By Erika Echternach
Methamphetamine (meth) addiction is a worldwide issue and Sydney could be at the centre of the solution.
A team of researchers at St Vincent’s Hospital in Sydney will test whether administering the ADHD medication lisdexamfetamine to people suffering from ice addiction can eliminate their dependency on meth.
Although the medication is typically used to treat ADHD in children, giving meth addicts a dose three times higher than the amount typically prescribed could be the first step to weaning meth abusers off the deadly drug.
The drug would be delivered in the form of a tablet (lisdex) that is similar to meth in both its chemical structure and its interactions with the body and brain, making it quite possible that the drug could lessen cravings for meth.
The lead researcher of the study at St Vincent’s, Dr Nadine Ezard, said using lisdexamfetamine should reduce negative withdrawal symptoms, naturally leading to a decrease in cravings and ultimately freeing patients from their dependency on meth.
“The idea is that, if it works, it might help those symptoms of withdrawal that trigger a desire to use methamphetamine,” Dr Ezard said.
Dr Alex Wodak, the president of the Australian Drug Law Reform Foundation and emeritus consultant for St Vincent’s Hospital’s drug and alcohol services, explained the effectiveness of substitution treatments in overcoming substance abuse.
“The most effective treatments for people with severe drug problems generally involve substitution of another, usually, longer acting ‘agonist’ drug to replace the problematic street drug e.g. methadone, buprenorphine or pharmaceutical heroin in heroin dependence,” Dr Wodak said.
“The advantages include replacing an illegal, short acting street drug for a legal and regulated longer-acting drug; replacing inherently risky self-administered injection of a street drug with much less risky oral ingestion; reduce the extreme variation between the very high peaks and very low troughs in blood concentration seen with short acting street drugs; and providing some daily structure & socialisation to a life previously very unstructured and often very lonely.”
The defining difference between meth and lisdex is lisdex’s slower-acting quality. Because of how lisdex is metabolised and converted to dexamphetamine in red blood cells, it acts slower than meth and does not produce a rapidly intense high like the deadly drug, sparing users from the crashes that follow. This also means the drug is long-lasting, so one tablet per day is all that is necessary.
Without the incentive of a euphoric high, there is no reason to abuse lisdex. Recovering addicts could not even abuse lisdex if they tried because another advantage of its slow-acting nature is that neither crushing, snorting nor injecting the drug will generate a high.
“Even if you crush it up and inject it, it’s not going to work quicker, you’re not going to get higher quicker,” Dr Ezard said.
Allowing routine meth users to escape the harmful binge and crash cycle would grant them freedom from side effects such as anxiety, paranoia, insomnia, etc.
Dr Wodak said that contrary to the abstinence approach, the harm reduction approach focuses on keeping people alive, healthy, maintaining good relationships, etc. even if some drug use continues. If substituting lisdex for meth serves this primary purpose, then continuing to take the drug indefinitely would be acceptable to those who support harm reduction.
In 2014, St Vincent’s conducted a test to figure out if a high dose of lisdexamfetamine was safe to administer to patients before proceeding with further trials. The encouraging results inspired the federal government and St Vincent’s Curran Foundation to invest more than $1 million into exploring the drug’s potential more.
The St Vincent’s study will monitor 180 subjects who regularly used meth for 19 weeks. During that period, one group of addicts will receive a placebo pill while the other will be given 250mg of lisdex. After comparing the results, researchers will conclude whether the replacement drug is safe and effective.
Spearheaded by Kirby Institute, the trials will take place at 4 different locations, Darlinghurst and Mt Druitt in Sydney, Newcastle and Adelaide, and is expected to last about two years.
Dr Wodak said that if the treatment is found to be effective, research would then need to be done into maximising the benefits and minimising adverse effects such as reducing cost.
“The ultimate aim would then be to try to ensure that the supply of treatment matches demand,” Dr Wodak said.
This possible breakthrough comes at a time when meth is becoming increasingly purer and stronger at lower prices, contributing to the epidemic Australia now finds itself in. As of 2012, one out of every 10 drug-related deaths in Australia involved methamphetamine.
Currently, the only treatment available to ice-addicts is counselling. Dr Ezard said the trials were exciting for the whole world because it would be great to have another option to offer people.
Should the lisdex trials prove successful, having that option may offer hope to those battling meth addiction.