Methamphetamine & Amphetamine-Type Stimulants
Basic Data -- Prevalence, Trends, Sources
Physiological and Psychological Effects
Environmental Impact of Methamphetamine Production
(Description of Methamphetamine) "Methamphetamine is a central nervous system stimulant drug that is similar in structure to amphetamine. Due to its high potential for abuse, methamphetamine is classified as a Schedule II drug and is available only through a prescription that cannot be refilled. Although methamphetamine can be prescribed by a doctor, its medical uses are limited, and the doses that are prescribed are much lower than those typically abused. Most of the methamphetamine abused in this country comes from foreign or domestic superlabs, although it can also be made in small, illegal laboratories, where its production endangers the people in the labs, neighbors, and the environment.
"How Is Methamphetamine Abused?
"Methamphetamine is a white, odorless, bitter-tasting crystalline powder that easily dissolves in water or alcohol and is taken orally, intranasally (snorting the powder), by needle injection, or by smoking."Source:National Institute on Drug Abuse, InfoFacts: Methamphetamine (Rockville, MD: US Department of Health and Human Services), Revised March 2010. Last accessed June 6, 2013.
(Prevalence of Nonmedical Stimulant and Methamphetamine Use in US)
" The number and percentage of persons aged 12 or older who were current nonmedical users of stimulants in 2013 (1.4 million or 0.5 percent) were similar to those in 2012 (1.2 million or 0.5 percent), but were higher than the estimates in 2011 (970,000 or 0.4 percent).
" The number and percentage of persons aged 12 or older who were current users of methamphetamine in 2013 (595,000 or 0.2 percent) were similar to those in 2012 (440,000 or 0.2 percent) and 2011 (439,000 or 0.2 percent). However, the estimates in 2013 were higher than those in 2010 (353,000 or 0.1 percent)."Source:Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014, pp. 17-18.
(Community Epidemiology Working Group Indicators of Methamphetamine Use in the US) "Increases in methamphetamine indicators reported in 2012 continued into 2013. These increases reversed a mostly declining trend since 2007. All CEWG area representatives reported increasing, stable, or mixed indicators in 2013, compared with 2012. Twelve of 19 CEWG area representatives reported increasing methamphetamine indicators in the 2013 reporting period; these were Atlanta, Cincinnati, Denver/Colorado, Detroit, Los Angeles, Minneapolis/St. Paul, St. Louis, San Diego, San Francisco, Seattle, South Florida/Miami-Dade and Broward Counties, and Texas. Mixed methamphetamine indicators (with some increasing, some decreasing, and some stable) were reported for 2013 by CEWG representatives from Maine and Phoenix. Indicators were low and stable in this reporting period in Boston, Chicago, New York City, and Philadelphia. Methamphetamine levels continued to be very low relative to other drugs in the Baltimore/Maryland/Washington, DC, area."Source:"Epidemiologic Trends in Drug Abuse: Proceedings of the Community Epidemiology Work Group, Highlights and Executive Summary, June 2014" (Bethesda, MD: National Institute on Drug Abuse, September 2014), p. 50.
(Trends in Methamphetamine Use by Young People in the US, 1999-2012) "Methamphetamine questions were introduced in 1999 because of rising concern about use of this drug; but a decline in use has been observed among all five populations in the years since then, although young adults did not show declines until 2005. In 2007 this decline continued in all five populations, and was significant in grades 8 and 12, with little further change thereafter, except for a jump up among 12th graders in 2011 and among young adults in 2012. In 2012 use in all five populations was at very low rates of annual prevalence — particularly among college students (0.2%). These substantial declines occurred during a period in which there were many stories in the media suggesting that methamphetamine use was a growing problem — an example of the importance of having accurate epidemiological data available against which to test conventional wisdom."Source:Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). "Monitoring the Future national survey results on drug use, 1975–2012: Volume I, Secondary school students." Ann Arbor: Institute for Social Research, The University of Michigan, p. 19.
