetamine dependence and 55 patients with dependence of other substances (“OS group”). Both groups were examined at beginning (baseline) and end of treatment (after 6 mo) with regard to treatment retention, craving, cognitive functioning, psychosocial resources, personality traits, depression, and other psychiatric symptoms. Instruments used were Raven’s IQ test, Mannheimer craving scale, cognitrone cognitive test battery, NEO personality factors inventory, Hamilton depression scale, Becks depression inventory, and a symptom checklist. The statistical methods used were χ2-test, t-test and multiple mixed ANOVAs. RESULTSA total drop-out rate of 40% (methamphetamine-group: 36.4%; OS-group: 43.6%) was observed without significant differences between groups. At baseline, methamphetamine-group subjects significantly differed from OS-group individuals in terms of a lower intelligence quotient, fewer years of education, slower working speed, and decreased working accuracy, as well as less cannabinoid and cocaine use. Methamphetamine-group subjects further showed a significantly lower score of conscientiousness, depressive, and psychiatric symptoms than subjects from the OS-group. In both groups, a reduction of craving and depressive symptoms and an improvement of working speed and working accuracy was noted after treatment. CONCLUSIONThere are differences between methamphetamine users and users of other drugs, but not with regard to the effectiveness of treatment in this inpatient setting. There are differences in cognitive function and psychopathology between methamphetamine and other drugs users. The existing treatment options seem to be an effective approach in treating methamphetamine dependence.

Combination of Clomipramine and Carbamazepine for Treatment of Patients with Methamphetamine Dependence

Objective: There are few new approaches to the pharmacotherapeutic treatment of methamphetamine dependence in the literature. The publications contain abundant data on various methods of pharmacotherapeutic treatment of methamphetamine dependence. However, no pharmacotherapeutic therapy for methamphetamine dependence is sufficient. Materials and Methods: This was a double-blind study in patients diagnosed with methamphetamine dependence according to DSM-5. A total of 100 patients who met the DSM-5 criteria for methamphetamine dependence were examined. All male patients from 18 to 60 years old. The patients were divided into two groups of 50 people: the first group received clomipramine (anafranil) 300 mg / day (100 mg 3 times a day) and carbamazepine 600 mg / day (200 mg 3 times a day) orally. The second group received an indifferent drug (placebo) Results: as shown by follow-up data (12 months), among 50 patients who received anaphrani and carbamazepine only, 10 had short-term breakdowns associated with exposure to microsocial causes. The rest of the patients were in remission. Among patients receiving placebo, only 5 patients experienced remission, all the rest had cases of relapse. Responder analysis was performed using chi-square (x2) and analysis of variance (ANOVA). Conclusion. Clinical statistics indicate the high efficiency of the use of anaphrani and carbamazepine in the treatment of methamphetamine dependence. The mechanisms of action of the drug are being discussed.

Adding extended-release methylphenidate to psychological intervention for treatment of methamphetamine dependence: A double-blind randomized controlled trial

Background: Iran has been faced with an emerging epidemic of methamphetamine (MA) use during recent years. No effective pharmacotherapy has been identified for MA treatment; and psychological interventions are the only available effective treatment. The aim of this study is to investigate the efficacy and safety of extended-release methylphenidate (ER-MTP) for the treatment of methamphetamine dependence. Methods: Sixty-two people with methamphetamine dependence, according to DSM-IV-TR, were randomly assigned to either fixed-dose extended-release methylphenidate (ER-MTP) (60 mg per day) or placebo for 12 weeks. All participants received twice-weekly cognitive behavioral treatment for stimulant dependence. Recent drug use and craving level were measured using weekly rapid urine test and craving visual analogue scale, respectively. The severity of addiction was measured using the Addiction Severity Index at baseline and study completion. Assessment of MA withdrawal was conducted using Amphetamine Withdrawal Questionnaire and Amphetamine Selective Severity Assessment at baseline, day 3, week 1, week 4 and week 12. Depression and high-risk behaviors assessed with the Beck Depression Inventory and the high-risk behavior questionnaire at baseline, weeks 4 and 12 of the study. SPSS software version 22 was used for data analysis and p<0.05 was considered significant. Results: Percent of weekly MA negative urine tests was not significantly different between groups during the course of the study (p=0.766). Two groups showed similar retention rates. Changes in MA craving, withdrawal, addiction severity, depression and high-risk behaviors were not significantly different between groups. No serious adverse event was observed. Conclusion: Our finding did not show the superiority of fixed-schedule ER-MTP over placebo when added to an intensive biweekly outpatient psychosocial treatment. Further studies using individually tailored flexible-dose regimes might provide new insights regarding the safety and efficacy of psychostimulant maintenance treatment for MA dependence.

