Category: Methamphetamine

Addiction Recovery Bulletin

SPEEDING TOWARDS OUR DEMISE –

April 27, 2021 – As the pills piled up, Jon DeLena was shaken. He’d lived through a spike in cocaine trafficking in Miami in the early 2000s and the dramatic rise in heroin and fentanyl use in New England in more recent years — the one that had left thousands dead because of overdoses.

But the veteran Drug Enforcement Administration (DEA) Special Agent in charge of the New England Field Office had never seen such a stark uptick as what he was seeing with methamphetamine use, and its ingenious delivery method: fake Adderall pills. These were piling up in seizures across a region that had not been known to have a significant methamphetamine-consuming population. “We’re seeing these pills,” he said, pointing to the replica Adderall on a table in front of him.

“They’re showing up all over New England but specifically here in New Hampshire. In all four corners of the state, we’re seizing these pills. And they’re deadly, and we need to get the message out there.” It may be too late. The pills, while still concentrated in areas like New England and representing just a small percentage of methamphetamine consumption, are eerily reminiscent of how fentanyl exploded through the region, tearing through communities in the form of an array of falsified pharmaceuticals. Exact figures on drug use are difficult to obtain, experts say, since surveys of consumers belie the use of stigmatized drugs like methamphetamine. The drug is also heavily used in poorly surveyed rural areas. The US Department of Health and Human Services counted about two million people who took methamphetamine in 2019, roughly the same number as in 2015. RAND, however, estimated more than three million methamphetamine users in 2016, a 50 percent increase since 2006.  Cocaine use, meanwhile, appears to have declined in recent years. RAND estimated there were just over two million cocaine users in 2016, down from nearly four million in 2006. And its survey tallied over two million heroin users, up about 30 percent since 2006, but still far below the number of methamphetamine users.

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The post The United States Of Meth appeared first on Addiction/Recovery eBulletin.

It doesn’t get that much attention, but the methamphetamine epidemic in the U.S. is startlingly widespread and lethal. The number of overdose deaths involving meth increased 7.5 times from 2007 to 2017, according to the U.S. National Institute on Drug Abuse. And, while there were 1.6 million users in 2017, according to the National Survey on Drug Use and Health, more current estimates peg the number at 3 million.

At the same time, effective treatment often relies on behavioral therapy programs that aren’t tailored to the needs of meth addicts, according to Kristin Muhlner, CEO and cofounder of addiction treatment startup Affect Therapeutics. There is no FDA-approved medical therapy for methamphetamine user disorder.

That’s why in 2020, Muhlner joined forces with Dr. Jeff De Flavio, a founder of opioid addiction treatment programs, among other  ventures aimed at broadening access to healthcare, to launch Affect, a New York City startup with an app-based treatment program for meth addicts that combines reward systems—paying cash for achieving certain tasks—with group therapy.

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De Flavio got the idea as an entrepreneur in residence at AlleyCorp, a New York City incubator which he joined in 2019. He devoted much of his time looking for interventions that would make the most sense for meth addicts. The best approach needed to address a big problem: With a large population of addicts in rural regions, it was difficult for them to get to in-person facilities. At the same time, those in urban areas faced childcare and work obligations that also got in the way of attending sessions consistently. The answer: treatment delivered digitally, specifically through a mobile app.

Last year, he enlisted Muhlner to help launch and run the company. With a background in building and running digital businesses, she also had also previously lost a close friend to a drug overdose. With $1 million in seed funding from AlleyCorp, they founded Affect last June.

Startup Combines Cash Rewards And Therapy In An App To Fight Meth Addiction first appeared at Forbes.com

Addiction Recovery Bulletin

In the first stage, patients (aged 18 to 65) were divided into two groups. One was given the combination therapy, which involved a shot of naltrexone every three weeks along with a daily dose of bupropion. The other group was given placebo shots and pills.

Urine drug screening was conducted four times in each stage. Those in the placebo group who saw no improvement by week six were rolled over into the second stage, and then randomly reassigned to either a new treatment group or another placebo group.

Success was defined as three clean drug screenings out of four.

At weeks 5 and 6 nearly 17% of the combo treatment group met that threshold, versus 3% of the placebo group. By weeks 11 and 12, those figures were roughly 11% versus less than 2%. And the treatment significantly reduced cravings and boosted quality of life, both without serious side effects, researchers reported.

Not that naltrexone plus bupropion is a sure thing. The team projects that for every nine treated patients only one will succeed.

And because naltrexone is not a generic, “this treatment, if approved, may be associated with some cost,” Volkow said. But “societal costs surrounding methamphetamine addiction are [also] high and rising,” she added.

In all likelihood, “these medications will now be used ‘off-label’ by physicians to treat their patients with methamphetamine addiction,” while research continues, Volkow said.

hat research is badly needed, cautioned Linda Richter, vice president of prevention research and analysis with the Partnership to End Addiction in New York City.

“The overall effectiveness was positive, but small,” Richter noted. “The duration of the study and size of the sample were limited, and the question remains as to whether using the medication combination in conjunction with behavioral therapies would enhance its effects.”

Nevertheless, if further research is similarly positive, she said, “the medication combination should be made widely available and be covered by public and private insurance.”

The study results were published Jan. 14 in the New England Journal of Medicine.

 

Addiction Recovery Bulletin

No meth heads on the staff? –

Sep. 21, 2020 – Thus began a quest to find a molecule that would maintain lobeline’s ability to inhibit the target VMAT2, but would be safe and effective for human use. Also, the researchers sought a compound that could be taken orally. Over the years, however, the team’s path was littered with frustrating results for their potential candidate molecules. One molecule showed poor bioavailability; another one was chemically unstable. Still others showed only weak interactions with VMAT2 or caused adverse effects such as cardiotoxicity or liver toxicity. There was particular disappointment with a molecule named GZ-793A, which seemed to check all the boxes but was then shown to change ion flow through a cardiac protein pore called the hERG channel, potentially sparking cardiac arrythmia.

Nevertheless, these early tests yielded valuable information—for example, ruling out unwanted effects. “At first, it was confusing for staff and students because nothing was happening in some of the off-target assays that they were performing,” Dr. Dwoskin reminisces. “But sometimes finding nothing is a good thing. It means a compound has good selectivity for the target and theoretically has no side effects. Over time, you learn that drug discovery is a high-risk, high-gain sort of effort.”

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