Methamphetamine (MA) use disorder poses a significant public health challenge, particularly given the rise in MA-involved overdoses over the past decade. Despite the severity of this issue, there is currently no FDA-approved medication specifically for treating MA use disorder. The ADAPT-2 trial publisehd results in Addiction and sought to address this gap by evaluating the efficacy of combined extended-release injectable naltrexone (NTX) and extended-release oral bupropion (BUPN) in reducing MA use.
The ADAPT-2 trial was structured to assess changes in MA use over a 12-week treatment period, with additional post-treatment follow-up at weeks 13 and 16. Participants were randomized into two groups: one receiving NTX + BUPN and the other receiving a placebo. The primary outcome measured was the marginal expected percentage of MA-negative urine screens, providing a clear indicator of reduction in MA use.
The trial's results showed a significant increase in the expected percentage of MA-negative urine tests among participants treated with NTX + BUPN. Over the entire 12 weeks, the NTX + BUPN group showed a substantial total increase in MA-negative urine tests of. The post-treatment follow-up period (weeks 13–16) did not show significant changes in MA use for either group. This suggests that the benefits of NTX + BUPN are most pronounced during active treatment. Further research is needed to explore the potential for sustained benefits beyond the treatment period.
The findings from the ADAPT-2 trial are particularly important given the current lack of FDA-approved medications for MA use disorder. "These findings have important implications for pharmacological treatment for methamphetamine use disorder. There is no FDA-approved medication for it, yet methamphetamine-involved overdoses have greatly increased over the past decade," said Dr. Michael Li, the study's lead author, in an publication on Medical Xpress. The significant reductions in MA use observed with NTX + BUPN highlight the potential of this combination as a viable treatment option.
The ADAPT-2 trial provides compelling evidence that NTX + BUPN can significantly reduce MA use in individuals with MA use disorder. This combination therapy offers a promising approach to addressing a critical public health issue, especially as the need for effective pharmacological treatments becomes increasingly urgent.
Sources: Addiction, Medical Xpress