Increases in methamphetamine use among heroin treatment admissions in the United States, 2008–17

Abstract

Background and Aims Due to their small sample sizes, geographic specificity and limited examination of socio-demographic characteristics, recent studies of methamphetamine use among people using heroin in the United States are limited in their ability to identify national and regional trends and to characterize populations at risk for using heroin and methamphetamine. This study aimed to examine trends and correlates of methamphetamine use among heroin treatment admissions in the United States. Design Longitudinal analysis of data from the 2008 to 2017 Treatment Episode Data Set.Descriptive statistics, trend analyses and multivariable logistic regression were used to examine characteristics associated with methamphetamine use among heroin treatment admissions. Setting United States. Participants Treatment admissions of people aged ≥ 12 years whose primary substance of use is heroin. Measurements Primary measurement was heroin treatment admissions involving methamphetamine. Secondary measurements were demographics of sex, age, race/ethnicity, US census region, living arrangement and employment status. Findings The percentage of primary heroin treatment admissions reporting methamphetamine use increased each year from 2.1% in 2008 to 12.4% in 2017, a relative percentage increase of 490% and an annual percentage change (APC) of 23.4% (P < 0.001). During the study period, increases were seen among males and females and among all demographic and geographic groups examined. Among primary heroin treatment admissions reporting methamphetamine use in 2017, 47.1% reported injecting, 46.0% reported smoking, 5.1% reporting snorting and 1.8% reported oral/other as their usual route of methamphetamine use. Conclusions Methamphetamine use among heroin treatment admissions in the United States increased from one in 50 primary heroin treatment admissions in 2008 to one in 8 admissions in 2017.

Risk Factors Associated With Infection of Blood-Borne Virus among People Who Used Methamphetamine

“…Deaths involving opioids and methamphetamine signi cantly increased by 14% between July 2017 and June 2018 [18]. People prefer to use multiple substances for various reasons: (a) to experience the synergistic effect; (b) to enhance the bene ts of each substance; (c) to overcome dysphoria and manage withdrawal symptoms; (d) to experiment; (e) to avail cheaper substances; (f) to balance the stimulation from methamphetamine with sedation from opioid/heroin [19,20]. However, since heroin, fentanyl, and methamphetamine are all short-acting substances, persons with IDU tend to inject more frequently to stay "high".…”

Safer smoking kits for methamphetamine consumption

“…Jones and colleagues reported an almost twofold rise in heroin treatment admissions involving methamphetamine in the United States from 2008 to 2017 . As concurrent heroin and methamphetamine injection is associated with injection frequency, re‐using syringes and sharing syringes , the authors aptly recommended the expansion of interventions that reduce injection drug‐use related harms.…”

Reducing negative consequences from use of methamphetamine

“…We read with interest the letter from Imtiaz and colleagues recommending increased attention to interventions that minimize methamphetamine smoking‐related harms . This letter expands upon our paper's emphasis on approaches to reduce the impact of injection drug use through evidence‐based addiction treatment, comprehensive syringe service programs and recovery support services .…”