ADHD Medication for Amphetamine Addiction Linked to Reduced Risk of Hospitalization and Death

Summary: Lisdexamfetamine (Vyvanse), a medication commonly used to treat ADHD, lowers the risk of hospitalization and death for those with amphetamine use disorder.

Source: Karolinska Institute

The ADHD medication lisdexamfetamine was associated with the lowest risk of hospitalization and death in people with amphetamine addiction, when medications generally used among persons with substance use disorders were compared.

This is shown in a large registry-based study by researchers at Karolinska Institutet in Sweden in collaboration with the University of Eastern Finland and Niuvanniemi Hospital, published in JAMA Psychiatry.

“Our results suggest that lisdexamfetamine is associated with the best outcomes, and encourage the conduction of randomized controlled trials to explore this further,” says Jari Tiihonen, professor at the Department of Clinical Neuroscience, Karolinska Institutet, and the study’s last author.

Amphetamines are the second most used illicit drugs in the world and amphetamine-related hospitalizations are increasing substantially.

However, there are currently no approved pharmacological interventions available for treating addiction to amphetamine or the variant methamphetamine. Certain medications have shown promising results, but to date, the studies have often been small and convincing evidence is lacking.

In the present study, the researchers investigated the association between generally used medications among persons with substance use disorder and the risk of two primary outcomes in people with amphetamine or methamphetamine use disorder: 1) hospitalization due to substance use disorder or 2) hospitalization due to any cause, or death.

The study included nearly 14,000 individuals; all residents aged 16 to 64 years living in Sweden with a registered first-time diagnosis of amphetamine or methamphetamine use disorder from July 2006 to December 2018. Individuals with schizophrenia or bipolar disorder were excluded.

The patients were followed from the time of diagnosis until the patient died, moved from Sweden, was diagnosed with schizophrenia or bipolar disorder or the study ended. The median follow-up time was 3.9 years.

The researchers looked at how the risk of hospitalization or death for each individual differed depending on whether they were on or off the medication at that time.

Amphetamines are the second most used illicit drugs in the world and amphetamine-related hospitalizations are increasing substantially. Credit: Champlax

“Our results show that lisdexamfetamine, a medication approved for treating ADHD and in some countries also for binge eating, was the only specific medication associated with reduced risk of hospitalization and death,” says the study’s first author Milja Heikkinen, researcher at the University of Eastern Finland and Niuvanniemi Hospital.

The risk of hospitalization due to substance use disorder was 18% lower and the risk of hospitalization due to any cause or death was 14% lower during periods of lisdexamfetamine use, compared to periods without the ADHD medication.

The combination of two or more different medications for substance use disorder was also associated with a lower risk of hospitalization or death.

Use of benzodiazepines was associated with poorer outcomes; 17% higher risk of hospitalization due to substance use disorder and 20% higher risk of hospitalization due to any cause or death, during periods of use compared to periods of non-use. The use of antidepressants was also associated with slightly worse outcomes than non-use.

The researchers note that pharmacological treatments are often discontinued when the clinical state has improved, and are started when the clinical state deteriorates.

Therefore, the results may underestimate the putative beneficial effect of treatments. To control for this phenomenon, the researchers conducted analyses by omitting the first 30 days of use. The results were then in line with the main analyses.

About this psychopharmacology and addiction research news

Author: Press Office
Source: Karolinska Institute
Contact: Press Office – Karolinska Institute
Image: The image is credited to Champlax

Original Research: Open access.
Association of Pharmacological Treatments and Hospitalization and Death in Individuals With Amphetamine Use Disorders in a Swedish Nationwide Cohort of 13 965 Patients” by Milja Heikkinen et al. JAMA Psychiatry


Abstract

Association of Pharmacological Treatments and Hospitalization and Death in Individuals With Amphetamine Use Disorders in a Swedish Nationwide Cohort of 13 965 Patients

Importance  

There are no medications approved by authorities for the treatment of amphetamine or methamphetamine dependence, and studies investigating the effectiveness of pharmacological treatments in hard outcomes, such as hospitalization and death, are lacking.