Adding extended-release methylphenidate to psychological intervention for treatment of methamphetamine dependence: A double-blind randomized controlled trial

Background: Iran has been faced with an emerging epidemic of methamphetamine (MA) use during recent years. No effective pharmacotherapy has been identified for MA treatment; and psychological interventions are the only available effective treatment. The aim of this study is to investigate the efficacy and safety of extended-release methylphenidate (ER-MTP) for the treatment of methamphetamine dependence. Methods: Sixty-two people with methamphetamine dependence, according to DSM-IV-TR, were randomly assigned to either fixed-dose extended-release methylphenidate (ER-MTP) (60 mg per day) or placebo for 12 weeks. All participants received twice-weekly cognitive behavioral treatment for stimulant dependence. Recent drug use and craving level were measured using weekly rapid urine test and craving visual analogue scale, respectively. The severity of addiction was measured using the Addiction Severity Index at baseline and study completion. Assessment of MA withdrawal was conducted using Amphetamine Withdrawal Questionnaire and Amphetamine Selective Severity Assessment at baseline, day 3, week 1, week 4 and week 12. Depression and high-risk behaviors assessed with the Beck Depression Inventory and the high-risk behavior questionnaire at baseline, weeks 4 and 12 of the study. SPSS software version 22 was used for data analysis and p<0.05 was considered significant. Results: Percent of weekly MA negative urine tests was not significantly different between groups during the course of the study (p=0.766). Two groups showed similar retention rates. Changes in MA craving, withdrawal, addiction severity, depression and high-risk behaviors were not significantly different between groups. No serious adverse event was observed. Conclusion: Our finding did not show the superiority of fixed-schedule ER-MTP over placebo when added to an intensive biweekly outpatient psychosocial treatment. Further studies using individually tailored flexible-dose regimes might provide new insights regarding the safety and efficacy of psychostimulant maintenance treatment for MA dependence.

12- and 18-month follow-up after residential treatment of methamphetamine dependence: Influence of treatment drop-out and different treatment concepts

This study investigates the effects of two different residential treatments and of treatment drop-out in a German methamphetamine (MA) dependent sample. 108 subjects from two addiction treatment concepts were recruited at treatment begin and followed-up at 12 (T2) and 18 (T3) months after treatment. Based on follow-up samples (n = 38 at T2, n = 25 at T3), 77.1% at T2 and 68.0% at T3 were MA abstinent. Classifying everyone, who did not participate at follow-ups as having had a relapse, showed MA-abstinence rates of 25.0% (at T2) and 15.7% (at T3). There was no difference in MA-use between treatment conditions nor between treatment completers and drop-outs. Having injected any substance predicted MA-use at T2 (p = .03). The median time of relapse was 1.5 days after hospital release. Depression scores at T2 predicted MA-use at T3 (p = .02). T2 participants that dropped out of treatment had higher craving scores at T2, than T2 subjects who completed treatment (p = .03). The results show positive effects of current inpatient treatment programs without differences between different concepts. More research is needed to clarify the impact of treatment drop-out. Attention should be paid to a successful transition from residential to outpatient services and to a reduction of study attrition.

Effectiveness of Acceptance and Commitment Therapy in Reduction of Craving and lapse in Methamphetamine Addict Patients

