No Drug Treats Stimulant Addiction Yet. The FDA Just Fast-Tracked a Device That Might.

If you’ve ever sat with a patient who uses methamphetamine or cocaine and had to tell them, honestly, that there’s no FDA-approved medication for what they’re dealing with, today’s news is the first real movement on that gap in years. The FDA granted Breakthrough Device Designation to NET Recovery’s transcutaneous alternating-current stimulator — a device already cleared to ease opioid withdrawal — as an aid in reducing stimulant use in adults, according to PR Newswire.

Stimulant use disorder has been the biggest hole in American addiction medicine for a decade, and it just got its first real crack in the FDA’s door.

The device works by delivering low-level electrical stimulation through the skin, a mechanism already used clinically for opioid withdrawal symptoms; the new designation lets NET Recovery pursue an accelerated review pathway to test and potentially expand the same approach to methamphetamine and cocaine use. Psychiatric Times reports the company’s own figures: roughly 4.5 million Americans have co-occurring opioid and stimulant use disorder, and stimulant-involved deaths made up 59% of all US overdose deaths between January 2021 and June 2024. That last number is worth sitting with — a majority of the country’s overdose deaths now involve a stimulant, in a treatment category where clinicians have contingency management (a behavioral, incentive-based approach) and essentially nothing else with strong evidence behind it.

Breakthrough Device Designation isn’t approval — it’s a faster, more collaborative review track, the device equivalent of what Congress built for urgently needed medications. It means more FDA engagement earlier in the process, not a guarantee the device works at scale, and the data that will actually prove it out hasn’t been generated yet. But sit with what the designation is implicitly admitting: a device for opioid withdrawal is being repurposed for stimulants because nothing built for stimulants exists. For a decade, the standard answer for methamphetamine or cocaine use disorder has been contingency management — modest cash or voucher incentives for a negative drug test — and, when that isn’t available or doesn’t land, nothing else with real evidence behind it. A patient walking into treatment today for a meth use disorder is still, this week, being offered less than a patient walking in for almost any other diagnosis in medicine. That’s the gap this designation is a crack in, not a fix for.