Craving, Impulsivity, and Subsequent Methamphetamine Use With Naltrexone-Bupropion Versus Placebo: Findings From a...

Area of Science:

• Clinical Psychology
• Psychopharmacology
• Addiction Medicine

Background:

• Methamphetamine use disorder (MUD) is a significant public health concern.
• Pharmacotherapy, including extended-release injectable naltrexone (NTX) and oral bupropion (BUP), shows promise for MUD treatment.
• Predictors of treatment response in MUD require further investigation.

Purpose of the Study:

• To determine if craving and impulsivity levels predict subsequent methamphetamine use in individuals undergoing pharmacotherapy.
• To analyze the secondary outcomes of the Accelerated Development of Additive Pharmacotherapy Treatment (ADAPT-2) trial.

Main Methods:

• Secondary analysis of 357 participants from the ADAPT-2 trial.
• Inclusion criteria: at least one transition in urine drug screen (UDS) status during the first 6 weeks.
• Craving assessed via Visual Analog Scale (VAS); impulsivity via the Concise Health Risk Tracking (CHRT) Scale.

Main Results:

• Higher craving levels were associated with a lower likelihood of transitioning from positive to negative UDS in both NTX-BUP and placebo groups.
• Impulsivity also significantly affected the probability of positive-to-negative UDS transition.
• Individuals with lower craving and higher impulsivity had a reduced chance of negative UDS transition.

Conclusions:

• Craving and impulsivity are significant predictors of treatment outcomes in MUD.
• Further research is needed to optimize NTX-BUP treatment by considering the roles of craving and impulsivity.
• These findings can inform personalized treatment strategies for MUD.