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Cited by 125Substance Abuse Treatment and OutcomesNeurotransmitter Receptor Influence on BehaviorOpioid Use Disorder Treatment

Effects of oral methamphetamine on cocaine use: A randomized, double-blind, placebo-controlled trial

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Mooney, Marc E., Herin, David V., Schmitz, Joy M., Moukaddam, Nidal, Green, Charles E., Grabowski, John·2009·Drug and Alcohol Dependence
DOI 10.1016/j.drugalcdep.2008.10.016PMC PMC2742691
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Abstract

Background No medication is currently approved for the treatment of cocaine dependence, but several preclinical and clinical reports suggest agonist-like medications, e.g., amphetamine analogues, may be a productive strategy for medication development. Objective This current proof-of-concept study sought to evaluate the safety, tolerability, and effectiveness of methamphetamine as a candidate treatment for cocaine dependence. Methods A randomized, double-blind, placebo-controlled study served to evaluate three treatment conditions in 82 cocaine-dependent individuals: (1) placebo (0mg, 6x/day; n=27), (2) immediate release (IR) methamphetamine (5mg, 6x/day; n=30), (3) sustained release (SR) methamphetamine (30 mg first pill, 1x/day; 0mg 5x/day; n=25). The study employed a sequential, two-phase design (i.e., 4 weeks of medication and counseling followed by 4 weeks of medication/counseling plus a contingency management procedure). Results Both preparation forms of methamphetamine were well-tolerated, with similar retention to placebo (0mg, 33%; 30 mg IR, 30%, 30 mg SR, 32%). Methamphetamine SR was associated with decreased sleep and increased weight loss. Medication adherence rates were high for the first dose of the day (95%), while adherence for subsequent capsules was lower. Those in the SR condition exhibited consistently lower rates of cocaine-positive urine samples (0mg, 60%; 30 mg IR, 66%; 30 mg SR, 29%), p<0.0001, and reported the greatest reduction in craving for cocaine, p<0.05. Conclusions SR methamphetamine significantly reduced cocaine use and craving. Additional research is warranted to develop and evaluate agonist-like medications that may effectively treat cocaine dependence.

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  • Among patients with lifetime amphetamine-type stimulant use disorder, 29.3% reported four or more adverse childhood events, 28.7% reported two to three, 21.6% reported one, and 20.4% reported none.

    “Among patients with lifetime ATS use disorder, 29.3% reported four or more ACEs, 28.7% reported two to three ACEs, 21.6% reported one ACE, and 20.4% reported no ACEs.250”

    From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [250]

    The Methods (section 2.1; page unavailable) describe participants selected for current cocaine dependence, and the Measures (section 2.4; page unavailable) do not include adverse childhood experiences. Searches for the four percentages and for childhood experiences among people with lifetime ATS use disorder found no passage reporting the claimed distribution. (LLM, conf=0.78)

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  1. First MB Spitzer RL Gibbon M Williams JB 1995 Structured Clinical Interview for DSM-VI Axis I Disorders- Patient Edition (SCID -I / P, Version 2.0) Biometric Research Department NY

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Authors
Mooney, M. E., Herin, D. V., Schmitz, J. M., Moukaddam, N., Green, C. E., & Grabowski, J.
Affiliations
University of Minnesota (US)
Corresponding author
Mooney, Marc E.
ORCID
Venue
Drug and Alcohol Dependence
Publisher
Elsevier BV
Published
2009-04
Volume
101
Issue
1-2
Pages
34-41
ISSN
0376-8716 (ISSN-L)
DOI
10.1016/j.drugalcdep.2008.10.016
PMC
PMC2742691
OpenAlex
W2008441751
Cited by
124
References
54
Citations by year
2026: 2 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 4 · 2021: 6 · 2020: 4 · 2019: 7 · 2018: 4 · 2017: 3 · 2016: 13 · 2015: 13 · 2014: 14 · 2013: 9 · 2012: 14
FWCI
4.96
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Drug and Alcohol Dependence (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5p50da009262-20)
  • National Institute on Drug Abuse (#P50 DA009262, R01DA016305, R00DA023548, K99DA023548, P50DA09262, L30 DA023817, R01-DA16305, K01DA019446, K01-DA-023548)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords
cocaine dependence, methamphetamine, cocaine craving, sustained-release formulation, medication adherence, contingency management, treatment retention, drug use reduction, sleep reduction, weight loss
MeSH terms
Adolescent, Adult, Affect, Central Nervous System Stimulants, Blood Pressure, Body Weight, Delayed-Action Preparations, Double-Blind Method, Female, Heart Rate, Humans, Male, Methamphetamine, Middle Aged, Riboflavin, Substance Abuse Detection, Treatment Outcome, Cocaine-Related Disorders, Young Adult

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