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Discussion Why are there no treatments for cocaine and meth addiction?

Subs aren't 'treatments' in the strictly medical sense because you're not dealing with an actual disease. They are what the name implies, substitute drugs.

They're only in use because opiates cause physical dependency (and therefore a withdrawal syndrome) in the first place. Stimulants do not cause this.
 
They day that Wellbutrin helps. I don't think it would in my case. I'm scripted Wellbutrin and Dexedrine Spansule. And believe or not, even my moderate ice doses blow those things out of the water.
 
Whenever I see someone mention Wellbutrin I think of that one reddit post where an opioid addict accidentally mistook his naltrexone tabs for his wellbutrin tabs and went through a hellish precipitated withdrawal. Dude almost died. If anyone is dependent on opioids and happens to have NTX and the white wellbutrin tablets at home: please seperate these two drugs as faaaaar away from each other as possible. They look practically identical. Dude's description of that day was so horrifying that I'm afraid to read his experience report a second time...
 
TheUltimateFixx said:
Subs aren't 'treatments' in the strictly medical sense because you're not dealing with an actual disease. They are what the name implies, substitute drugs.

They're only in use because opiates cause physical dependency (and therefore a withdrawal syndrome) in the first place. Stimulants do not cause this.
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Stimulants do cause physical dependency.

There is an actual identified physical withdrawal syndrome from stimulants where people become hyper-somnolent, have significant issues with blood sugar and insulin management, this is because methamphetamine significantly affects the glucose and insulin metabolism of addicts. There is weight gain, adrenal fatigue, peripheral neuropathic pain, sweating and tremors, and even cardiac rhythm abnormalities during withdrawal from methamphetamine and other stimulants.
 
Boston Medical Center uses a combination of contingency management, risk reduction around psychosis, naltrexone, mild to moderate psychostimulants, in a nurse care manager based outpatient program called START.

I know some folks who have accessed services through it with good response - they especially try to outreach typically unreached communities (BIPOC and LGBTQ spectrum) and it is also open to anyone with a stimulant use issue. Not specifically recovery focused (though that certainly is one option for care) - I do think there's a wait due to staffing limitations. That said, it's outpatient, and worth looking into for folks who live in MA.
 
Parabolan said:
They day that Wellbutrin helps. I don't think it would in my case. I'm scripted Wellbutrin and Dexedrine Spansule. And believe or not, even my moderate ice doses blow those things out of the water.
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Absolutely.

Desoxyn (pharma 'ice') is prescribed at 5-25mg with 5mg being roughly equivalent to 10mg of dextro. Dex spansules are 10 or 15mg each with a max dose of around 60mg/day.

Given the high purity of meth these days, that is miniscule compared to what I'd imagine a 'moderate' dose of recreational meth would look like. It's not uncommon for folks I work with to use 200-300mg in a short period of time, especially given how cheap street meth is these days. Given the lack of activation of norepinephrine, you're able to take much much larger doses of meth compared to d-amp and not feel overstimulated. Someone using the equivalent of 2-300mg of meth, in dextro would be something like 400-600mg. That makes my muscles vibrate just thinking about it.

I do think a good place to start is trying to reduce the way one uses meth. Moving away from smoked/intransal/bootie/IV to sublingual/oral dosing is far less compulsive in effect, and can be much easier to manage ones use. From there, exploring much lower doses to try and note the effects from smaller amounts can actually be quite enjoyable, and could make it easier to switch off of street meth onto a pharma stimulant. When using less, combining with something like memantine can help you get a bit more of an effect and also help with managing tolerance to a degree - that said, there's no magic bullet... you have to want to change and do the work to make those changes sustainable in the long run.
 
Mysterier said:
www.nbcnews.com

Why are there no treatments for cocaine and meth addiction?

Amid warnings about rising stimulant use disorders, the FDA is urging drugmakers to develop treatments for cocaine and methamphetamine addiction.
www.nbcnews.com www.nbcnews.com
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They'll often use stimulants like Modafinil (Provigil/Modalert) which is usually prescribed for Narcolepsy or an stimulating (I think, dopaminergic) anti-depressant like Bupropion. There are treatments, just less options as unlike something like alcohol/benzo withdrawal (which kills people) are opioid withdrawal (which is dangerous and horrific), stimulant withdrawal isn't dangerous.
Is it even that bad (genuinely asking)? I've been on really high-dose amphetamines all day every day for like 3 months and suddenly stopped and the only form of withdrawal I'd get was an urge to sleep I couldn't control (like I WAS going to sleep whether I liked it or not), I'd sleep like 36 hours straight and then be normal again.
 
Stimulants are an odd bird. For decades it was believed that while they can produce psychological addiction, they do not produce physical dependence. BUT more recently we have studied stimulant abuse and chronic use does produce changes in brain chemistry.

I'm convinced that it produces physical withdrawal symptoms but that they manifest more in in brain chemistry and so are harder to quantify.

A good friend (a chemist) was making d-meth and every 3-4 months us, his friends, would end up having to call their brother then call their parents and essentially have to call Nederlandse Psychiatrische Spoedeisende Geneeskunde.

Kind of sad. A really nice person but he truly believed that the entire world was a conspiracy and he was the only 'free' person. We fed them, we clothed them, we even gave them a bicycle (vital to any Dutch person) and he still thought we were some sort of case officers put in place to monitor their actions.
 
AlsoTapered said:
Stimulants are an odd bird. For decades it was believed that while they can produce psychological addiction, they do not produce physical dependence. BUT more recently we have studied stimulant abuse and chronic use does produce changes in brain chemistry.

I'm convinced that it produces physical withdrawal symptoms but that they manifest more in in brain chemistry and so are harder to quantify.

A good friend (a chemist) was making d-meth and every 3-4 months us, his friends, would end up having to call their brother then call their parents and essentially have to call Nederlandse Psychiatrische Spoedeisende Geneeskunde.

Kind of sad. A really nice person but he truly believed that the entire world was a conspiracy and he was the only 'free' person. We fed them, we clothed them, we even gave them a bicycle (vital to any Dutch person) and he still thought we were some sort of case officers put in place to monitor their actions.
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Damn that sucks. I know that most people who don't quit crack end up with serious psychiatric disorders.

You have an opinion on therapeutic doses? Assuming you think they're safe. Just curious.

For what it's worth, I think that like over 99% of possible drugs haven't been discovered, so maybe in the futre there will be somehting reliable.
 
Well no medicine is safe. When prescribed, psychostimulants represents the best outcome for the patient than NOT prescribing said class of medicine. But it appears that side-effects are a real problem. I wouldn't touch them unless a specialist convinced me it was appropriate.
 
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