APA: Pure 'Ice' Fueling Methamphetamine Epidemic
Michael Smith, MedPage Today Staff Writer May 24,
May 24 — The rate of methamphetamine use in the U.S.
is relatively stable, but—apparently
paradoxically—admissions to treatment programs have
one reason for the increase may be the success of
law enforcement programs in shutting down illegal
domestic labs producing the drugs-opening the market
to purer crystalline methamphetamine, or "ice," the
American Psychiatric Association meeting here was
From 1993 and 2004,
the number of admissions for treatment of substance
abuse involving stimulant—most connected with
methamphetamine—rose from 28,000 a year to about
150,000, said James Colliver, Ph.D., of the National
Institute on Drug Abuse, during a symposium on the
epidemic of methamphetamine abuse.
The figures are based
on state numbers reported as part of the Treatment
Episode Data Set (TEDS), collected by the Substance
Abuse and Mental Health Services Administration.
But data from the
National Survey on Drug Use and Health (NSDUH) and
the University of Michigan's Monitoring the Future
(MTF) study indicate that the rate of
methamphetamine use remains roughly constant. At any
time, about 5.1% of the adolescent and adult
populations say they've used the drug at some time
in their lives, about 0.6% say they've used the drug
in the past year, and 0.3% say they've used it in
the past month, he said.
"We do not see
evidence of a big increase" in the number of users,
he said in an interview. "So what's going on?"
In some ways, Dr.
Colliver said, the prevalence and treatment data
- The state-by-state
rates of both measures tend to be in lockstep. If
a state has a high prevalence rate it also has a
high treatment rate and vice versa. Interestingly,
western states tend to be high, midwest and
southern states are in the middle, while the
northeast is low, he said.
- Of the 300,000
people every year who reported using the drug in
the previous month, the proportion who met
criteria for abuse or dependence on any illicit
drug has risen from 28% in 2002 to 59% in 2004.
Over the same time, the proportion addicted to
stimulants has gone from 10.5% to 22%.
- And two slightly
different measures of treatment numbers—one from
NSDUH and one from TEDS—are "going up at the same
rate and they're in the same ballpark," Dr.
Dr. Colliver noted
that law enforcement data show that domestic
methamphetamine production has declined, that
seizures of illicit labs have fallen, and that more
states are now tightly controlling the precursor
chemicals needed to make the drug. At the same time,
imports of methamphetamine from Mexico—purer than
the domestic product—have increased.
Also, the route of
administration of the drug has changed, he said:
More users are now smoking the crystalline
form—dubbed "ice"—and fewer are injecting it or
inhaling it as a powder.
In 1993, he reported,
only a few thousand of the 28,000 patients admitted
for treatment said they smoked the drug. By 2003,
the number was nearly 80,000 of the roughly 150,000
admissions, but all other routes of administration
had remained roughly constant for several years.
"Smoking is a route
of administration that delivers the drug very
rapidly to the brain, producing greater
reinforcement effects, which therefore may produce
higher rates of dependence," he said.
The combination of
purer offshore drugs and a tendency for users to
smoke the substance may "be associated with greater
rates of dependence and greater rates of
presentation for treatment among a reasonably
constant pool of users," Dr. Tolliver concluded.
Indeed, such a
scenario appears to be the case in Hawaii, which is
leading the epidemic, said Linda Chang, M.D., of the
University of Hawaii, who studies the neurological
effects of the drugs in adults and children. "We get
almost pharmaceutical grade drugs and we think
that's why it's so toxic," Dr. Chang said.
"Because the drug is
neurotoxic, if you're getting more, it can cause
more damage to the system," she said in an