(Trends in Prevalence of Crystal Meth (Ice) Use Among Youth in the US, 1990-2012) "Measures on the use of crystal methamphetamine (ice) (a crystallized form of methamphetamine that can be smoked, much like crack) have been included in MTF [Monitoring The Future] since 1990. The use of crystal methamphetamine increased between the early and late 1990s among the three populations asked about their use: 12th graders, college students, and young adults. However, use never reached very high levels. The estimates are less stable than usual due to the relatively small samples asked about this drug, but it appears that among 12th graders crystal methamphetamine use held fairly steady from 1999 through 2005 (when it was 2.3%); since then it has declined to 0.8% in 2012. Use rose somewhat among college students and other young adults until 2005, before dropping substantially since then. After their peak levels were reached in 2005, college students and young adults showed substantial drops in annual prevalence to 0.6% by 2012."Source:Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). "Monitoring the Future national survey results on drug use, 1975–2012: Volume I, Secondary school students." Ann Arbor: Institute for Social Research, The University of Michigan, p. 20.
(Initiation of Methamphetamine Use in the US, 2012) "The number of recent new users of methamphetamine among persons aged 12 or older was 133,000 in 2012 (Figure 5.6), which also was the 2011 estimate and was similar to the 2010 estimate (107,000). However, the number of initiates in 2012 was lower than the estimates in 2002 to 2004 and in 2006 (ranging from 259,000 to 318,000). The average age at first use among new methamphetamine users aged 12 to 49 in 2012 was 19.7 years, which was similar to the corresponding estimates from 2002 to 2011 (ranging from 17.8 to 22.2 years)."Source:Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013, p. 59.
(Estimated Prevalence of Current Methamphetamine Use in the US, 2014) "In 2014, the estimated 1.6 million people aged 12 or older who were current nonmedical users of stimulants included 569,000 people who were current methamphetamine users (Figure 8). Thus, almost two thirds of current nonmedical users of stimulants in 2014 who were aged 12 or older reported current nonmedical use of prescription stimulants but not methamphetamine.
"These numbers of nonmedical users of stimulants and methamphetamine users represent 0.6 percent of the population aged 12 or older who were current nonmedical users of stimulants (Figure 9) and 0.2 percent who were current users of methamphetamine in 2014 (Figure 10). The percentage of the population aged 12 or older in 2014 who were current nonmedical users of stimulants was higher than the percentages for most years between 2005 and 2012. Meanwhile, the percentage of the population aged 12 or older in 2014 who were current users of methamphetamine was similar to the percentages for most years between 2002 and 2013."Source:Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50), pp. 8-9.
(Estimated Value of US Methamphetamine Market) "A more recent study using a demand-side approach estimates that the annual retail value of the U.S. methamphetamine market is between $3 and $8 billion, with a best guess of $5 billion.12 The margin of error is large because the footprint of methamphetamine use does not match the footprint of the data collection system. Methamphetamine use in the United States is concentrated in certain regions, and it is not primarily an urban drug, whereas data collection systems are centered in urban areas. Moreover, because there have been dramatic shifts in methamphetamine consumption and production during the past decade, estimates are highly dependent on the year analyzed. While there are considerable uncertainties, the amphetamine market is clearly smaller than the cocaine and cannabis markets in North America, smaller than the cocaine market in South America, and potentially smaller than markets for other drugs elsewhere in the hemisphere as well. However, data are not available to provide a detailed analysis for all regions."Source:Organization of American States, "The Drug Problem in the Americas: Studies: Chapter 4: The Economics of Drug Trafficking," 2013, p. 12.
(Law Enforcement Perception of Methamphetamines) "In fact, according to National Drug Threat Survey (NDTS) 2006 data, 38.8 percent of state and local law enforcement officials nationwide report methamphetamine as the greatest drug threat to their areas, a higher percentage than that for any other drug."Source:National Drug Intelligence Center, "National Methamphetamine Threat Assessment" (Johnstown, PA: US Dept. of Justice, Nov. 2006), p. 1.