Objective: Today, substance abuse has become one of the major problems in societies and has become more prevalent among young people.The aim of this study is to appointment of acceptance and commitment therapy (ACT) effectiveness in reduction of craving and lapse in methamphetamine addict patients. Method: In this study had been used single-case experimental design in kind of multiple-baseline design in asynchronous manner. Three of male methamphetamine addict patients choose that had come to Welfare Organization and to the Addiction Withdrawal Center in Takab Township by diagnostic interview and structured clinical interview and with purposeful sampling method. The study tools had been used such as Structured Clinical interview (SCID), demographic characteristic questionnaire, urine test, Relapse Prediction Scale (RPS) and Individual Therapy Protocol (ACT).the achieved results considered by methods of visual inspection, reliable change index (RCI), change percentage formula, clinical significance change and operational measurement. Findings: Achieved data showed that acceptance and commitment therapy in treatment's targets intensity reduction (craving and lapse) statistically is in level of (P<0.05), clinically and significance operational measurement. Conclusion: Acceptance and commitment therapy (ACT) is effective in intensity reduction of craving and lapse in methamphetamine addict patients. Given that the therapeutic approach increases psychological flexibility in patients, it can be used to treat methamphetamine dependence.

Cognitive deficits in methamphetamine addiction: Independent contributions of dependence and intelligence

BackgroundMethamphetamine's effects on brain function have been associated with cognitive deficits, which have a negative impact on clinical outcomes. However, it remains unclear if cognitive deficits relate to methamphetamine dependence (potentially amenable to abstinence and retraining) or background characteristics, mental health and other drug use. We tested the association between methamphetamine dependence and cognitive performance, while factoring in the impact of background characteristics, depressive symptoms and tobacco, alcohol and cannabis use. MethodThe sample comprised 108 treatment-seeking participants who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV TR) criteria for methamphetamine dependence and 50 socio-demographically matched controls. We administered a comprehensive neuropsychological test battery (delay discounting, decision making, disinhibition, episodic and working memory) and examined cognitive deficits in methamphetamine users after taking into account socio-demographic characteristics, tobacco, alcohol and cannabis use, and depressive symptoms. ResultsHierarchical multiple regression analyses showed that methamphetamine dependence was associated with poorer performance in decision-making and disinhibition over and above other predictors, while IQ better explained performance in episodic and working memory. Although duration of methamphetamine use was linked to disinhibition, other patterns of methamphetamine use (including dose and frequency) were not consistently related to performance. ConclusionsMethamphetamine dependence impacts inhibitory control and decision-making, whereas lower IQ associates with memory/working memory deficits among methamphetamine users. Findings suggest the need to target disinhibition and impulsive decision-making as part of methamphetamine dependence treatment, while buffering the impact of IQ on memory systems.

Clinical study of GIRK channel inhibitors as candidate medicines for drug dependence

Recently, topics related to substance dependence and behavioral addiction have been reported through the media. Therapeutic treatment for substance dependence and behavioral addiction is one of the challenges in a clinical practice. This is because there is no therapeutic treatment for a complete cure, and reuses and repetitive hospitalization occur in patients. Therefore, it is an urgent need to develop new treatments for substance dependence and behavioral addiction. In the present review, we outline associations between dependence and G-protein-activated inwardly rectifying potassium (GIRK) channels which we focus on as therapeutic targets, and introduce ongoing clinical study using an inhibitor of GIRK channels. Previous studies including animals and patients have accumulated the results that GIRK channels have a key role for mediating signals from addictive substances. GIRK channels are expressed in various rodent brain regions including the reward system. The activation of G protein-coupled receptors (GPCRs) that activates GIRK channels through G-protein βγ subunits and activated GIRK channels contribute to control of neuronal excitability. Pretreatment with ifenprodil that is one of the GIRK channel blockers suppressed addictive substance-induced behaviors in animals. Ifenprodil is safe and broadly used as a cerebral circulation/metabolism ameliorator that is covered by medical insurance in Japan. The authors reported that ifenprodil treatment for 3 months decreased alcohol use scores in patients with alcohol dependence compared with patients who received the control medication. We currently conduct a clinical trial to investigate the outcomes of ifenprodil treatment for methamphetamine dependence. In the future, we will expand clinical studies using ifenprodil for patients with other substance dependence and behavioral addiction.

Review: Does Gabapentin Relieve Opioids, Cannabis and Methamphetamines Addictions?