Objective  

To investigate the association between pharmacotherapies and hospitalization and mortality outcomes in persons with amphetamine or methamphetamine use disorder.

Design, Setting, and Participants  

This nationwide register-based cohort study was conducted from July 2006 to December 2018 with a median (IQR) follow-up time of 3.9 (1.0-6.1) years. Data were analyzed from December 1, 2021, to May 24, 2022. All residents aged 16 to 64 years living in Sweden with a registered first-time diagnosis of amphetamine or methamphetamine use disorder and without previous diagnoses of schizophrenia or bipolar disorder were identified from nationwide registers of inpatient care, specialized outpatient care, sickness absence, and disability pension.

Exposures  

Medications for substance use disorders (SUDs) or for attention-deficit/hyperactive disorder, mood stabilizers, antidepressants, benzodiazepines and related drugs, and antipsychotics. Medication use vs nonuse was modeled with the PRE2DUP (from prescription drug purchases to drug use periods) method.

Main Outcomes and Measures  

Primary outcomes were hospitalization due to SUD and any hospitalization or death, which were analyzed using within-individual models by comparing use and nonuse periods of 17 specific medications or medication classes in the same individual to minimize selection bias. The secondary outcome was all-cause mortality, studied using between-individual analysis as traditional Cox models.

Results  

There were 13 965 individuals in the cohort (9671 [69.3%] male; mean [SD] age, 34.4 [13.0] years). During follow-up, 7543 individuals (54.0%) were taking antidepressants, 6101 (43.7%) benzodiazepines, 5067 (36.3%) antipsychotics, 3941 (28.2%) ADHD medications (1511 [10.8%] were taking lisdexamphetamine), 2856 (20.5%) SUD medications, and 1706 (12.2%) mood stabilizers. A total of 10 341 patients (74.0%) were hospitalized due to SUDs, 11 492 patients (82.3%) were hospitalized due to any cause or died, and 1321 patients (9.5%) died of any cause. Lisdexamphetamine was the only medication in this study that was significantly associated with a decrease in risk of 3 outcomes (adjusted hazard ratio [aHR], 0.82; 95% CI, 0.72-0.94 for SUD hospitalization; aHR, 0.86; 95% CI, 0.78-0.95 for any hospitalization or death; aHR, 0.43; 95% CI, 0.24-0.77 for all-cause mortality). Methylphenidate use also was associated with lower all-cause mortality (aHR, 0.56; 95% CI, 0.43-0.74). Use of benzodiazepines was associated with a significantly higher risk of SUD hospitalization (aHR, 1.17; 95% CI, 1.12-1.22), any hospitalization or death (aHR, 1.20; 95% CI, 1.17-1.24), and all-cause mortality (aHR, 1.39; 95% CI, 1.20-1.60). Use of antidepressants or antipsychotics was associated with a slight increase in risk of SUD hospitalization (aHR, 1.07; 95% CI, 1.03-1.11 and aHR, 1.05; 95% CI, 1.01-1.09) as well as any hospitalization or death (aHR, 1.10; 95% CI, 1.06-1.14 and aHR, 1.06; 95% CI, 1.03-1.10, respectively).

Conclusions and Relevance  

In this study, use of lisdexamphetamine was associated with improved outcomes in persons with amphetamine or methamphetamine use disorders, encouraging the conduct of randomized clinical trials. Prescription benzodiazepine use was associated with poor outcomes.

