Rates Of Methamphetamine Use Research Articles

Methamphetamine use associated with gun and knife violence: A matched cohort analysis

IntroductionThere may be an association between violence and methamphetamine use. We hypothesized that trauma patients screening positive for methamphetamines are more likely to present after penetrating trauma and have increased mortality. MethodsThe 2017–2019 TQIP was used to 1:2 match methamphetamine (meth+) patients to patients testing negative for all drugs (meth-). Patients with polysubstance/alcohol use were excluded. Bivariate and logistic regression analyses were performed. ResultsThe rate of methamphetamine use was 3.1 %. After matching, there was no difference in vitals, injury severity score, sex, and comorbidities between cohorts (all p > 0.05). Compared to meth-, the meth+ group was more commonly sustained penetrating trauma (19.8 % vs. 9.2 %, p < 0.001) with stab-wounds being the most common penetrating mechanism (10.5 % vs. 4.5 %, p < 0.001). The meth+ group more commonly underwent surgery immediately from the emergency department (ED) (20.3 % vs. 13.3 %, p < 0.001). The associated risk of death in the ED was higher for the meth+ group (OR 2.77, CI 1.45–5.28, p = 0.002), however, the risk was similar for patients that were admitted or received an operation (p = 0.065). ConclusionTrauma patients using methamphetamine more commonly presented after gun or knife violence and required immediate surgical intervention. They also have increased associated risk of death in the ED. Given these serious findings, a multidisciplinary approach in helping curtail the worsening epidemic of methamphetamine use appears warranted as it is related to penetrating trauma and outcomes. Level of evidenceIV.

Characterising methamphetamine use to inform health and social policies in Manitoba, Canada: a protocol for a retrospective cohort study using linked administrative data

IntroductionRising use of methamphetamine is causing significant public health concern in Canada. The biological and behavioural effects of methamphetamine range from wakefulness, vigour and euphoria to adverse physical health outcomes...

Associations between prescription and illicit stimulant and opioid use in the United States, 2015–2020

IntroductionOverdose deaths involving opioids and stimulants continue to reach unprecedented levels in the United States. Although significant attention has been paid to the relationship between prescription and illicit opioid use, little work has focused on the association between prescription and illicit stimulant use. Thus, this study explores characteristics of those who use or misuse prescription stimulants and/or opioids and associations with use of cocaine, methamphetamine, and heroin. MethodsWe used 2015–2020 data from the National Survey on Drug Use and Health. Using adjusted multivariable logistic regression, we estimated the associations between past year prescription stimulant or prescription opioid prescribed use and misuse; various demographic characteristics; and past-year cocaine, methamphetamine, or heroin use. ResultsFrom 2015 to 2020, 4.9 and 9.8 million US adults annually reported misusing prescription stimulants and opioids, respectively. Individuals who misused prescription stimulants were more likely to be ages 18–25 (45.8 %; 95 % CI: 44.0–47.5) than individuals who misused prescription opioids (21.7 %; 95 % CI: 20.7–22.7). We observed higher rates of cocaine use among individuals reporting prescription stimulant misuse (12.0 %; 95 % CI: 11.0–12.9) compared to those reporting prescription opioid misuse (5.7 %; 95 % CI: 5.1–6.3, p < 0.001). Heroin use was more common among individuals with prescription opioid misuse (2.1 %; 95 % CI: 1.7–2.2) than prescription stimulant misuse (0.6 %; 95 % CI: 0.4–0.7, p < 0.001). However, rates of methamphetamine use among individuals with prescription stimulant misuse (2.4 %; 95 % CI: 1.9–3.0) did not differ from individuals with prescription opioid misuse (2.1 %; 95 % CI: 1.7–2.5, p = 0.67). ConclusionsPrescription stimulant misuse, compared to prescription opioid misuse, was associated with higher levels of cocaine use but not methamphetamine use. Treatment providers should consider screening for other substance use disorders among people who report prescription stimulant use or misuse. Additional research should seek to understand the mechanism underlying the different associations between prescription stimulant misuse and cocaine or methamphetamine use.

Amphetamines in Workplace Testing Hair Samples over the Years 2011-2020.

Amphetamines (AMPs) in hair were investigated with thousands of workplace testing head and body hair samples collected and analyzed over 10years and tabulated by year. All samples were washed by a published extensive method prior to confirmation by liquid chromatography-mass spectrometry-mass spectrometry. Presented are concentrations of parent methamphetamine (METH), 3,4-methylenedioxymethamphetamine (MDMA) and methylenedioxyamphetamine as metabolite and AMP as metabolite and without the presence of parent drug. Some differences in METH concentrations from year to year were significant, and some ratios of metabolite to parent drug for both METH and MDMA also varied significantly. While rates of METH use may not have changed significantly, some aspects of the drugs ingested as demonstrated by hair analysis varied over the 10-year period.