The study reviews the suitability of using Gabapentin for treating opioid, cannabis and methamphetamine use disorders. This revision consists of 61 biographical references based on a PubMed database search (January of 1983-May of 2018). Gabapentin displayed respectively 50% and 66.7% of success for treating methamphetamine dependence and opioid withdrawal symptoms. Furthermore, a few research studies have reported Gabapentin´s efficacy for alleviating cannabis dependence (two studies), and cannabis withdrawal symptoms (one study). Similarly, a single study reported Gabapentin reduction of opioid consumption during the detoxification process. Based on the revision, we can conclude that: (a) Gabapentin is useful for treating opioid withdrawal symptoms, (b) additional studies are necessary for elucidating the effectiveness of Gabapentin for treating methamphetamine dependence, cannabis dependence and its withdrawal symptoms, and (c) more studies are necessary to confirm the efficacy of Gabapentin in reducing opioid consumption during detoxification.

P.153 Efficacy, safety and tolerability of varenicline in treating methamphetamine dependence: A systematic review

P.153 Efficacy, safety and tolerability of varenicline in treating methamphetamine dependence: A systematic review

Study of effects of ifenprodil in patients with methamphetamine dependence: Protocol for an exploratory, randomized, double-blind, placebo-controlled trial.

AimsPharmacotherapy for methamphetamine dependence has not yet been developed in Japan or elsewhere in the world. Ifenprodil is a blocker of G protein‐activated inwardly rectifying potassium channels that play a key role in the mechanism of action of addictive substances. Our aim is to examine the safety, efficacy, and outcomes of ifenprodil for the treatment of methamphetamine dependence in a randomized, double‐blind, placebo‐controlled trial.MethodsThe recruitment of outpatients with methamphetamine dependence began in January 2018. The patients will be randomized into three arms: placebo, 60 mg/d ifenprodil, or 120 mg/d ifenprodil. Placebo or ifenprodil will be taken for 84 days. We will use Cerocral fine granule 4%® (ifenprodil tartrate). Follow‐up assessments will be conducted for 84 d after the drug administration period. All of the patients will be assessed by self‐administered questionnaires and urine tests. The primary outcome will be the presence or absence of methamphetamine use during the 84‐day administration period in the 120 mg/d ifenprodil and placebo groups. Secondary outcomes will include the number of days and percentage of days of abstinence from methamphetamine use, positive urine for methamphetamine, relapse risk, and drug craving.DiscussionThis study is the first clinical trial of ifenprodil treatment for methamphetamine dependence and is designed as an intervention test with off‐label drug use. The present study is expected to provide evidence of the effects of ifenprodil treatment on methamphetamine dependence.Trial registryThis trial was registered in the UMIN clinical trial registry (UMIN000030849; date of registration: January 17, 2018).

Riluzole for treatment of men with methamphetamine dependence: A randomized, double-blind, placebo-controlled clinical trial.

Riluzole is a glutamate regulator and effective in treatment of neuropsychiatric conditions. We assessed riluzole for treatment of methamphetamine dependence. In this randomized, double-blind, placebo-controlled clinical trial, male outpatients with methamphetamine dependence who were 18-65 years old received either 50 mg riluzole ( n=34) or placebo ( n=54) twice daily for 12 weeks. Patients were excluded in case of comorbid serious medical conditions or neurologic disorders, comorbid psychiatric disorders other than methamphetamine dependence requiring specific treatment interventions, simultaneous positive urine test result for substances of abuse other than methamphetamine, smoking >3 days per week, simultaneous consumption of medications which are contraindicated or have interaction with riluzole. Concerning primary outcomes, the cumulative mean number of attended weekly visits was higher in the riluzole arm compared with the placebo arm approaching a statistically significant difference (riluzole, median (range)=13.00 (2.00-13.00); placebo=4.00 (2.00-13.00); Mann-Whitney U=505.00, p-value=0.073), and the weekly measured rate of positive methamphetamine urine test results was significantly lower in the riluzole arm by the end of the study (riluzole=1 (5.00%), placebo=9 (45.00%), p-value=0.004). Patients in the riluzole arm experienced significantly greater improvement on all the craving, withdrawal, and depression measures regarding mean score changes from baseline to endpoint. No significant difference was detected between the two arms in terms of incidence of adverse events. Future randomized clinical trials are needed to investigate proper dosing strategy in a more inclusive sample.

