ibudilast reduces the subjective effects (Worley et al., 2016). A phase II clinical trial of ibudilast for outpatients seeking treatment for methamphetamine dependence is underway [ClinicalTrials.gov Identifier: NCT01860807]. Another phase II trial of the effects of ibudilast on neuroinflammation in methamphetamine-dependent users in remission is also in progress [ClinicalTrials.gov Identifier: NCT03341078]. The PPARγ agonist pioglitazone does not affect positive subjective effects of oxycodone in non-dependent prescription opioid users (Jones et al., 2016), and a Phase 1 clinical trial (which was prematurely terminated due to slow enrollment), revealed no evidence that pioglitazone reduces symptoms of withdrawal in opioid dependent patients (Schroeder et al., 2018). N-acetylcysteine treatment over an 8-week period does not reduce cocaine use or craving; however, a subset of participants who were abstinent when the trial began did have reduced cocaine cravings and remained abstinent longer (LaRowe et al., 2013). Minocycline reduces the positive subjective effects of the psychostimulant dextroamphetamine (Sofuoglu et al., 2011). Thus, several immune modulators, some of which have also been shown to reduce alcohol consumption or craving, are being actively investigated for their clinical effectiveness in treating opioid and psychostimulant abuse (Table 7). Hence, neuroimmune targeting medications may potentially be used to treat AUD patients