Join our Newsletter
I agree to have my personal information transferred to AWeber for Neuroscience Newsletter ( more information )
Sign up to receive our recent neuroscience headlines and summaries sent to your email once a day, totally free.
We hate spam and only use your email to contact you about newsletters. You can cancel your subscription any time.
  1. I have struggled with meth use many years. I remember years ago I was introduced to Adderall. I would open the pill and pour out the powder to snort it. It was not my preferred way to use. I am a smoker, but I was told it was a similar high and without the “coming down” feeling. Pretty much all the good feelings without the bad. In my opinion that’s exactly what it was for me. I used that while it was available and that was that. As for meth, I have learned over the years what a bad choice that first hit has done. I’ve conditioned myself to be dependent on the drug. To me meth is mostly a mind fuck. Yes it has some uncomfortable withdrawals but I know I won’t die If I fight it. But I fail to overpower the mind and let it convince me that I need it. I can honestly say it doesn’t even get me high anymore, its just the satisfaction of having that smoke break going thru the actions. I’ve noticed that sometimes I don’t even have to use when I have it. Basically just knowing I have some is enough to get it off my mind and be able to focus on other things. It’s when I know I don’t have any that its all I think about. Complete mind game. The reason is, when I very first took a hit..the feeling was euphoric. It released more dopamine than anything before. To me I think that’s the real drug,and what I’m after. It’s what tells you that your interested in something. And your preferred thing to do goes to the highest realease of it. For me at least. So the problem is, meth has been the winner for that specific chemical. So I’ve been chasing it ever since. The shit isn’t even like it use to be. Mostly trash now but carrying out the action fools my mind and is satisfied. Basically if you can just find something that will release dopamine more than meth, it will help kicking the habit, if that’s what you WANT do. I try and tell myself I do, but my mind says “No we’re good here, your talking
    crazy man, were let’s smoke!” They say most won’t until they hit rock bottom and eventually you have a moment of power enough to overcome it. I guess thats what it will take. This drug has taken alot from me. Alot of time I’ll never get back. Things I use to love and lost interest in. I’ve experienced some pretty dark and lonely times. So bad, I say “I hate doing this” while I’m taking a hit, and take another one. I don’t have much friends especially none that I could see or confide in because they would just join in and smoke with me. I don’t go anywhere so for me being bored is also the biggest trigger for using. An idle mind is the devils playground I guess is true. I hope I see brighter days in the future. For those who can relate, your not alone. Just know there’s someone out there going through the same struggle, at that very same moment. There is also many that have overcome and broken the shackles. Let’s try and join that side. What do you say? It’s only in darkness that you can see the light, and I think I see it..God bless and thank you all who gave me your time in reading. Just thought I’d share.

  2. There are some people out there that react totally the opposite on methamphetamine, I know one such individual,and she does not look or act like she has ever used it, she was born with recticular brain stem disorder, her mother has been on phenobarbital and dylantin for epilepsy and schizophrenia wich she was born with due to her mither having german measles while pregnant with my friends mother,a counselor told her one toime she was self medicating, problem is its very hard for an adult to get dysoxib prescribed, yet our government makes a drug called dysoxin wich is pure methamphetamine used for narcolepsy, weight loss and also ADHD,maybe you all need to do further research

  3. I am so sorry you have had such a hard life. I took have a meth addiction. I have had one for 25 years. I have basically held it together.Even though I have lost 10 jobs in that time due to my addiction, I some how always find another. But I am so sick of being dependent on and controlled by Meth. I would be very interested in a medication like that one mentioned. I really think the medical field needs to seriously create an medication for Meth withdrawal and all the terrible withdrawal symtoms. It would be a godsend to alit of people in