Speed kills: Associations between methamphetamine use, HIV infection, tobacco use, and accelerated mortality among gay and bisexual men in Los Angeles, CA 20years after methamphetamine dependence treatment

BackgroundTo better characterize mortality among methamphetamine users, we estimated rates of all-cause mortality by HIV serostatus and smoking history in gay and bisexual men (GBM) treated for methamphetamine dependence, and explored associated clinical and socio-behavioral characteristics. MethodsWe searched public records to identify deaths among men screened between 1998–2000 for a trial of outpatient therapy for GBM with methamphetamine dependence. Crude mortality rates (CMRs) were calculated, and standardized mortality ratios (SMRs) estimated, comparing data with historical information from CDC WONDER. Associations of mortality with HIV infection, tobacco use, and other factors were explored using Kaplan-Meier survival analysis and Cox proportional hazards models. ResultsOf 191 methamphetamine-dependent GBM (median age 35 years; majority Caucasian), 62.8% had HIV infection, and 31.4% smoked tobacco at baseline. During the 20-year follow-up period, 12.6% died. Relative to controls, methamphetamine-dependent GBM had a three-fold higher 20-year SMR: 3.39, 95% CI: 2.69-4.09. Especially high mortality was observed among participants reporting tobacco use (adjusted HR 3.48, 95% CI: 1.54–7.89), club drug use prior to starting methamphetamine (2.63, 1.15–6.00), or other clinical diagnoses at baseline (3.89, 1.15–13.22). At 20 years, the CMR for HIV infected participants (7.7 per 1000 PY) was 1.5 times that for men without HIV (5.2 per 1000 PY; p = 0.22) and there was a 5-fold difference in CMRs for HIV infected tobacco smokers (16.9 per 1000 PY) compared to non-smokers (3.4 per 1000 PY; p < 0.01). ConclusionIn our sample of methamphetamine-dependent GBM, concomitant HIV infection and tobacco use were associated with dramatic increases in mortality.

LiMA: a study protocol for a randomised, double-blind, placebo controlled trial of lisdexamfetamine for the treatment of methamphetamine dependence

IntroductionMethamphetamine dependence is a growing public health concern. There is currently no pharmacotherapy approved for methamphetamine dependence. Lisdexamfetamine (LDX) dimesylate, used in the treatment of attention-deficit hyperactivity disorder and binge...

Matrix Model and Cognitive - Behavior Therapy for Methamphetamine Dependence: The Problems to Implementation in Four Cities of Iran

Background: Methamphetamine dependence is a health concern in Iran. The matrix model and cognitive - behavior therapy are the two treatment programs for this problem. Objectives: The current study aimed at exploring the problems associated with delivering these two treatments for methamphetamine dependence among patients dependent on methadone in four cities of Iran (Tehran, Shiraz, Isfahan, and Karaj). Methods: A total of 3000 subjects (2200 males and 800 females) participated in the study from December 2012 to December 2016. Fifteen psychologists participated in the study. Participants were recruited from 179 outpatient psychiatric and psychological centers as well as methadone treatment clinics. Results: Females, compared with males, were more likely to state long duration of treatment (70.8% vs. 48.5%, P = 0.01), high costs (57.1% vs. 44.8%, P = 0.01), and boredom associated with the treatments (54.3% vs. 42.4%, P = 0.01). Males, compared with females, were more likely to state the necessity of professional training of psychologists for treatment delivery (46.4% vs. 29.3%, P = 0.01), interference of the treatments with job and life (46.3% vs. 15.7%, P = 0.01) and the intensiveness of the treatments (45.4% vs. 15.7%, P = 0.01). Interviewing psychologists also stated that long duration of the two treatments led to a high attrition rate (52%) among the patients. All of them (100%) stated that intensive and long - term professional training of psychologists was needed. Almost 60% of the psychologists stated that both treatments were intensive, which led to poor patient engagement. Conclusions: The problems associated with delivering these two treatments should be managed in methadone withdrawal centers in Iran. Lower costs and brief interventions should be provided for such patients.

