Intended for healthcare professionals

News Roundup [abridged Versions Appear In The Paper Journal]

Methamphetamine epidemic hits middle America

BMJ 2006; 332 doi: (Published 16 February 2006) Cite this as: BMJ 2006;332:382
  1. Janice Hopkins Tanne
  1. New York

    Methamphetamine misuse, involving cooking up the drug in kitchens and makeshift laboratories, is overwhelming hospitals and police departments in the United States, particularly in small towns in rural parts of the West and Midwest.

    The drug can be produced from easily available household products and from cold medicines that contain ephedrine or pseudoephedrine. It can be smoked, injected, snorted, or eaten. Smoking or injecting gives the fastest effect.

    Last month the National Association of Counties, which represents county governments, issued a report on how methamphetamine misuse was affecting hospital emergency rooms and treatment programmes. The report was based on two surveys of counties. Responses came from 200 hospital emergency room officials in 39 states and 200 directors of treatment programmes in 26 states. A survey last year indicated that the drug was a growing problem for local law enforcement officials.

    The surveys showed that methamphetamine was responsible for more emergency department visits than any other drug and that the need for treatment programmes is growing dramatically.

    The epidemic began in the western US and is moving east, the surveys show.

    County governments must pay for the costs of investigating and closing methamphetamine laboratories, which contaminate the environment with toxic and often explosive chemicals. They must also pay the costs of holding law breakers in jail and trying them, treating them in county funded hospitals, and providing treatment for their addiction.

    In many cases children are living in the homes of methamphetamine users or makers. They often suffer neglect and abuse, which can become a medical issue.

    The Congressional Caucus to Fight and Control Methamphetamine says that methamphetamine users are generally in their teens or early twenties and are office and manual workers in rural and newly urban areas. They are evenly divided between men and women. Use of the drug has been mostly in white communities, but it is increasing in Hispanic and native American communities (

    The caucus says that methamphetamine laboratories were found in 47 states in 2004 and that seizures of methamphetamine laboratory equipment increased from 7438 in 1999 to 17 170 in 2004. More than two thirds of laboratories are located in homes in rural and residential areas, making them difficult for police to detect.

    The National Association of Counties' report says that the side effects of methamphetamine use include convulsions, dangerously high body temperature, strokes, cardiac arrhythmias, heart attacks, bone and tooth loss, stomach cramps, and shaking.

    “Chronic methamphetamine abuse can lead to psychotic behavior including intense paranoia, visual and auditory hallucinations, and out-of-control rages that can result in violent episodes. Long-term use of methamphetamine may result in anxiety, insomnia, and addiction” the report says.

    Hospitals reported that methamphetamine related emergency visits have increased over the past five years and that the users rarely have health insurance, leading to an increase in hospital costs. Addiction treatment officials said that methamphetamine users need longer treatment than users of other drugs and that only a few counties had sufficient capacity to treat them, because funds are short.

    The report and surveys are available at

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