From the Research
Naltrexone may be used off-label as part of a comprehensive treatment approach for methamphetamine use disorder, with a typical dosage of 50 mg once daily orally, and should be combined with behavioral therapy, counseling, and support groups. The most recent and highest quality study on this topic is from 2021 1, which found that extended-release injectable naltrexone plus oral extended-release bupropion was associated with a higher response rate compared to placebo in adults with moderate or severe methamphetamine use disorder. Key points to consider when using naltrexone for methamphetamine use disorder include:
- Ensuring patients are opioid-free for 7-10 days before starting naltrexone to avoid precipitating withdrawal
- Monitoring liver function due to the potential for naltrexone to cause hepatotoxicity
- Combining naltrexone with behavioral therapy, counseling, and support groups as part of a comprehensive treatment plan
- Being aware that evidence for naltrexone in methamphetamine treatment is less robust than for alcohol or opioid use disorders, but some patients may experience reduced cravings and improved outcomes, particularly those with co-occurring alcohol use problems. Other studies, such as those from 2001 2, 2017 3, 2005 4, and 2014 5, provide additional context and information on the treatment of substance use disorders, but the 2021 study 1 provides the most relevant and up-to-date guidance on the use of naltrexone for methamphetamine use disorder.