This study is being done to learn more about whether TMS may be a helpful treatment option for methamphetamine use disorder during pregnancy. TMS is a non-invasive brain stimulation treatment that is investigational for MaUD and has not been approved by the FDA for this use.

You may be eligible for this study if you meet the following criteria.

Inclusion Criteria:

• Ages 22+
• Pregnant women
• Between 12-34 weeks pregnant
• Diagnosed with methamphetamine use disorder in the past 12 months
• Have engaged in healthcare (through family medicine, Obstetrics/Gynecology, Internal Medicine, etc) during this pregnancy
• Are able to receive the Transcranial Magnetic Stimulation (TMS) treatment (e.g. do not have metal implants, metal device(s) in head or body, cochlear implants, implanted brain stimulators, aneurysm clips). Dental implants that are TMS safe are not exclusionary)
• No history of epilepsy, a personal history of seizures, or a family history of epilepsy or seizure in a first degree relative
• No history of or current diagnosis of chronic hypertension (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg), and/or history of or current diagnosis of preeclampsia

If you qualify and choose to participate:

• You will be randomly assigned to one of three study groups:
  
  • Standard TMS: 16 TMS treatment sessions over approximately 4 weeks.
  • Accelerated TMS: 16 TMS treatment sessions over approximately 2 weeks, with multiple sessions per day.
  • Treatment as Usual: Continue receiving standard care for MaUD during pregnancy without TMS as part of the study.
• You will complete 8 in-person study assessment visits. The screening visit may take up to 2 hours, and the remaining visits usually take about 45 minutes.
• You will be asked to complete questionnaires and provide urine samples.
• If you are assigned to a TMS group, you will need to travel to the Huntsman Mental Health Institute at the University of Utah for treatment sessions, generally Monday through Friday.
• The study includes follow-up during pregnancy and after delivery. Researchers will collect information about your baby’s health and early development through medical records and brief follow-up assessments, which may be completed virtually.
• You may also choose to participate in an optional interview about your experience with the study.

The total length of study participation is up to 10 months.

Total compensation for the study depends on the arm you are assigned to.

• Treatment as usual arm = $200
• Standard TMS = $360
• Accelerated TMS = $300

Participants will also receive TMS treatment at no cost if they qualify and are randomly assigned to a TMS group.

There is no cost for you to participate in our research study.