Prevalence of Methamphetamine Use, Overdose Death on the Rise

Beth Han, MD, PhD, MPH

In a cross-sectional study, investigators found consistent upwards trends in overdose mortality, greater risk patterns of methamphetamine use, and populations at higher risk for methamphetamine use disorder diversifying rapidly.

The study, conducted by a team led by Beth Han, MD, PhD, MPH, National Institute on Drug Abuse, National Institutes of Health (NIH), analyzed data from participants in the 2015 to 2019 National Surveys on Drug Use and Health (NSDUH) including methamphetamine use, methamphetamine use disorder, injection, and frequent use patterns in patients.

It’s important to try and understand the patterns of methamphetamine use because mortality associated with its use has increased in the US. Investigators aim to evaluate the past-year of methamphetamine use and methamphetamine use disorder in order to assess the national trends.

The Study

The investigators examined the data from 195,711 individuals aged 18-64 years based on their participation in the National Survey on Drug Use and Health from 2015-2019. Frequent methamphetamine use was defined as 100 days or more in the past 12 months.

Data from years prior to 2015 couldn’t be examined because of NSDUH method changes that resulted in trend breaks in 2015.

The NSDUH used the diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) to estimate the prevalence of certain substance use disorders including alcohol, cannabis, cocaine, heroine, methamphetamine, hallucinogens, prescription opioids, tranquilizers or sedatives, and stimulants in the past year.

Descriptive analyses were used to examine linear, quadric, cubic, and quartic trends in psychostimulant-involved overdose deaths with or without opioids or cocaine; methamphetamine use overall; methamphetamine use sub-groups; and frequent methamphetamine use.

The Results

Investigators found that methamphetamine use, frequent use, co-use with cocaine, and methamphetamine use disorder increased from 43-105%. They also found that methamphetamine use disorder without injection doubled, and among Black individuals it increased 10-fold.

This drastic 10-fold increase isn’t exclusive to Black individuals, but also risk factors including lower socioeconomic status factors, criminal justice involvement, and comorbidities.

From 2016-2019 methamphetamine use increased 60% among adults 26 years and older from 0.5-0.8%, which is the equivalent of 1.1 million to 1.7 million people. Within the same time period, methamphetamine use disorder increased from 539,000-904,000 people.

From 2015-2019 there was an increase in individuals who reported past-year methamphetamine use from 1.4 million to 2.0 million (43%). Overdose deaths involving psychostimulants other than cocaine (largely methamphetamine) increased a staggering 180%.

The results explain the more-than-doubled increase in psychostimulant-involved overdose deaths among individuals between ages 18-23 years. Deaths approximately tripled among individuals in the 24-34 year, 35-49 year, and 50-64 year age groups.

A previous study found that the fastest increase in psychostimulant-involved overdose death rates were among black men during 2011-2018. Rates increased for all racial/ethnic groups that were examined in this previous study.

Indications of these findings suggest that implementing evidence-based prevention and treatment interventions that include racially and ethnically diverse populations is crucial.

“Understanding patterns of methamphetamine use may help inform related prevention and treatment,” investigators wrote.

This study, “Methamphetamine Use, Methamphetamine Use Disorder, and Associated Overdose Deaths Among US Adults” was published in JAMA Psychiatry.