(Mexican Methamphetamine Production) "Law enforcement pressure and strong precursor chemical sales restrictions have achieved marked success in decreasing domestic methamphetamine production. Mexican DTOs, however, have exploited the vacuum created by rapidly expanding their control over methamphetamine distribution -- even to eastern states -- as users and distributors who previously produced the drug have sought new, consistent sources. These Mexican methamphetamine distribution groups (supported by increased methamphetamine production in Mexico) are often more difficult for local law enforcement agencies to identify, investigate, and dismantle because they typically are much more organized and experienced than local independent producers and distributors. Moreover, these Mexican criminal groups typically produce and distribute ice methamphetamine that usually is smoked, potentially resulting in a more rapid onset of addiction to the drug."Source:National Drug Intelligence Center, "National Methamphetamine Threat Assessment 2007" (Johnstown, PA: US Dept. of Justice, Nov. 2006), p. 1.
(US Military Use of Amphetamines) "During Vietnam both the Air Force and Navy made amphetamines available to aviators. Intermittently since Vietnam up through Desert Storm the Air Force has used both amphetamines and sedatives in selected aircraft for specific missions."Source:"Performance Maintenance During Continuous Flight Operations: A Guide For Flight Surgeons," NAVMED P-6410, Naval Strike and Air Warfare Center, Jan. 1, 2000, p. 8.
(Effects of Amphetamine and Methamphetamine Use) "A paranoid psychosis may result from long-term use; rarely, the psychosis is precipitated by a single high dose or by repeated moderate doses. Typical features include delusions of persecution, ideas of reference (notions that everyday occurrences have special meaning or significance personally meant for or directed to the patient), and feelings of omnipotence. Some users experience a prolonged depression, during which suicide is possible. Recovery from even prolonged amphetamine psychosis is usual but is slow. The more florid symptoms fade within a few days or weeks, but some confusion, memory loss, and delusional ideas commonly persist for months."Source:"Amphetamines," The Merck Manual for Health Care Professionals, Special Subjects: Drug Use and Dependence: Amphetamines, Merck & Co. Inc. (July 2008).
(Source of Methamphetamine Supply in the US, 2008) "Preliminary 2008 availability and seizure data indicate a strengthening in domestic methamphetamine availability and domestic methamphetamine production, and an increase in the flow of methamphetamine into the United States from Mexico—most likely attributable to the efforts of methamphetamine producers in both countries to reestablish the methamphetamine supply chain in the face of disruptions and shortages that began occurring in early 2007. Throughout 2007 methamphetamine availability decreased in U.S. drug markets, causing instability in the methamphetamine supply chain. Prior to 2007, U.S. drug markets relied on the strong flow of methamphetamine produced in Mexico, a supply system established in 2005 and strengthened in 2006. However, ephedrine and pseudoephedrine restrictions in Mexico resulted in a decrease in methamphetamine production in Mexico and reduced the flow of the drug from Mexico to the United States in 2007 and from January through June 2008."
(Medical Uses) "Some amphetamines, including dextroamphetamine, methamphetamine, and the related methylphenidate, are widely used medically to treat attention-deficit hyperactivity disorder, obesity, and narcolepsy, thus creating a supply subject to diversion for illicit use. Methamphetamine is easily manufactured illicitly."Source:"Amphetamines," The Merck Manual for Health Care Professionals, Special Subjects: Drug Use and Dependence: Amphetamines, Merck & Co. Inc. (July 2008).
(Methamphetamines, HIV and Hepatitis Transmission) "Transmission of HIV and hepatitis B and C can be consequences of methamphetamine abuse. The intoxicating effects of methamphetamine, regardless of how it is taken, can also alter judgment and inhibition and lead people to engage in unsafe behaviors, including risky sexual behavior. Among abusers who inject the drug, HIV and other infectious diseases can be spread through contaminated needles, syringes, and other injection equipment that is used by more than one person."Source:National Institute on Drug Abuse, InfoFacts: Methamphetamine (Rockville, MD: US Department of Health and Human Services), Revised: July 2009.
