Methamphetamine Topical Brief Series: Vol. 1, Issue 1 What is countries involved in World War II provided amphetamine to soldiers Methamphetamine? for performance enhancement and the drug was used by “actors, artists, Methamphetamine is an addictive, athletes, politicians, and the public stimulant drug that affects the alike.”5 central nervous system. It is typically used in powder or pill form and can By the 1960s, media coverage be ingested orally, snorted, smoked, began drawing simplistic, negative or injected. Methamphetamine is connections between amphetamine known as meth, blue, ice, speed, and and crime, and government officials 1 crystal among other names. The term discussed public safety and drugs amphetamine has been used broadly as a social concern.6 Over-the- to refer to a group of chemicals that counter amphetamines were have similar, stimulating properties available until 1959,7 and by 1970 and methamphetamine is included in all amphetamines were added to 2 this group. According to the National the controlled substances list as Institute on Drug Abuse (NIDA), Schedule II drugs. Schedule II drugs “Methamphetamine differs from required a new prescription with amphetamine in that, at comparable each fill and strict documentation doses, much greater amounts of the by doctors and pharmacists.8 drug get into the brain, making it a The reduction in a legal supply 3 more potent stimulant.” of amphetamine led to increased black-market production and sale From the 1930s to the 1960s, of various types of amphetamine U.S. pharmaceutical companies – including methamphetamine – produced and sold many types of over subsequent decades.9,10 By the amphetamine as prescription and early 2000s, approximately 3 million over-the-counter drugs to treat Americans consumed amphetamine- health conditions like asthma, type stimulants nonmedically.11 narcolepsy, and depression.4 Many Key Findings • Methamphetamine use was highest in Western states in 2017; • Young adults, aged 18-25, had the highest prevalence of methamphetamine use in Colorado and nationally in 2017; • The average cost of methamphetamine has dropped in Colorado and the U.S. in the past decade; • The number of Colorado high school students who have ever used methamphetamine has declined in the past five years; and, • The number of overdose deaths in Colorado due to Summer 2019 methamphetamine more than doubled from 2013 to 2017. National Trends 2012 and 2018.14 Most methamphetamine available in the U.S. is produced in Mexico and smuggled In 2017 in the U.S., 0.6% of the total population across the Southwest border (SWB), and seizures reported using methamphetamine in the of methamphetamine on the SWB have more past year, which is approximately 1.6 million than tripled since 2012.15 Methamphetamine people. Nearly 760,000 people reported from Mexico remains a high-purity, high-potency, using methamphetamine in the past month. low-cost alternative to smaller quantities of For comparison, just under 500,000 adults methamphetamine manufactured in the U.S. As a reported using heroin during the same time result, most U.S. labs produce small amounts for period. An estimated 27,000 adolescents, personal use.16 95,000 young adults, and 73,000 adults used methamphetamine for the first time in 2017. Nationally, the number of people with a methamphetamine use disorder increased A large number of 18-25 year-olds tried significantly from 684,000 in 2016 to 964,000 methamphetamine for the first time in 2017. in 2017. A methamphetamine use disorder includes clinically significant impairment, such as health problems, disability, and failure to meet 100,000 work, school, and home responsibilities due to 95,000 methamphetamine use.17 73,000 The rate of substance abuse treatment facility admissions for methamphetamine misuse 50,000 decreased from 68 per 100,000 in 2005 to 49 per 100,000 in 2015, although the rate varies 27,000 greatly by geographic region. Admissions to treatment facilities for methamphetamine misuse 0 are drastically higher in the western U.S. East Young Adults Adults Adolescents of the Mississippi River, less than one percent Aged 18-25 Aged 26+ Aged 12-17 of admissions to treatment facilities listed Data source: National Survey on Drug Use and Health, SAMHSA methamphetamine as the primary substance. Between 2016 and 2017, young adults Regions west of the Mississippi River experienced reported a significant increase in use. The admission rates for methamphetamine ranging highest increase for the age group occurred from 12-29%.18 in past-month use in non-metropolitan, urbanized areas, which are defined as having Use of methamphetamine was highest a population of 20,000 or more. In addition to in the Western U.S. in 2017. MIDWEST differences by age group, males were nearly 0.56% twice as likely as females to report past-month NORTHEAST 0.28% methamphetamine use in 2017.12 