Analyses of Substance Abuse and Treatment Need Issues

Methamphetamine Abuse in the United States

Methamphetamine-Related Deaths

Admissions to Specialty Substance Abuse Treatment Facilities

References

Table 2:    Distribution of Methamphetamine/Speed-Related Deaths by Selected Demographic Characteristics:     1992-1995

Table 2 continued:     

Table 4:    Distribution of Methamphetamine/Speed-Related Emergency Department Episodes by Selected Demographic Characteristics:     1991-1995

Table 5 continued:     

Table 7:    Number of Admissions to Treatment Facilities that Receive Public Funding for Primary Amphetamine Use (including Methamphetamine):     1993-1995

Table 9:    Percentage and 95% Confidence Intervals of Total Population Ages 12 and Older Reporting Past Year Nonmedical Stimulant Use and Lifetime Use of Methamphetamine, by Demographic Characteristics:     1994-96

3. Methamphetamine Abuse in the United States

By Janet C. Greenblatt and Joseph C. Gfroerer

Data from the Substance Abuse and Mental Health Services Administration (SAMHSA) strongly suggest that there has been a large increase in the abuse of methamphetamine. These increases in methamphetamine-related deaths and methamphetamine-related emergency episodes at hospitals have occurred primarily since 1992. Large increases in methamphetamine admissions to publicly funded treatment facilities occurred between 1992 and 1995. Most activity occurred in the western region of the U.S., but methamphetamine abuse also appears to be increasing in the mid-West and in some southern States.

Methamphetamine, a powerful stimulant drug, is commonly referred to as "speed," "crystal," "crank," "go," and, most recently, "ice," a smokable form of methamphetamine. It is currently the most widespread amphetamine that is illegally manufactured, distributed, and abused. The manufacture of methamphetamine is a relatively simple process and can be carried out by individuals without special knowledge or expertise in chemistry. Methamphetamine is often taken in combination with other drugs such as cocaine and marijuana and, like heroin and cocaine, can be inhaled, injected, ingested, or smoked. A single mode of administration may dominate in a particular area.

Methamphetamine users in treatment have reported physical symptoms associated with the use of methamphetamine including weight loss, tachycardia (abnormal rapidity of heart action), tachypnea (abnormal rapidity of respiration), hyperthermia (unusually high fever), insomnia, and muscular tremors. The behavioral and psychiatric symptoms reported most often include violent behavior, repetitive activity, memory loss, paranoia, delusions of reference, auditory hallucinations, and confusion or fright. (2)

Data presented come from several SAMHSA sources. The Drug Abuse Warning Network (DAWN) consists of two data collection efforts:     data on drug abuse deaths that were reported by medical examiners in participating metropolitan areas (3) and data collected on drug-related episodes to a national probability sample of hospital emergency departments (4). Data on client admissions to specialty substance abuse treatment are obtained from the Treatment Episode Data Set (TEDS) (5). TEDS, which is compiled by SAMHSA from reports from states, covers primarily publicly-funded treatment facilities and accounts for about half of all public and private admissions to treatment in the U.S. All states do not participate, and a few participating states do not identify methamphetamine abusers separately. For a discussion of the limitations of the TEDS data, see SAMHSA Advance Report No. 12 (6). The National Household Survey on Drug Abuse (NHSDA) is an ongoing national probability survey that provides information on the use of illicit drugs, alcohol, and tobacco in the civilian noninstitutionalized population of the U.S., 12 years old and older (7).

Methamphetamine-Related Deaths

Data reported to DAWN by participating medical examiners show that between 1992 and 1994, methamphetamine-related deaths more than doubled, going from 224 to 508 (Table 1). Between 1994 and 1995, overall the number of deaths reported fell by 4 percent (to 487 in 1995). However, the number of deaths has continued to increase in two western cities each year between 1992 and 1995 (Las Vegas and Los Angeles). In 1995, a majority of the deaths (84%) involved more than one drug, most often alcohol, heroin, or cocaine. In 1995, the majority of the decedents were age 26 to 44 (68%). 81% were male, and 77% were white (Table 2).

Methamphetamine-Related Hospital ED Episodes

Methamphetamine-related ED episodes more than tripled between 1991 and 1994, rising from 4,900 to 17,700 (see Table 3). Between 1994 and 1995, there was no statistically significant change in methamphetamine-related episodes overall (16,200 in 1995). Between the first half of 1994 and the first half of 1995, the number of episodes increased by 35 percent, followed by a decrease in the last six months of 1995 (7,800 in the first half of 1994, 9,800 in first half of 1995, 6,400 in the second half of 1995). The decline in methamphetamine-related mentions continued through the first six months of 1996, with mentions decreasing to 4,000. Reports by local area epidemiologists indicate there was a shortage of methamphetamine beginning in the last half of 1995 in some western cities such as San Diego, Los Angeles, Phoenix, and San Francisco.