The use of methamphetamine in the probation population

Objective: Our research aimed to determine the frequency of methamphetamine use among people referred to health institutions for treatment with the probation decision and to reveal the sociodemographic and clinical profile of people who use methamphetamine. Method: Four hundred and forty-two consecutive cases between 18 and 65 years of age who were referred for treatment to the Probation Outpatient Clinic in Bakirkoy Prof. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery were included in the study. Sociodemographic and clinical information of the cases, substance use and treatment histories, and criminal histories were recorded and evaluated with a semi-structured form. Urine toxicology results, which were taken as one of the obligations of the probation treatment program, were examined. Results: Substance metabolites were detected in the urine toxicological analysis of 81% of the cases. Methamphetamine use was detected in 24.4% of the sample. It was the second most common illicit substance after cannabis and the fourth common seized. Inhalation was the most common method of methamphetamine use. Of the cases still using methamphetamine, 90.7% (n=98) were found to use at least one substance other than methamphetamine. Emergency admissions for substance-related problems, inpatient addiction treatment, outpatient psychiatric treatment, and forensic histories were significantly higher in the group with methamphetamine use than in the group without methamphetamine use. Conclusion: Our study is the first to evaluate the rate of methamphetamine use in the probation population and the sociodemographic and clinical profile of people with methamphetamine use. According to the data obtained, one-fourth of the probation population was using methamphetamine. This group represented a more criminally engaged subgroup of substance users with more inpatient addiction treatment and outpatient psychiatric treatment needs with a high rate of polysubstance use. Recognizing the profile of methamphetamine users is essential to develop strategies to meet their treatment needs. In addition, a probation program might provide an opportunity to raise awareness of substance-related medical and social problems and to motivate individuals who are relatively less engaged with treatment to initiate a therapeutic process.

Evaluating the impact of an emergency department protocol that guides management of methamphetamine-induced agitation and psychosis.

BackgroundMethamphetamine is an addictive stimulant that may induce symptoms of agitation and psychosis. The estimated rate of methamphetamine use is 6.6 per 1000 people. Currently, no treatment guidelines exist to support the optimal management of patients presenting with methamphetamine-induced agitation. Emergency department (ED) providers may prescribe various benzodiazepines (BZDs) and antipsychotics (APs) as first-line agents to stabilize these agitated patients. This study aims to determine the effectiveness of a protocol to guide management of this condition.MethodsThis was a retrospective, pre- and poststudy conducted from July 2020 to March 2021 at a large academic medical center. A multidisciplinary protocol was designed to help manage methamphetamine-induced agitation in the ED. The primary outcome of the study was a reduction in the number of BZDs and APs used for the treatment of methamphetamine-induced agitation. This was measured by the incidence of overprescribing, defined as 3 or more APs or BZDs administered within 30 minutes. Secondary outcomes included the use of physical restraints, ED length of stay, and adverse events.ResultsWe did not observe a significantly lower incidence of overprescribing, adverse events, or ED length of stay when comparing pre- and postprotocol groups. A subgroup analysis demonstrated that when protocol was followed, there was a statistically significant reduction in overprescribing (P = .001).DiscussionWe did not find any differences among our primary and secondary outcomes, which may be attributed to protocol nonadherence. Full compliance to the protocol may reduce the rate of overprescribing APs or BZDs in patients with methamphetamine-induced agitation.

Craving among individuals with stimulant use disorder in residential social model-based treatment – Can exercise help?

BackgroundIn a randomized controlled 8-week trial, we examined the efficacy of aerobic and resistance exercise in reducing craving for methamphetamine (MA) among individuals with MA-use disorder during residential treatment. MethodsIndividuals with MA use disorder (138) who were newly enrolled in residential treatment volunteered for random assignment to either an 8-week exercise intervention (EX) or health education control (HE), with both conditions meeting 3 times weekly; 3 dropped out of the trial, bringing the analysis sample to 135. The majority of participants were male (80%), and 48% were Latino/Hispanic. The mean age of the sample was 31.7 (SD = 6.9) years. Using multivariate mixed models, differences between conditions were examined in: (1) craving for MA, measured by self-reported ratings on a Visual Analog Scale over the 8-week trial and, (2) MA use, measured by self-report and urine drug screens at baseline and 30 and 60 days after discharge from the 8-week study. ResultsResults revealed significantly lower craving scores among the participants in the EX group than those in the HE group over the 8-week trial (median daily craving score for EX = 13.5, for HE = 21.8; p = .009). In addition, participants with less craving during treatment had significantly lower rates of MA use after discharge than participants with high craving measured at 30-days (p = .004) and 60-days post-discharge (p < .001). ConclusionsResults support the utility of incorporating a structured exercise program for individuals with MA-use disorder to reduce craving and improve MA-use outcomes.

