Testing an Accelerated TMS Protocol for Methamphetamine Use Disorder

Inclusion Criteria:

1. Age 21-65 years inclusive;

2. Meets DSM-5 criteria for past-year moderate or severe methamphetamine use disorder;

3. By Timeline Follow Back endorses at least 10 days of methamphetamine use out of thelast month;

4. Provides a urine drug screen positive for methamphetamine;

5. Able to provide informed consent;

6. No change in current psychiatric medication regimen, or medication free, for atleast 4 weeks prior to study entry;

7. Adequate English proficiency for study consent, and completion of the studyinstruments.

Exclusion Criteria:

1. Lifetime non-substance-induced psychotic disorders, schizophrenia, schizoaffectivedisorder or bipolar disorder defined by DSM-5;

2. Current diagnosis of DSM-5 drug use disorder other than stimulant, cannabis ornicotine use disorder;

3. Non-substance-induced manic episode within the past 3 years or major depressiveepisode in the past year;

4. Current clinically significant neurological disorder or medical illness, includinghistory of seizures, cardiovascular disease/cardiac event, which in the opinion ofthe study physician would make study participation unsafe;

5. Presence of a clinically significant abnormality on baseline MRI;

6. Inability to have an MRI;

7. Currently breastfeeding, is currently pregnant or lack of use of effectivecontraception in women of childbearing age, as assessed by urine pregnancy test andself-report (participants will consent to continue effective contraceptives duringthe study);

8. Active criminal justice involvement (i.e., any unresolved legal problems that couldjeopardize continuation or completion of the study);

9. History of head injury with loss of consciousness for more than 15 minutes;

10. Diagnosis of dementia;

11. Prescribed benzodiazepines or anticonvulsants;

12. Currently enrolled in formal substance use disorder treatment;

13. Metal implants or non-removable metal objects above the waist;

14. Lifetime history of prior clinical treatment with TMS;

15. Serious risk of suicide or homicide;

16. Unable/unwilling to follow the study procedures;

17. History of intractable migraine;

18. Assessed to be at risk for alcohol or opioid withdrawal.