Risks of methamphetamine abuse during pregnancy. One of the major problems in the United States is the prenatal exposure to methamphetamine. Less than 1 percent of pregnant women aged 15-44 had used methamphetamine in the past year, any use among this population is of concern according to the NSDUH. Unfortunately, our knowledge of the effects of methamphetamine during pregnancy is limited. The few human studies that exist have shown increased rates of premature delivery, placental abruption, fetal growth retardation, and heart and brain abnormalities. However, these studies are difficult to interpret due to methodological issues, such as small sample size and maternal use of other drugs. Ongoing research is continuing to study developmental outcomes such as cognition, social relationships, motor skills, and medical status of children exposed to methamphetamine before birth.
Are methamphetamine abusers at risk for contracting HIV/AIDS and hepatitis B and C?
Increased HIV and hepatitis B and C transmission are consequences of increased methamphetamine abuse, not only in individuals who inject the drug, but also in noninjecting methamphetamine abusers. Among injection drug users, infection with HIV and other infectious diseases is spread primarily through the re-use of contaminated syringes, needles, or other paraphernalia by more than one person. However, regardless of how it is taken, the intoxicating effects of methamphetamine can alter judgment and inhibition and lead people to engage in unsafe behaviors.
Methamphetamine has become associated with a culture of risky sexual behavior, both among men who have sex with men (MSM) and heterosexual populations. This link may be due to the fact that methamphetamine and related psychomotor stimulants can increase libido. Paradoxically, long-term methamphetamine abuse may be associated with decreased sexual functioning, at least in men. The combination of injection and sexual risk-taking may result in HIV becoming a greater problem among methamphetamine abusers than among opiate and other drug abusers, something that already seems to be occurring, according to some epidemiologic reports. For example, while the link between HIV infection and methamphetamine abuse has not yet been established for heterosexuals, data show an association between methamphetamine abuse and the spread of HIV among MSM.
Methamphetamine abuse may also worsen the progression of HIV and its consequences. In animal studies, methamphetamine increased viral replication; in human methamphetamine abusers, HIV caused greater neuronal injury and cognitive impairment compared with nondrug abusers. NIDA-funded research has found that, through drug abuse treatment, prevention, and community-based outreach programs, drug abusers can change their HIV risk behaviors. Drug abuse can be eliminated and drug-related risk behaviors, such as needle-sharing and unsafe sexual practices, can be reduced significantly, thus decreasing the risk of exposure to HIV and other infectious diseases. Therefore, drug abuse treatment is HIV prevention.
What treatments are effective for methamphetamine abusers?
At this time, the most effective treatments for methamphetamine addiction are behavioral therapies such as cognitive behavioral and contingency management interventions. For example, the Matrix Model, a comprehensive behavioral treatment approach that combines behavioral therapy, family education, individual counseling, 12-Step support, drug testing, and encouragement for nondrug-related activities, has been shown to be effective in reducing methamphetamine abuse. Contingency management interventions, which provide tangible incentives in exchange for engaging in treatment and maintaining abstinence, have also been shown to be effective.
There are currently no specific medications that counteract the effects of methamphetamine or that prolong abstinence from and reduce the abuse of methamphetamine by an individual addicted to the drug. However, there are a number of medications that are FDA-approved for other illnesses that might also be useful in treating methamphetamine addiction. Recent study findings reveal that bupropion, the anti-depressant marketed as Wellbutrin, reduced the methamphetamine-induced "high" as well as drug cravings elicited by drug-related cues. A variety of new compounds are being developed for preclinical model studies whereas this medication and others are now in clinical trials.