Between 1993 and 1995, episodes increased in nine of the 21 metropolitan areas oversampled by DAWN. The number of methamphetamine-related episodes more than doubled in Denver, St. Louis, Atlanta, and Dallas. During this time period, the number of episodes nearly doubled in Minneapolis and New Orleans. Methamphetamine-related ED episodes, like deaths, predominantly occur among whites and males (65% each). The numbers of episodes increased between 1991 and 1995 among blacks (by 145%) and Hispanics (by 356%) compared with an increase of 202 percent among whites. Between 1991 and 1995, the number of methamphetamine-related ED episodes increased 244 percent among males (from 3,057 to 10,516) and 206 percent among females (from 1,810 to 5,540) (Table 4).

Admissions to Specialty Substance Abuse Treatment Facilities

The numbers of admissions for primary methamphetamine use at treatment facilities that received public funding for reporting States for 1993 through 1995 are shown in Table 5. Among the 35 States with 10 or more methamphetamine admissions in all three years, 31 States showed increases between 1993 and 1995. The States with the largest numbers of methamphetamine admissions in 1995 were California (26,591), Iowa (3,774), Washington (3,072), Utah (1,372), and Nevada (1,349). (Note that Arizona does not report to TEDS, and Texas does not provide methamphetamine admissions separately from amphetamines). Large increases were also seen in Hawaii (from 482 in 1993 to 1,029 in 1995), Missouri (from 9 in 1993 to 962 in 1995), Idaho (from 166 in 1993 to 877 in 1995), Minnesota (from 232 in 1993 to 857 in 1995), Kansas (from 238 in 1993 to 819 in 1995), Oklahoma (from 92 in 1993 to 635 in 1995), and Montana (from 159 in 1992 to 609 in 1995).

Metropolitan area data (see Table 6) show that, between 1993 and 1995, the number of primary methamphetamine admissions to treatment more than doubled in Denver (from 197 in 1993 to 500 in 1995), Minneapolis (from 152 in 1993 to 586 in 1995), and Seattle (from 121 in 1993 to 520 in 1995). Large increases were also seen in San Francisco (from 439 in 1993 to 1055 in 1995), Los Angeles (from 1,307 in 1993 to 2,514 in 1995), and San Diego (from 2,252 in 1993 to 3,513 in 1995). The primary reported routes of administration were inhalation in Los Angeles, Minneapolis, San Diego, and San Francisco and injection in Denver and Seattle.

Some states (Arkansas, Connecticut, Oregon and Texas) do not report methamphetamine and amphetamine admissions separately. Data for these states and selected cities in these states are included in Table 7. The number of amphetamine/methamphetamine-related admissions more than doubled in Arkansas (from 269 in 1993 to 1,043 in 1995) and nearly doubled in Oregon (from 2,435 in 1993 to 7,178 in 1995). Between 1993 and 1995, a large increase was seen in Portland, OR (from 948 in 1993 to 2,528 in 1995).

Levels of Use in the U.S. Population

The 1996 National Household Survey on Drug Abuse (NHSDA) estimates that about 4.8 million people have used methamphetamine in their lifetime (Table 8). Between 1994 and 1996, there were no statistically significant changes in lifetime methamphetamine use in any of the demographic catagories shown. In 1996, rates of lifetime use were lowest in the South (1.5%) and highest in the West (4.1%). Because the NHSDA does not ask about current methamphetamine use, past year nonmedical stimulant users who also used methamphetamine in their lifetime were analyzed as a proxy for current methamphetamine use (Table 9). In 1996, rates of use were highest among the unemployed (2.4%), those between the ages of 18 and 25 (1.0%), and those living in the West (1.4%).

References

1)Community Epidemiology Work Group. (1995). Epidemiologic Trends in Drug Abuse:     Volume I:     Highlights and Executive Summary, Bethesda, Maryland:     US Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse, June 1995. NIH publication no. 95-3990.

2)Miller, MA. (1995). Trends and patterns of methamphetamine smoking in Hawaii. In:     Methamphetamine abuse:     epidemiologic issues and implications. Miller MA, Kozel NJ, eds. Rockville, Maryland:     US Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse, June 1995. NIH publication no. 95-3990. National Institute on Drug Abuse, 1991. Research monograph 115, DHHS publication no. (AM) 91-1836.

3)Office of Applied Studies. Substance Abuse and Mental Health Services Administration. (1997). Drug Abuse Warning Network Annual Medical Examiner Data 1995; Rockville, Maryland; Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, 1995. Drug Abuse Warning Network Series:     D-1 (DHHS Publication No. (SMA) 97-3126).

4)Office of Applied Studies, Substance Abuse and Mental Health Services Administration. (1996). Preliminary Estimates from the Drug Abuse Warning Network. 1995 Preliminary Estimates of Drug-Related Emergency Department Episodes. Rockville, Maryland:     US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, 1996. Advance Report Number 17.

5)Office of Applied Studies, Substance Abuse and Mental Health Services Administration. Client Admissions to Specialty Substance Abuse Treatment in the United States:     Treatment Episode Data Set (TEDS), Fiscal Year 1993-1995. Rockville, Maryland:     US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, (unpublished data).

6)Office of Applied Studies, Substance Abuse and Mental Health Services Administration. (1997). National admissions to substance abuse treatment services:     The treatment episode data set (TEDS) 1992-1995. Advance Report Number 12. Rockville, Substance Abuse and Mental Health Services Administration, DHHS Publication No. (SMA) 97-3128.

