Are There Medications That Help With Meth Use?

The Honest Answer: There Is No FDA-Approved Medication for Methamphetamine Use Disorder

At this time, there is no FDA-approved medication specifically for methamphetamine use disorder.

That can be frustrating, especially because medications are central to treatment for other substance use disorders. For opioid use disorder, medications like buprenorphine and methadone can be life-changing. For alcohol use disorder, medications like naltrexone, acamprosate, and disulfiram may help.

Methamphetamine use disorder is different. There is not currently a medication that works for methamphetamine use disorder in the same way that buprenorphine works for opioid use disorder.

But “no FDA-approved medication” does not mean “no treatment.” It also does not mean medication can never be part of the plan.

In addiction medicine, doctors sometimes use medications off-label when there is evidence they may help, when the risks are reasonable, and when the medication fits the patient’s situation. For methamphetamine use disorder, that usually means asking whether a medication might help reduce use, reduce cravings, treat related symptoms, or support a broader recovery plan.

Why Meth Treatment Is Different

Methamphetamine is a stimulant. It can affect energy, focus, confidence, sleep, appetite, mood, anxiety, paranoia, heart health, and decision-making.

When someone stops or cuts back, they may feel worse before they feel better. Exhaustion, depression, anxiety, irritability, sleep changes, low motivation, and cravings can all make early recovery difficult.

That is one reason treatment usually needs to be practical and comprehensive. Medication may be one part of the plan, but it is never the whole plan.

Vivitrol and Wellbutrin: What the Evidence Shows

The medication combination that gets the most attention for methamphetamine use disorder is extended-release naltrexone and bupropion.

Extended-release naltrexone is commonly known by the brand name Vivitrol. It is a monthly injection that is FDA-approved for alcohol use disorder and for prevention of return to opioid use after a person has already stopped opioids.

Bupropion is commonly known by the brand name Wellbutrin. It is FDA-approved for depression and smoking cessation.

Neither medication is FDA-approved specifically for methamphetamine use disorder. However, the combination has been studied.

In a major clinical trial, people with methamphetamine use disorder were treated with extended-release naltrexone injections plus oral bupropion. The study did show benefit compared with placebo, but the benefit was modest.

The important point is that this was not a “cure” and it was not a medication that worked for most people.

In the study, a treatment “response” was based on urine drug testing. Participants were considered responders if they had at least three methamphetamine-negative urine tests out of four tests collected near the end of a treatment stage. Using that definition, the response rate was higher in the naltrexone-bupropion group than in the placebo group.

That is encouraging, but it should be interpreted carefully. A modest improvement in urine drug testing can still matter. For some patients, fewer days of methamphetamine use may mean better sleep, fewer binges, fewer risky situations, fewer missed responsibilities, or more chances to stay engaged in treatment.

A practical way to think about Vivitrol and Wellbutrin is this:

They may help some patients reduce methamphetamine use, especially when they are part of a larger treatment plan. They are not a replacement for follow-up, structure, behavioral support, or addressing the reasons methamphetamine use keeps happening.

When Might Medication Make Sense?

Medication may be worth discussing when a person wants help reducing or stopping methamphetamine use and is open to a medical treatment plan.

The Vivitrol and Wellbutrin combination may be especially relevant when the medications can address more than one problem at the same time. For example, naltrexone may also help with alcohol cravings in someone who has alcohol use disorder. Bupropion may be helpful for some patients with depression or tobacco use disorder.

Other symptoms may also need medical attention. Some people recovering from methamphetamine use have significant depression, anxiety, insomnia, trauma symptoms, or attention problems. Treating these symptoms does not automatically treat methamphetamine use disorder, but it can make recovery more realistic.

Medication decisions should be individualized. A doctor would need to consider medical history, seizure risk, eating disorder history, blood pressure, opioid use, alcohol use, liver health, psychiatric symptoms, other medications, and the patient’s goals.

Contingency Management: A Treatment Worth Understanding

One of the strongest evidence-based treatments for stimulant use disorder is called contingency management.

The name can sound technical, but the idea is straightforward. Contingency management uses structured positive reinforcement to support recovery behaviors. For example, a program may provide small rewards or incentives when a patient attends visits, completes treatment steps, or has urine drug tests that show no stimulant use.

This can sound too simple at first. But addiction affects motivation, reward, habit, and decision-making. Contingency management works with those systems instead of simply lecturing against them.

It is not bribery. It is not treating people like children. It is a structured behavioral treatment that recognizes how difficult early recovery can be and reinforces progress in real time.

How Shoreline Thinks About This

At Shoreline, we do not present medication as a quick fix for methamphetamine use disorder. There is no FDA-approved medication for meth use, and the available medication evidence is modest.

But we also do not believe patients should be told that “nothing can be done.”

For some patients, off-label medication may be worth discussing. For others, the first priority may be addressing sleep, mood, alcohol use, opioid risk, safety planning, or building enough structure to make change possible.

Our approach is to look at the whole picture: the substance use, the patient’s goals, co-occurring mental health symptoms, medical risks, and what kind of support is realistic. Methamphetamine use disorder can be difficult to treat, but serious, practical, evidence-informed care can still help.