Half a million Americans use methamphetamine every week

BMJ 2005; 331 doi: (Published 01 September 2005) Cite this as: BMJ 2005;331:476
  1. Bob Roehr
  1. Washington

    An estimated 12.3 million Americans, or 5% of the adult population, have used methamphetamine at least once, claims a US expert on substance misuse. He also says an estimated 600 000 people are weekly users of the drug.

    Alex Kral, of the non-profit scientific research and development group RTI International, was speaking at the first US national conference on methamphetamine, HIV, and hepatitis, held in Salt Lake City, Utah, last month. The conference brought together medical providers, social services, and law enforcement agencies in a bid to address the widespread misuse of the drug.

    Embedded Image

    A police sergeant in protective gear with chemicals seized in a raid on a Tennessee methamphetamine laboratory


    Methamphetamine, which is also known as meth, crystal, ice, speed, and “Tina,” has been linked with risky sexual behaviour and with a more rapid progression of the symptoms of AIDS.

    Some have dubbed current use of the drug in the United States an “epidemic,” but the drug historian Patricia Case, of Harvard University, has described it as another “outbreak” within a pattern of endemic use.

    Methamphetamine releases high concentrations of the neurotransmitter dopamine in the brain, inducing a sense of energy and wellbeing. Despite the increasing restriction of its use, the drug is relatively cheap and easy to produce in home “labs,” which has helped drive the current wave of illegal use, she said.

    Dr Case has traced the use of this particular class of drugs over the decades. Benzedrine, an amphetamine introduced in the United States as an over the counter nasal spray in 1932, was widely used in pill form by all military forces in World War II and was included in soldiers' field kits. In recent years modafinil (Provigil), a similar stimulant approved by the Food and Drug Administration in 1998, was used by US military personnel in Iraq.

    Although many people use methamphetamine regularly and maintain normal social functioning, it can become addictive, said Dr Kral. He said that from 1992 to 2002 admissions to drug treatment facilities for misuse of the drug increased from 10 to 52 per 100 000 people. Recovery can be difficult for heavy users, because it can take a year or more for dopamine concentrations to return to normal. Worldwide the number of users is estimated at 35 million, he added, citing data from the World Health Organization.

    The drug was marketed to US women in the 1950s and 1960s as an antidepressant and weight loss agent, and women now make up 42% of admissions to emergency care for its use—significantly more than for other misused drugs.

    Few hard data are available on which treatments are most effective, but behavioural techniques used for cocaine addiction seem to work well for methamphetamine addiction.

    Methamphetamine misuse does not seem to be a major problem in the United Kingdom, but a survey by London's City University in 2004 found that around one in five gay men in the capital had used the drug at least once.

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