7)Office of Applied Studies, Substance Abuse and Mental Health Services Administration. (1997). National Household Survey on Drug Abuse. Main Findings 1995, Series H-1. Rockville, Substance Abuse and Mental Health Services Administration, DHHS Publication No. (SMA) 97-3127.

Table 1:    Number of Methamphetamine-Related Deaths in Selected Metropolitan Areas:     1992-1995

Note:    Excludes deaths in which AIDS was reported, deaths in which "drug unknown" was the only substance mentioned, and homicides.

The following metropolitan areas reported no methamphetamine-related deaths during 1992-1995:     Anchorage, Birmingham, Buffalo, Cleveland, Detroit, Fargo, Indianapolis, Miami, Nashua, New Orleans, Newark, and Norfolk.

Source:    Office of Applied Studies, SAMHSA, Drug Abuse Warning Network.

Table 2:    Distribution of Methamphetamine/Speed-Related Deaths by Selected Demographic Characteristics:     1992-1995

* Less than 1%.

Table 2 continued:   

* Less than 1%.

Table 2 continued:   

* Less than 1%.

Note:    Excludes deaths in which AIDS was reported, deaths in which "drug unknown" was the only substance mentioned, and homicides.

Source:     Office of Applied Studies, SAMHSA, Drug Abuse Warning Network.

Table 3:    Estimated Number of Emergency Department Methamphetamine Mentions in the U.S. and In Selected Metropolitan Areas:     1991-1995

* Estimates for this time period are preliminary. Final estimates may be higher or lower due to nonresponse adjustment and other factors.

1 - Part of the increase between 1993 and 1994 in the national estimate was due to a change in reporting practice in two hospitals in the National Panel component of the DAWN sample (i.e., the areas outside the 21 listed metropolitan areas). Excluding these two hospitals, the increase was still 45% between 1993 and 1994.

... Estimated quantity less than 10 or fewer than 10 cases in the denominator.

Source:    Office of Applied Studies, SAMHSA, Drug Abuse Warning Network.

Table 4:    Distribution of Methamphetamine/Speed-Related Emergency Department Episodes by Selected Demographic Characteristics:     1991-1995

*Estimates for this time period are preliminary. Final estimates may be higher or lower due to nonresponse adjustment and other factors.

Note:    Part of the increase between 1993 and 1994 in the national estimate was due to a change in reporting practice in two hospitals in the National Panel component of the DAWN sample (i.e., the areas outside the 21 listed metropolitan areas). Excluding these two hospitals, the increase was still 45% between 1993 and 1994.

Source:    Office of Applied Studies, SAMHSA, Drug Abuse Warning Network.

Table 5:    Number of Primary Methamphetamine Admissions to Publicly-funded Treatment Units in Reporting States:     1993-1995

N/A = Not Available.

NOTE:    States not yet contributing data to TEDS include:     Arizona and Mississippi. Arkansas, Connecticut, Oregon and Texas do not provide methamphetamine admissions separately.

* = States for which consistent data are available for 1993 through 1995.

Source:    Office of Applied Studies, SAMHSA, Treatment Episode Data Set.

Table 5 continued:   

N/A = Not Available.

NOTE:    States not yet contributing data to TEDS include:     Arizona and Mississippi. Arkansas, Connecticut, Oregon and Texas do not provide methamphetamine admissions separately.

* = States for which consistent data are available for 1993 through 1995.

Source:    Office of Applied Studies, SAMHSA, Treatment Episode Data Set.

Table 6:    Number of Admissions to Publicly-funded Treatment Units for Primary Methamphetamine Use and Percent Distribution by Route of Administration:     1993-95

Source:    Office of Applied Studies, SAMHSA, Treatment Episode Data Set.

Table 7:    Number of Admissions to Treatment Facilities that Receive Public Funding for Primary Amphetamine Use (including Methamphetamine):     1993-1995

* = States for which consistent data are available for 1993 through 1995.

Source:    Office of Applied Studies, SAMHSA, Treatment Episode Data Set.

Table 8:    Percentage and 95 Percent Confidence Intervals of Total Population Ages 12 and Older Reporting Lifetime Methamphetamine Use, by Demographic Characteristics:     1994-96

NOTE:     These estimates are not comparable to data from 1993 and earlier NHSDA’s because of the change in the questionnaire beginning in 1994.

¹ Data on current education and employment for those age 18 and older only.

Source:    Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse, 1994-6.

Table 9:    Percentage and 95% Confidence Intervals of Total Population Ages 12 and Older Reporting Past Year Nonmedical Stimulant Use and Lifetime Use of Methamphetamine, by Demographic Characteristics:     1994-96

¹ Data on current education and employment for those age 18 and older only.

Note:    Past year nonmedical stimulant users who used methamphetamine in their lifetimes are used as a proxy for past year methamphetamine use. Among past year stimulant users who report lifetime methamphetamine use, 55% report no other stimulant ever used nonmedically.

Source:    Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse, 1994-6.

This page was last updated on June 03, 2008.

SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.