Motivational Interviewing Can Facilitate Entry to Matrix Treatment for Methamphetamine Dependence

Background: Methamphetamine dependence on a stable methadone dose is a health problem in Iran (i.e. the most populated Persian Gulf country). However, many Iranian patients are not motivated to enter treatment. Objectives: The study aimed to assess the efficacy of motivational interviewing for entry to matrix treatment for methamphetamine dependence. Methods: A study was conducted on 275 Persian male and female methadone patients who were methamphetamine-dependent, however they reported unwillingness to receive the matrix model. The study was conducted in 20 methadone services in Karaj, Iran during 2014. Addiction severity index was used to collect data on demographics and illicit drug use. Psychological well-being and social functioning were assessed using the Persian versions of the general health questionnaire-28 and the social functioning subscale of the opiate treatment index. Results: The study indicated that 5 sessions of motivational interviewing were significantly efficacious in increasing attendance in the Matrix Model in the treatment group (P < 0.001). Attendance in motivational interviewing was significantly accompanied with increased psychological well-being (P < 0.001) and social functioning (P < 0.001). Conclusions: Motivational interviewing should be provided for those participants who are methamphetamine dependent but are not motivated for change. Conducting randomized controlled trials is suggested.

Methamphetamine dependence in methadone treatment services in Iran: the first literature review of a new health concern.

Methamphetamine dependence is a serious health problem among Iranian methadone patients. The current study is the first research that reviewed the prevalence of methamphetamine dependence and the associated harms among Iranian methadone patients. The other aims were to review the history of receiving methamphetamine treatment among methadone patients and the evaluated psychosocial treatments for methamphetamine dependence and/or associated harms. Searching included both peer-reviewed literature and grey literature in English and Persian. Reference lists of the relevant papers and reports were searched manually for more information. The time period between 1 January 2005 and 28 October 2017 was set for searching. Available evidence indicated that methamphetamine dependence increased from 3.9% among the two genders in 2007 to 60.3% among men in 2014 and 89.5% among women in 2015-2016. The prevalence of methamphetamine dependence was higher among female methadone patients than their male counterparts. Methamphetamine dependence was associated with multiple health problems in the social and health contexts of the two genders especially women. However, receiving methamphetamine treatment was negligible. The review indicated that cognitive-behavioural therapy improved psychological well-being. The Matrix Model led to abstinence from methamphetamine and improved psychological well-being. Motivational interviewing increased attendance in treatment. Family therapy improved the quality of life and social support. However, more similar studies were needed. Despite a serious increase in methamphetamine dependence, there were a few evaluated psychosocial treatments. There is an immediate need to evaluate efficacious psychosocial treatments especially for women. Methamphetamine treatment should be provided in methadone treatment services.

Identification of Novel Signal Transduction, Immune Function, and Oxidative Stress Genes and Pathways by Topiramate for Treatment of Methamphetamine Dependence Based on Secondary Outcomes.

Topiramate (TPM) is suggested to be a promising medication for treatment of methamphetamine (METH) dependence, but the molecular basis remains to be elucidated. Among 140 METH-dependent participants randomly assigned to receive either TPM (N = 69) or placebo (N = 71) in a previously conducted randomized controlled trial, 50 TPM- and 49 placebo-treated participants had a total 212 RNA samples available at baseline, week 8, and week 12 time points. Following our primary analysis of gene expression data, we reanalyzed the microarray expression data based on a latent class analysis of binary secondary outcomes during weeks 1-12 that provided a classification of 21 responders and 31 non-responders with consistent responses at both time points. Based on secondary outcomes, 1,381, 576, 905, and 711 differentially expressed genes at nominal P values < 0.05 were identified in responders versus non-responders for week 8 TPM, week 8 placebo, week 12 TPM, and week 12 placebo groups, respectively. Among 1,381 genes identified in week 8 TPM responders, 359 genes were identified in both week 8 and week 12 TPM groups, of which 300 genes were exclusively detected in TPM responders. Of them, 32 genes had nominal P values < 5 × 10-3 at either week 8 or week 12 and false discovery rates < 0.15 at both time points with consistent directions of gene expression changes, which include GABARAPL1, GPR155, and IL15RA in GABA receptor signaling that represent direct targets for TPM. Analyses of these 300 genes revealed 7 enriched pathways belonging to neuronal function/synaptic plasticity, signal transduction, inflammation/immune function, and oxidative stress response categories. No pathways were enriched for 72 genes exclusively detected in both week 8 and week 12 placebo groups. This secondary analysis study of gene expression data from a TPM clinical trial not only yielded consistent results with those of primary analysis but also identified additional new genes and pathways on TPM response to METH addiction.