(Prevalence of Methamphetamine Use in 1990s) "The number of new users of stimulants generally increased during the 1990s, but there has been little change since 2000. Incidence of methamphetamine use generally rose between 1992 and 1998. Since then, there have been no statistically significant changes."Source:Substance Abuse and Mental Health Services Administration. (2004). Results from the 2003 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-25, DHHS Publication No. SMA 04-3964). Rockville, MD, p. 46.
(US Military Use of Stimulants) "Following Desert Storm an anonymous survey of deployed fighter pilots was completed. 464 surveys were returned (43%). For Desert Storm: 57% used stimulants at some time (17% routinely, 58% occasionally, 25% only once). Within individual units, usage varied from 3% to 96%, with higher usage in units tasked for sustained combat patrol (CAP) missions. Sixty one percent of those who used stimulants reported them essential to mission accomplishment."Source:Naval Strike and Air Warfare Center, "Performance Maintenance During Continuous Flight Operations: A Guide For Flight Surgeons," NAVMED P-6410, Jan. 1, 2000, p. 10.
(Pathophysiology of Amphetamines)
"Amphetamines enhance release of catecholamines, increasing intrasynaptic levels of norepinephrine, dopamine, and serotonin. The resulting marked α- and β-receptor stimulation and general CNS excitation account for the “desired” effects of increased alertness, euphoria, and anorexia, as well as the adverse effects of delirium, hypertension, hyperthermia, and seizures. Effects of amphetamines are similar, varying in intensity and duration of psychoactive effects; MDMA and its relatives have more mood-enhancing properties, perhaps related to a greater effect on serotonin. Amphetamines can be taken orally as pills or capsules, nasally by inhaling or smoking, or by injection.
"Chronic effects: Repeated use of amphetamines induces dependence. Tolerance develops slowly, but amounts several 100-fold greater than the amount originally used may eventually be ingested or injected. Tolerance to various effects develops unequally. Tachycardia and increased alertness diminish, but hallucinations and delusions may occur.
"Amphetamines typically cause erectile dysfunction in men but enhance sexual desire. Use is associated with unsafe sex practices, and users are at increased risk of sexually transmitted infections, including HIV infection. Amphetamine abusers are prone to injury because the drug produces excitation and grandiosity followed by excess fatigue and sleepiness."Source:"Amphetamine," The Merck Manual for Health Care Professionals, Special Subjects: Drug Use and Dependence: Amphetamines, Merck & Co. Inc., Revised: July 2008.
(Acute Effects of Amphetamines) "Many psychologic effects of amphetamines are similar to those of cocaine; they include increased alertness and concentration, euphoria, and feelings of well-being and grandiosity. Palpitations, tremor, diaphoresis, and mydriasis may also occur during intoxication.
"Binges (perhaps over several days) lead to an exhaustion syndrome, involving intense fatigue and need for sleep after the stimulation phase.Source:"Amphetamine," The Merck Manual for Health Care Professionals, Special Subjects: Drug Use and Dependence: Amphetamines, Merck & Co. Inc., Revised: July 2008.
"Amphetamines are CNS stimulants and are used both medicinally and as drugs of abuse. Amphetamines are generally taken recreationally and to enhance performance (e.g., truck drivers staying awake). Ecstasy falls within this category, and as a methylated amphetamine derivative it also has hallucinogenic properties. Amphetamines have been associated with crash occurrence and could logically be associated with driving impairment both in the stimulation and withdrawal stages; in the latter case especially as the drug interacts with fatigue."Source:Lacey, John H.; Kelley-Baker, Tara; Furr-Holden, Debra; Voas, Robert B.; Romano, Eduardo; Ramirez, Anthony; Brainard, Katharine; Moore, Christine; Torres, Pedro; and Berning, Amy , "2007 National Roadside Survey of Alcohol and Drug Use by Drivers," Pacific Institute for Research and Evaluation (Calverton, MD: National Highway Traffic Safety Administration, December 2009), p. 26.
(Chronic Effects) " A paranoid psychosis may result from long-term use; rarely, the psychosis is precipitated by a single high dose or by repeated moderate doses. Typical features include delusions of persecution, ideas of reference (notions that everyday occurrences have special meaning or significance personally meant for or directed to the patient), and feelings of omnipotence. Some users experience a prolonged depression, during which suicide is possible. Recovery from even prolonged amphetamine psychosis is usual but is slow. The more florid symptoms fade within a few days or weeks, but some confusion, memory loss, and delusional ideas commonly persist for months.
