Goofballing of Opioid and Methamphetamine: The Science Behind the Deadly Cocktail

Abstract

Globally, millions of people suffer from various substance use disorders (SUD), including mono-and polydrug use of opioids and methamphetamine. Brain regions such as the cingulate cortex, infralimbic cortex, dorsal striatum, nucleus accumbens, basolateral and central amygdala have been shown to play important roles in addiction-related behavioral changes. Clinical and pre-clinical studies have characterized these brain regions and their corresponding neurochemical changes in numerous phases of drug dependence such as acute drug use, intoxication, craving, withdrawal, and relapse. At present, many studies have reported the individual effects of opioids and methamphetamine. However, little is known about their combined effects. Co-use of these drugs produces effects greater than either drug alone, where one decreases the side effects of the other, and the combination produces a prolonged intoxication period or a more desirable intoxication effect. An increasing number of studies have associated polydrug abuse with poorer treatment outcomes, drug-related deaths, and more severe psychopathologies. To date, the pharmacological treatment efficacy for polydrug abuse is vague, and still at the experimental stage. This present review discusses the human and animal behavioral, neuroanatomical, and neurochemical changes underlying both morphine and methamphetamine dependence separately, as well as its combination. This narrative review also delineates the recent advances in the pharmacotherapy of mono- and poly drug-use of opioids and methamphetamine at clinical and preclinical stages.

Socially Integrated Polysubstance (SIP) system: An open-source solution for continuous monitoring of polysubstance fluid intake in group housed mice

“…While these percentages are relatively low, they still translate to over 17 million people with past month heavy alcohol use (5 or more binge drinking episodes in the past 30 days) and over 40 million people with any past year SUD diagnosis. Critically, this report and others also highlight high rates of polysubstance use (use of multiple substances) [ 8 , 9 , 17 , 21 , 42 ]. Polysubstance use can include use changes across the lifespan (longitudinal), sequential (use of one substance followed by use of another substance), and simultaneous co-use of substances (use of multiple substances at the same time).…”

Socially Integrated Polysubstance (SIP) system: an open-source solution for continuous monitoring of polysubstance fluid intake in group housed mice

“…While these percentages are relatively low, they still translate to over 17 million people with past month heavy alcohol use (5 or more binge drinking episodes in the past 30 days) and over 40 million people with any past year SUD diagnosis. Critically, this report and others also highlight high rates of polysubstance use (use of multiple substances) (Compton et al, 2021; Crummy et al, 2020; Hazani et al, 2022; James et al, 2021; SAMHSA, 2020). Polysubstance use can include use changes across the lifespan (longitudinal), sequential (use of one substance followed by use of another substance), and simultaneous co-use of substances (use of multiple substances at the same time).…”

Unmet needs and harm reduction preferences of syringe services program participants: Differences by co-use of street opioids and methamphetamine

“…Finally, we did not assess whether participants who reported use of both methamphetamine and street opioids also used the two simultaneously. Simultaneous use (sometimes referred to as "goofballing") produces greater effects than using either drug alone (Hazani et al, 2022), and is associated with additional risks, including homelessness, injecting daily, and self-reported opioid overdose (Glick et al, 2021). However, it is unknown whether the increased needs of co-using PWID in this study were associated with "goofballing.…”