Despite the recent uptick in young adult methamphetamine use, methamphetamine use by adolescents has decreased since 1999. According to the 2017 Monitoring the Future survey, 8th, 10th, and 12th graders’ lifetime use of methamphetamine declined steadily 13 from 1999 to 2017. WEST 0.81% The amount of methamphetamine smuggled SOUTH into the U.S. has increased significantly in 0.56% recent years. According to U.S. Customs and Border Protection (CBP), nationwide seizures of methamphetamine increased 279% between Data source: National Survey on Drug Use and Health, SAMHSA From 2015 to 2017, past-year methamphetamine rates. In 2017, only 2% of Colorado high school use rates were highest in Western states, including students reported using methamphetamine Colorado. While the national average for one or more times during their life.25 However, methamphetamine use in people aged 12 and older troubling trends remain. The percentage of was 0.56% of the population, it was 0.81% in the youth who believe there is great risk from West. This is higher than the averages for the South, limited use of methamphetamine fell from 90% Midwest, or Northeast.19 More than 70% of local law in 2013 to 84% in 2018. At the same time, the enforcement agencies from the Pacific and West- proportion of youth who reported “easy or Central regions of the U.S. report methamphetamine somewhat easy access to methamphetamine” as the greatest drug threat in their area.20 increased.26 Trends in Colorado As the rate of methamphetamine use by adults in Colorado increased, so did the rate of people In Colorado, the percentage of adults using seeking treatment for addiction to the drug. methamphetamine From 2013 to 2017, the rate of people seeking in the past year treatment for methamphetamine increased Young adults had the highest 52% across the state, with the largest increases increased from prevalence of past-year 0.65% to 0.91% methamphetamine use in 2017. for adults aged 25 to 34. Regionally, the highest between 2015 rate of treatment admissions occurred in Eastern 1.34% Colorado. Statewide, treatment admissions for and 2017, with 1.16% individuals aged methamphetamine accounted for 23% of all 27 18-25 experiencing 0.84% admissions, which is second only to alcohol. the highest 0.57% The Southeast region had the highest increase prevalence in 2017. (rate per 100,000) of people seeking treatment for methamphetamine between 2013 and 2017. Colorado was one 2015- 2016- 2016 2017 of 13 states that Northwest Northeast Aged 18-25 Aged 26+ 2013: 110.1 2013: 481.5 had a statistically 2017: 206.3 2017: 271.5 Data source: National Survey on 96.3% -210.0% Drug Use and Health, SAMHSA significant increase Denver/Boulder 2013: 58.7 in use in one or 2017: 90.7 more age groups.21 The average age of first use 32.1% South Central of methamphetamine in Colorado for individuals 2013: 610.6 22 2017: 153.1 seeking treatment was 21 years old. As use of the -457.5% drug has increased, the price has steadily decreased Southwest 2013: 136.0 Southeast in the past decade. In 2017: 202.8 2013: 34.3 66.8% 2017: 232.8 Use of methamphetamine was highest Denver in 2010, an ounce 198.5% in the Western U.S. in 2017. of methamphetamine MIDWEST cost $1400 on average as Data Source: Drug and Alcohol Coordinated Data System 0.56% NORTHEAST compared to $350 in 2018.23 0.28% The local downward trend in pricing follows a national Treating Misuse trend. The price per gram Research has found methamphetamine of methamphetamine fell “alters brain structures involved in decision- 13.6% in the U.S. from 2012 making and impairs the ability to suppress to 2017.24 habitual behaviors that have become useless or counterproductive. Changes in brain Encouragingly, rates of structure and function could explain why Colorado high school WEST methamphetamine addiction is so hard to treat students who ever used 0.81% and has a significant chance of relapse early SOUTH methamphetamine dropped in treatment.”28 Symptoms of withdrawal from 0.56% 38% between 2013 and methamphetamine include depression, anxiety, 2017. The decrease was fatigue, and an intense craving for the drug. steeper among high school females, who already used Data source: National Survey on Drug Use and Health, SAMHSA methamphetamine at lower Currently, the most effective Stimulant Oenses in Colorado, 2009-2017 treatments for methamphetamine (rate per 100,000) addiction are behavioral therapies, Cocaine Methamphetamine such as cognitive-behavioral 140 126 interventions. Although no 120 pharmacological approaches to 100 treating methamphetamine use 80 disorder currently exist, the NIDA 60 43 is funding research to investigate 40 32 29 potential treatments. 20 29 0 2009 2010 2011 2012 2013 2014 2015 2016 2017 Impact Data source: Colorado Bureau of Investigation Methamphetamine misuse has led from 2011 to 2017. Stimulant offenses to public health and safety issues.