Fredericton clinic part of national study on treatment for crystal meth addiction

A Fredericton clinic is taking part in a national trial on possible treatments for addiction to crystal meth and other stimulants.

River Stone Recovery Centre was asked to take part because it's already been prescribing some experimental treatments, said Dr. Sara Davidson, its medical director, in an interview with Information Morning Fredericton.

"I do feel there's been great successes we've had with people that use crystal meth — people that are now back in school, people that are back with their families. It's really made a big difference," she said.

Davidson and other researchers are now trying to document how well their methods fare under scientific scrutiny.

A total of five medical sites across the country are involved, said Davidson, including research hospitals in Vancouver, Toronto and Montreal. The study is being billed as the largest-ever clinical trial for methamphetamine use disorder.

"Methamphetamine is being used by many New Brunswickers — more in recent years, especially in the form of crystal meth, resulting in devastating health impacts, and increased deaths and drug [offences]," said Davidson in a news release.

"Crystal meth is an unregulated, illegal, synthetic and highly addictive drug that affects the central nervous system," she wrote.

"Stimulant drugs are used by many different people, but crystal is often used by people who are living in vulnerable circumstances, often in combination with opioids, including fentanyl.

"It can stave off feelings of hunger and cold, and enable users to stay awake for long periods when they feel the need to remain vigilant when living outside."

And it's cheap and accessible, she noted.

So far there are no evidence-based medical treatments that support recovery from dependency.

ADHD drug as meth replacement

Some participants in the new research study will be given drugs that have already been approved for other uses, such as ADHD, as a replacement for the stimulants they have been taking that are illegal and may contain unknown substances, Davidson told CBC.

River Stone has years of experience doing this with lisdexamfetamine, sold under the brand name Vyvanse, she said.

"I just would really love to be able to have that evidence, and in some cases that will help other doctors and nurse practitioners feel comfortable prescribing this in other cities."

At the same time, participants will also be treated with an approach called contingency management, said Davidson.

That means the patient gets a reward, such as money, every week that they stay clean. To date, contingency management has the best clinical evidence for treating stimulant addiction, she said. The flaw is that it's hard to scale up to the level that people need.

'A chance to catch their breath'

A medical option, similar to using methadone to treat opiate dependency, would be helpful, said Davidson.

The idea is to substitute a once-daily controlled substance for alternatives that have more volatile effects.

"When you take something that dissolves slowly over the course of the day, it can really help get rid of that up and down cycle and the crashes and the withdrawal."

"It lets people have a chance to catch their breath and look around and think, 'OK, now what? You know, what's next?'"

River Stone is currently recruiting 88 people to take part in the study over the next three years.

Because it's for scientific research, some of them will be getting fake pills, or placebos, but they'll still be getting regular psychological support.

Participants must be 19 to 55 years old and have moderate to severe methamphetamine use disorder, no severe cardiac issues and a desire to reduce or stop their meth use.

The study will explore whether medication and psychological support can reduce meth use and improve health and quality of life and reduce risky behaviour and contact with the criminal justice system.

Other parties involved in the study include the University of Montreal Research Hospital, the Canadian Institute of Health Research and the Canadian Research Initiative in Substance Misuse.