  4. This maybe true, but if it’s somebody new to this medication. It can be abused and cause much more then a addiction. This was my street drug until I was no longer able to afford them. Going from 10$ a pill to not even being able to find them. I had horrible with draws and I picked up a addiction of meth. Having no support and being depressed and having 2 baby’s to attend to I as well thought vybance helped a lot. I managed to keep 2 Jobs and was on my own. Taking a pill after I took my children to day care and attending work. Picked my baby’s up and spent everyday with them. Wasn’t a mom who went out with friends partied or anything. But I was one that had stressed at the beginning. Until I found my fix (vybance) when I couldn’t find them anymore I picked up a different addiction similar to vybance, (methamphetamine) I started off smoking. Due to lack of energy and just stressed out having horrible with draws from not having that one pill that used to help me cope. It was hard not having a support team at all. But I was used to it. Because ive been on my own since a child. I learned to deal with it. Being a single mom with 2 children on the streets, with no ride, and just a few days to find somewhere else to go from who we was staying with. , I managed to get a home have my own vehicle within 2 weeks. I stayed on task and nothing got into my way. So it was very hard for me once I had no access to his pill. I would take my children to day care every morning. Once I dropped them off I would go by a friend’s that managed this drug for me. They wouldn’t let me hit the pipe more then once. That one hit was all I needed it was just like taking one pill. I went to work and it regulared out my day no changes just like I was on the pill. I self medicated because I have never found a treatment for my problems. Maybe because there’s no such thing as treatment. There’s only one thing to save a life and that’s God. It’s called healing! Don’t let the devil fool you. I picked up the addiction I managed to stop it early because I knew my children’s father had a addiction before he got locked up. Once he got out I was 2 weeks clean. Still doing good but struggling. I figured once he got home it would be easier. His brother had came and seen him the day he got home. I was very shaky once his brother arrived to my house because the paste he was going and my heart beat was just like a confused reaction a very tensed lost feeling. I talked to my boyfriend at the time witch was the father of my baby’s and let him know when he was locked up I messed up. Explain it to him and asked him to ask his brother to leave. He did the opposite and said let’s do it just tonight and never pick it up again. I refused to do it. But he did it. Once he did it he never quit it. It was like I was alone again but with him there. Almost the feeling of a dead soul. His brother told me he was tryna get back on his feet and tryna get back his wife and kids. Tryna sober up and needed a place to stay. I let him in not even noticing what was fixing to happen. I wothdrawed for days before I touched it again. I didn’t leave my baby’s father due to he was finally home my kids was excited. I just wanted to continue the family that made me me. It’s hard to continue when ur lost. But I managed to do what I could to keep my baby’s in a home. . Doing whatever I could to fight my tears back to go to work and to keep things going. I tried to pull myself away because I knew my addiction was getting worse. But when I did I was very emotional at the time ended up loosing my home lost respect for myself by not forcing. Myself to get up or not telling others to leave just letting them take control. So once we had to get out it was up to me to make the next move. I managed to do it in a motel room. I paid 67$ every night doing all I can painting detailing, I gained a addiction that way. Because that’s all meth ever done to me. Was bring me up when my spirits was down. It’s all a mind controlled substance just like vybance. So I got off the drug again I got a trailer and from there things went down hill again. I tried my best. God knows what I’ve been thru. We don’t all have a mom or dad to help us emotionally or financially. We don’t all have a family. We don’t all have so called real friends. I was at my lowest I lost it all ust to pick up my addiction to gain it back again. I didn’t pick up addiction again until my kids was removed from me. My friends talked down on me. My family wouldn’t even listen to me. Everybody listen to each other. Brought me down. Then I get back on drugs. Never felt a high or a trip up until I felt like I couldnt leave with out the pipe like that was my only fix. Not being able to see or hear from my children led me to the worst place ever. I was a momma that was on her own. The best bond with my children. Never once neglected them. I didn’t fall of until they was tooking from me I went 3 months without hearing from my son. To my daughter kicking me and hitting me and said she hated me it was my fault daddy and bubba was gone. She said I wanna go to nanny’s I was broken as well. She was my fix. But at the time I was just in tears I couldn’t control myself so I let her go to my aunt’s. From there I wasn’t able to see her as much as I wanted. There was others around doing worse then me and little did anybody know what was really going on. My daughter was removed from