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Medications for meth use disorder: what the research shows
There’s no FDA-approved medication for methamphetamine use disorder yet, but several treatments can help. Here’s what the evidence says.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
✓ Medically reviewed by Earl Johns, MSN, PMHNP-BC
Photos are illustrative and don’t show actual patients.
Methamphetamine, also called crystal, tina or meth, affects many gay and bisexual men, especially in party and chemsex scenes. Recovery is possible, and treatment works better than many people expect.
Is there a medication for meth addiction?
Not yet an FDA-approved one. Unlike alcohol or opioid use disorder, meth use disorder has no medication approved specifically for it. Several medications have shown real benefit in research, though, and clinicians can prescribe them off label.
Naltrexone plus bupropion
In a large 2021 study published in the New England Journal of Medicine, a monthly naltrexone injection combined with daily extended-release bupropion helped more people reduce meth use than placebo. The benefit was modest but meaningful, and it gave many people a foothold in recovery.
Mirtazapine
Mirtazapine, an antidepressant, reduced meth use in a study of gay and bisexual men and transgender women in San Francisco. It may also help with the poor sleep, low appetite and low mood that are common when cutting back.
Contingency management
The most effective treatment studied so far isn’t a pill. Contingency management gives small, real rewards for drug-free urine tests, and it consistently reduces stimulant use. California’s Medi-Cal Recovery Incentives Program offers it at participating clinics.
Treating what comes with it
Depression, anxiety, ADHD, trauma and sleep problems often travel with meth use. Treating them can make cutting back easier and help prevent relapse.
Getting help
SAMHSA’s free, confidential helpline is available 24/7 at 1-800-662-4357. If you’re in the Bay Area, affirming recovery groups for gay and bisexual men are also available.
A gentle next step
Wellthy Psychiatry offers judgment-free, LGBTQ+ affirming care by telehealth across California. A free 15-minute phone consult is an easy way to see if we’re a good fit.
This article is for general education and isn’t medical advice. If you’re in crisis, call or text 988, the Suicide & Crisis Lifeline, or call 911.
About the author
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner · UCSF-trained · Founder of Wellthy Psychiatry & Wellness
Earl provides LGBTQ+ and neurodivergent-affirming psychiatric care, blending medication management, therapy and whole-person approaches. His background includes inpatient psychiatry and community mental health at Glenn County Behavioral Health and Equity Health, a federally qualified health center. He sees clients in San Francisco and by telehealth across California.
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