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 the last 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 at least 4 weeks prior to study entry; 7. Adequate English proficiency for study consent, and completion of the study instruments. Exclusion Criteria: 1. Lifetime non-substance-induced psychotic disorders, schizophrenia, schizoaffective disorder or bipolar disorder defined by DSM-5; 2. Current diagnosis of DSM-5 drug use disorder other than stimulant, cannabis or nicotine use disorder; 3. Non-substance-induced manic episode within the past 3 years or major depressive episode in the past year; 4. Current clinically significant neurological disorder or medical illness, including history of seizures, cardiovascular disease/cardiac event, which in the opinion of the 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 effective contraception in women of childbearing age, as assessed by urine pregnancy test and self-report (participants will consent to continue effective contraceptives during the study); 8. Active criminal justice involvement (i.e., any unresolved legal problems that could jeopardize 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.