that house due to care giver failing a drug test a few months later. Before all that tho. My baby daddy decided to one day just bring me my son asked if I would watch him after 3 konths of just ignoring my phojencalls. Every ride inwould find always had something come up. They could be on there way and would never show up. I was so down from this. My stress level was to the max. So I fell off. They never let my daughter come see me and would hardly allow me there. That’s the reason I lost control I felt betrayed. And meth never fixed me but it kept my head up and blocked out all things that was going on. It actually made people think I was normal. Until I was coming down I was crazy. When my son arrived right then and there I was done with that drug. What I had went straight in 4 plastic bags smashed and at the bottom of the outside trash can in a bag of trash with 4 trash bags over it. When I say I was done I mean I was never going to pick that crap up again. I knew my daughter would come home. I knew my life was back. Up until the next day that my aunt said be watching I’m on my way. I gotta bubba dressed herd a knock on the door it was a case worker. She came in she took a look around the house. My baby daddy had called in on me. He knews what went on before bringing my son. But he also knew that I was done once my son arrived. He tried to come get my son later that night and my son said no this is my mom and this is my home. My baby daddy didn’t like the fact I wouldn’t allow him to go with him. Because he wouldn’t answer my calls he showed up drunk to get him. He was mainly with his grandma. He needed to be home. So he knew I was gonna feel a drug test the very next day. Once ei took a ua I had no choice but to call him and have him pick my son up. I didn’t ever want my baby’s in foster home. I was put out to be the guilty one. I wasn’t able to explain my problems. There was only one fix. But I didnt go straight back to the drug once my son was picked up. I was in bed tryna fight soberity. I was doing so good but I was not healthy at all. My body started shutting down my kidneys was not working. I went one for almost 2 weeks and somebody came and told me I needed to take at least one hit. I explained to them on what one hit done to me. All it took was that one hit. I cried couldn’t even hardly talk or move a muscle. Almost dead. I couldn’t walk I couldn’t breathe. They talked me into it. The next few days I was back to normal. This substance has legit tooking over my life. I reached out for help tryna control myself slowed down a lot and done a pyscholicol. I never had a chance to go to my counciling because my case worker didn’t call and do her part. My case worker was supposed to take me back for another evaluation but never showed up. Nor did she answer any of my calls. But yet I didn’t continue with a family plan. Because I was tryna get better not be traumatized and have my PTSD lead me to a worse part. I knew what I needed. I needed to hear my baby’s voice at least once a day I needed more then one visit every 2 weeks. But instead they thought I needed help parenting my children. They thought I needed classes that was gonna bring me flash backs. They really thought I needed na. I knew drugs was no good. But I didn’t need to even hear the word meth or go to a class that just speaks on drugs. Just be reminded what started my addiction and what it had done for me. I needed to get a job but I couldn’t be arlund another child without falling to pieces. I just needed a little support emotionally. For somebody to say positive things and not things that was holding me back. But since I didnt do as they thought. I have no rights to my kids. Nightmares flashbacks. I still have faith. And I know they cant taks my children for life. God gives me another chance each day I wake up I’m still working on myself. But as of for me the only thing that cal help is the lord’s healing. God says forgive but don’t forget. help out one another. He keeps his promises as long as you follow your guidance. Nobody’s perfect and we all have issues we are tryna over come. Dont loose control of yourself. Learn on God. Sometimes it’s a long walk in a journey you get a little lost. Never forget your way back home. I love my 2 children and I’m only holding on because God tells me it’s a test. Don’t let the devil win. God reminds me that I’ll get there. Listen to his own understanding I refuse to listen to anybody else. I got a book on me at all times. Its open in my heart and I believe. I shared my story to fix yours before it turned pages and began a new chapter.

    1. I think your reply was rather arrogant. I’ll give you the benefit of the doubt. Perhaps you have walked in her shoes before. Based on your comment, I seriously doubt it.

      1. I totally agree. And also very insensitive. She just poured out her whole heart and story .And then there’s someone that makes an arrogant insensitive remark like that. Shame on them.

  5. So what does this mean? Does taking this ADHD medicine for methamphetamine addiction possible? And is it available? Bc I am an addict and am 100% interested in taking this medication to over come my meth Addiction!!!

    1. I think it’s kind of comical that a study had to be done. Any meth addict will tell you adhd meds.
      make withdrawals much easier.

Your email address will not be published. Required fields are marked *