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Methamphetamine Quantitative Urine Concentrations during a Controlled Trial of Fluoxetine Treatment: Preliminary Analysis

Although better methamphetamine-specific treatments are crucially needed, there has been little research reported regarding potential pharmacotherapies. 2 Whereas numerous trials have been performed to test a number of potential pharmacologic treatments for cocaine dependence, relatively few such tests have been aimed at methamphetamine. Future trials devoted to testing potential treatments for methamphetamine abuse will need to include sensitive and valid measures of outcome. In addition to subjective self-reports of drug use, urine drug testing has traditionally been the standard for objective measures. Most urine drug testing in substance abuse treatment research has used qualitative techniques. Qualitative urine test results indicate only whether a sample does or does not have drug present. Presence of drug is reported as positive or negative, with an arbitrary threshold, generally 300 ng/ml, selected as a cutoff. Qualitative measurement does not differentiate greater or lesser amounts of drug in urine; 300 ng/ml is considered just as drug-“positive” as 300,000 ng/ml. However, in clinical trials it is necessary to measure urine outcomes more exactly, in order to be able to substantiate self-reports of decreasing drug use. Such an outcome may well be the case, as it is unlikely that early pharmacotherapy efforts in the treatment of stimulant abuse are likely to yield sudden, total abstinence. For these reasons, quantitative determination of drug and metabolite levels in biofluids is increasingly being used in the measurement of outcome, particularly in