Substance abuse treatment helps reduce reported methamphetamine use among men who have sex with men

A nearly decade-long study by UCLA researchers found that substance abuse treatment of any kind may help to reduce methamphetamine usage among men who have sex with other men – a population that has been disproportionately impacted by the U.S. methamphetamine crisis in recent years.

The findings come from the mSTUDY, funded by the National Institute on Drug Abuse (NIDA), and are published in the Journal of Substance Use and Addiction Treatment. The study analyzed responses from a group of nearly 300 men in Los Angeles who self-reported how frequently they used methamphetamine in the previous six months and whether they were receiving substance use treatment during that time. The reports were collected from 2014-2022 with a total of 285 participants who reported using methamphetamine at least once.

UCLA researchers found that daily methamphetamine users who were receiving some form of substance use treatment – whether it be for meth, opioids, cannabis or other substances -- were twice as likely to report a reduction in their methamphetamine usage during their next visit compared to those not receiving treatment.

Additionally, they found participants who received a form of substance use treatment had longer periods of abstinence as well as reduced periods of weekly or daily use. Researchers say the findings highlight the importance of treatment programs that focus on use reduction rather than those that require a commitment to abstinence.

“It speaks to that fact that even though treatment options for methamphetamine are limited, it’s important to be able to try and increase access to treatment for people and increase treatment options,” said Allison Rosen, the study’s lead author and an epidemiologist at the UCLA Department of Family Medicine. “And that treatment of some kind seems to work. We can’t really say what the mechanism is but maybe just being connected to the treatment system is valuable in itself.”

The mSTUDY’s lead investigators are Drs. Pamina Gorbach, Department of Epidemiology, Fielding School of Public Health and Division of Infectious Disease, David Geffen School of Medicine and Steven Shoptaw, Department of Family Medicine, David Geffen School of Medicine.

“These findings are groundbreaking in showing that people reduce their frequency of methamphetamine use following substance use treatment,” Shoptaw said. “The health benefits to reducing methamphetamine use include lowering risks for drug-related physical adverse effects and improving odds for better social, economic, and mental health status. These data provide strong evidence supporting the significance of outcomes to substance use treatment beyond requirements for complete abstinence.”

The U.S. has seen a significant rise in methamphetamine use and in recent years. A National Institutes of Health study in 2021 found that from 2015 through 2019, the number of American adults who reported using meth for more than 100 days of the year increased by 66% while the number of overdose deaths increased by 180%. Recent studies have shown men who have sex with men are disproportionately more likely than the general population to use methamphetamine, which can increase the transmission of HIV through high-risk sexual practices such as having sex without a condom. Methamphetamine has also been linked to poor treatment outcomes and accelerated disease progression of men with HIV.

But compared to other substances such as opioids, methamphetamine has comparatively fewer treatment options and none that have been approved by the U.S. Food and Drug Administration, Rosen said.

While Rosen said there have controlled, clinical trials of some methamphetamine treatments that provide a point-in-time perspective, Rosen said her study is unique in being an observational study that tracks methamphetamine use in the real world over a longer time period.

“What’s really important here is that we’re providing some evidence outside of the very controlled clinical trial setting that substance use treatment may be able to help folks reduce their methamphetamine use,” Rosen said.

Rosen said further research is needed on other factors including the comparative effectiveness of individual treatment methods for methamphetamine use, how the simultaneous use of other substances can impact methamphetamine use of participants and how more frequent reporting of methamphetamine use can affect how frequently participants use methamphetamine.

Article: Association of current substance use treatment with future reduced methamphetamine use in an observational cohort of men who have sex with men in Los Angeles Published Nov. 14, 2023, Rosen et al. Journal of Substance Use and Addiction Treatment, Volume 157, 2024, 209228, ISSN 2949-8759, https://doi.org/10.1016/j.josat.2023.209228