Advancing Non-Abstinence Outcomes in the Treatment of Methamphetamine Use Disorder

ABSTRACT This project will provide critical evidence to advance multiple non-abstinence endpoints through the conduct of a clinical trial that will evaluate how reduced methamphetamine use impacts a diverse range of outcomes in individuals seeking treatment for Methamphetamine Use Disorder (MUD). The rise in MUD is a growing public health concern with rates of methamphetamine-associated overdose greatly increasing, especially in underserved populations, made worse by a lack of approved or implemented MUD interventions. Methamphetamine use is associated with a range of health concerns that can be non-abstinence treatment targets but that have yet to be prospectively evaluated in clinical trials. This trial seeks to determine whether reduced methamphetamine use improves outcomes like cardiovascular health, immune function, sleep quality and other measures related to psychosocial function. We propose a randomized, controlled 12-week trial using incentives to reduce methamphetamine use, with an additional 12 weeks of follow up. We will randomly assign treatment seeking subjects with MUD to one of two groups (1:1; n=100/group): 1) incentives for providing one or fewer methamphetamine positive urine samples per week in the trial, in which frequency of use is expected to be substantially reduced or 2) a non-contingent control group, in which frequency of use is expected to remain stable. We will assess improvements in selected outcomes using validated self-report items and objective measures, including blood biomarkers. This research will fill a critical knowledge gap with impactful data about the biomedical and psychosocial benefits of reduced methamphetamine use, which can then be used to advance non-abstinence outcomes as treatment indicators for MUD trials.