"Users have a high rate of severe tooth decay affecting multiple teeth; causes include decreased salivation, acidic combustion products, and poor oral hygiene."Source:"Amphetamine," The Merck Manual for Health Care Professionals, Special Subjects: Drug Use and Dependence: Amphetamines, Merck & Co. Inc., Revised: July 2008.
(Withdrawal) "Although no stereotypical withdrawal syndrome occurs when amphetamines are stopped, EEG changes occur, considered by some experts to fulfill the physical criteria for dependence. Abruptly stopping use may uncover or exacerbate underlying depression or precipitate a serious depressive reaction. Withdrawal is often followed by 2 or 3 days of intense fatigue or sleepiness and depression."Source:"Amphetamine," The Merck Manual for Health Care Professionals, Special Subjects: Drug Use and Dependence: Amphetamines, Merck & Co. Inc., Revised: July 2008.
(Dopamine) "Methamphetamine increases the release and blocks the reuptake of the brain chemical (or neurotransmitter) dopamine, leading to high levels of the chemical in the brain, a common mechanism of action for most drugs of abuse. Dopamine is involved in reward, motivation, the experience of pleasure, and motor function. Methamphetamine’s ability to rapidly release dopamine in reward regions of the brain produces the intense euphoria, or 'rush,' that many users feel after snorting, smoking, or injecting the drug."Source:National Institute on Drug Abuse, InfoFacts: Methamphetamine (Rockville, MD: US Department of Health and Human Services), Revised: July 2009.
Environmental Hazards from Methamphetamine Production
(Dangers) "Illicit production of methamphetamine may involve hazardous materials that are toxic, corrosive, flammable, or explosive. Such materials include anhydrous ammonia, sulfuric acid, hydrochloric acid, red phosphorous, lithium metal, sodium metal, iodine, and toluene. Upon discovery, the hazardous materials contained at clandestine drug laboratory locations are classified and managed as hazardous wastes."Source:"Methamphetamine Initiative: Final Environmental Assessment," US Dept. of Justice Office of Community Oriented Policing Services, May 13, 2003, p. 4.
(Lab Clean-up Costs) "Toxic chemicals used to produce methamphetamine often are discarded in rivers, fields, and forests, causing environmental damage that results in high cleanup costs. For example, DEA's annual cost for cleanup of clandestine laboratories (almost entirely methamphetamine laboratories) in the United States has increased steadily from FY1995 ($2 million), to FY1999 ($12.2 million), to FY 2002 ($23.8 million). Moreover, the Los Angeles County Regional Criminal Information Clearinghouse, a component of the Los Angeles HIDTA, reports that in 2002 methamphetamine laboratory cleanup costs in the combined Central Valley and Los Angeles HIDTA areas alone reached $3,909,809. Statewide, California spent $4,974,517 to remediate methamphetamine laboratories and dumpsites in 2002."
(Lab Fires and Explosions) "Further contributing to the threat posed by the trafficking and abuse of methamphetamine, some chemicals used to produce methamphetamine are flammable, and improper storage, use, or disposal of such chemicals often leads to clandestine laboratory fires and explosions. National Clandestine Laboratory Seizure System (NCLSS) 2003 data show that there were 529 reported methamphetamine laboratory fires or explosions nationwide, a slight decrease from 654 reported fires or explosions in 2002."
(Growth of Clandestine Labs) "The incidence of clandestine drug laboratories has grown dramatically in the past 10 years. For example, in Fiscal Year 1992, the DEA's National Clandestine Laboratory Cleanup Program funded approximately 400 removal actions and by fiscal year 2001, the DEA Program funded more than 6,400 removal actions."Source:"Methamphetamine Initiative: Final Environmental Assessment," US Dept. of Justice Office of Community Oriented Policing Services, May 13, 2003, p. 6.