Resurgent Methamphetamine use at Treatment Admission in the United States, 2008–2017

Christopher M. Jones, PharmD, DrPH; Emily O. Olsen, PhD, MSPH; Julie O'Donnell, PhD, MPH and Desiree Mustaquim, MPH

Disclosures

Am J Public Health. 2020;110(4):509-516. 

In This Article

Abstract and Introduction

Abstract

Objectives: To evaluate trends and correlates of methamphetamine use in the United States.

Methods: Data are from 15 747 334 drug-related treatment admissions among persons aged 12 years or older in the 2008–2017 Treatment Episode Data Set. We analyzed trends and used multivariable logistic regression.

Results: Methamphetamine-related admissions increased from 15.1% of drug-related treatment admissions in 2008 to 23.6% in 2017. Increases occurred among nearly all demographic groups. Methamphetamine injection increased from 17.5% of admissions in 2008 to 28.4% in 2017. Among methamphetamine-related admissions, heroin use increased from 5.3% of admissions in 2008 to 23.6% in 2017. Characteristics associated with increased odds of reporting methamphetamine use at admission included female sex; admissions aged 35 to 44 years; admissions in the Midwest, South, and West; unemployment; not in labor force; living dependent; living homeless; and having a referral from criminal justice, a health care provider, or other community treatment source.

Conclusions: Treatment admissions involving methamphetamine use increased significantly over the past decade and appear to be linked to the ongoing opioid crisis in the United States. Efforts to mobilize public health prevention, treatment, and response strategies to address rising methamphetamine use and overdose are needed.

Introduction

Methamphetamine is a highly addictive and potent synthetic central nervous system stimulant.[1] Methamphetamine use, especially chronic use, is associated with a range of physical and psychological sequelae, including psychosis and other mental disorders; cognitive and neurological deficits; cardiovascular and renal dysfunction; transmission of HIV, viral hepatitis, and sexually transmitted infections; and increased mortality.[1–12]

Although drug policy in the past decade has focused on the opioid crisis, recent law enforcement data and news reports indicate that methamphetamine availability and use are increasing in the United States.[13–17] Methamphetamine drug seizures reported by US Customs and Border Protection increased from 19 613 pounds in fiscal year 2014 to 56 362 pounds in fiscal year 2018.[15] Methamphetamine reports in the Drug Enforcement Administration's National Forensic Laboratory Information System have increased 136% since 2008.[14] The Drug Enforcement Administration now reports that methamphetamine availability has increased throughout the United States.[13]

According to the National Survey on Drug Use and Health, 1.9 million people aged 12 years or older reported past-year methamphetamine use, and 1.1 million met diagnostic criteria for a past-year methamphetamine use disorder in 2018.[18] An analysis of US drug overdose deaths found that psychostimulant-related (e.g., methamphetamine) deaths increased significantly between 2003 and 2017, with 10 333 overdose deaths involving these drugs in 2017. Furthermore, this analysis reported that opioids, particularly illicit synthetic opioids, are increasingly involved in these deaths. By 2017, 50.4% of psychostimulant-related overdose deaths involved opioids, suggesting that the rise in methamphetamine-related harms is linked to the ongoing opioid overdose epidemic in the United States.[19]

Several small studies lend further support to the link between resurgent methamphetamine use and the opioid crisis.[20–23] Among people engaging with syringe services programs in Seattle, Washington, combined heroin and methamphetamine injection in the past 3 months increased from 18% in 2009 to 31% in 2017 among men who have sex with men and from 10% to 53% among women and men who did not have sex with men.[20] In a Denver, Colorado, study of people who inject drugs, 50% reported injection of heroin and methamphetamine in the past 12 months in 2015.[21] Among individuals seeking treatment in approximately 170 treatment facilities in the United States, past-month methamphetamine use among people with opioid use disorder increased from 18.8% in the second quarter of 2011 to 34.2% in the first quarter of 2017.[22]

Although these studies provide important information on rising methamphetamine use, they are limited by their small sample sizes, geographic specificity, and limited assessment of sociodemographic characteristics associated with methamphetamine use. To date, an examination of national methamphetamine trends is lacking. To address this gap and to inform prevention, treatment, and response efforts, we examined national treatment data to assess trends in methamphetamine use and the demographic and substance use characteristics associated with methamphetamine use at treatment admission.

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