Treating Stimulant Addiction With Repetitive Transcranial Magnetic Stimulation

Inclusion Criteria: * Structured Clinical Interview for DSM Disorders (SCID) confirmed diagnosis of SUD, severe * Last use of stimulants \>1 and \<6 weeks * Stable medication regimen (no change in dose or agents between 2 weeks prior to the start of and throughout the treatment phase of the study) * Stable social environment and housing to enable regular attendance at clinic visits. * Ability to undergo cognitive testing, functional magnetic resonance imaging (fMRI) scans, and rTMS (no contraindications) * Intelligence Quotient (IQ) \> 80 * Stable medical health * Veteran at Palo Alto VA's Addiction Treatment Services Exclusion Criteria: * Pregnant or lactating female * History of prior adverse reaction to TMS * On medications thought to significantly lower seizure threshold, e.g.: * clozapine * chlorpromazine * clomipramine * bupropion \> 400 mg/day * Use of direct dopaminergic antagonists or agonists * History of seizures or conditions known to substantially increase risk for seizures * Implants or medical devices incompatible with TMS * Acute or unstable chronic medical illness that would affect participation or compliance with study procedures, e.g. unstable angina * Unstable psychiatric symptoms that precludes consistent participation in the study, e.g.: * active current suicidal intent or plan * severe psychosis * Inability to undergo fMRI scan, e.g. claustrophobia, presence of ferromagnetic objects in subject's body * Other substance use disorder not in sustained remission * Chronic or recurring Axis I psychiatric condition preceding SUD other than PTSD