A qualitative examination of recent increases in methamphetamine use in a cohort of rural people who use drugs

IntroductionRising rates of methamphetamine use among populations using opioids is an escalating public health concern. The purpose of this manuscript is to identify socioecologic factors driving increases in methamphetamine use among Appalachian Kentucky adults with a history of opioid use. MethodsSemi-structured qualitative interviews were conducted among 20 Appalachian Kentuckians in the Social Network of Appalachian Peoples (SNAP) cohort who reported lifetime opioid use and past 30-day methamphetamine use. Interviews focused on initiation of methamphetamine use, factors that influence methamphetamine use at the individual, interpersonal, community and society levels. ResultsParticipants reported using methamphetamine to self-treat underlying issues, including withdrawal from opioids, chronic pain, and emotional distress. Initiation of use was most often facilitated through their drug networks. Participants reported that methamphetamine was widely available and affordable in their community. Several participants with extensive histories of non-medical prescription opioid (NMPO) use described transitioning to methamphetamine as their drug of choice as opioids became less available in their community. Participants also reported economic distress and lack of recreational opportunities as drivers of increased methamphetamine use. DiscussionRecent increases in methamphetamine use among those with a history of opioid use is facilitated by methamphetamine’s relative availability and affordability. Methamphetamine use was also highly influenced by societal factors such as economic deprivation and policies that decreased availability of NMPOs. Surging methamphetamine use exacerbates inequities in addiction care brought to light by the opioid epidemic. Interventions aimed at addressing the socioecological drivers of methamphetamine use among people who use opioids are warranted.

A Narrative Review of the Recent 'Ice' Epidemic: An Australian Perspective.

Background:The use of methamphetamine or amphetamine stimulant drugs has been identified by authoritative public health bodies as a global health issue, with a worrying trend towards production and consumption of a higher purity crystalline form methamphetamine (ice) over the past decade. This trend has been well documented within Australia, resulting in a public perception of there being an ‘ice’ epidemic in regional/rural areas. Considering the illicit nature of ice, monitoring it is challenging and as such little information is available regarding the actual extent of methamphetamine use, harms and patterns in regional/remote Australia.Aim:To collate the available literature regarding methamphetamine use in regional/rural Australia and identify gaps in the literature.Methods:A literature search was conducted by searching 6 databases (PUBMED, Medline, CINAHL, EMBASE, PsycINFO and SCOPUS) following which exclusion/inclusion criteria were applied. Included papers were appraised with the Joanna Briggs Institute Critical appraisal tools and synthesised in light of the sociocultural, ethnic and geographic differences in methamphetamine use in Australia.Results:Regarding rural/regional Australia there is a significant lack of research into methamphetamine use, patterns and epidemiology since the rise of crystalline methamphetamine in 2013. The existing literature available suggests great variability in methamphetamine harms in rural communities. This can be a double-edged sword however, as the introduction of ice into a remote/rural community may result in greater harms if it becomes ingrained in local customs. Similarly, there is a lack of research into the specific factors within Indigenous communities leading to an increased rate of methamphetamine use amongst members.Recommendation:Future research should address the causes of variance in methamphetamine harms in rural/remote regions. Although the scope of this paper was the Australian context, a wider international approach may yield useful information.

Patterns and Characteristics of Methamphetamine Use Among Adults - United States, 2015-2018.

Methamphetamine is a highly addictive central nervous system stimulant. Methamphetamine use is associated with a range of health harms, including psychosis and other mental disorders, cardiovascular and renal dysfunction, infectious disease transmission, and overdose (1,2). Although overall population rates of methamphetamine use have remained relatively stable in recent years (3), methamphetamine availability and methamphetamine-related harms (e.g., methamphetamine involvement in overdose deaths and number of treatment admissions) have increased in the United States* (4,5); however, analyses examining methamphetamine use patterns and characteristics associated with its use are limited. This report uses data from the 2015-2018 National Surveys on Drug Use and Health (NSDUHs) to estimate methamphetamine use rates in the United States and to identify characteristics associated with past-year methamphetamine use. Rates (per 1,000 adults aged ≥18 years) for past-year methamphetamine use were estimated overall, by demographic group, and by state. Frequency of past-year use and prevalence of other substance use and mental illness among adults reporting past-year use were assessed. Multivariable logistic regression examined characteristics associated with past-year use. During 2015-2018, the estimated rate of past-year methamphetamine use among adults was 6.6 per 1,000. Among adults reporting past-year methamphetamine use, an estimated 27.3% reported using on ≥200 days, 52.9% had a methamphetamine use disorder, and 22.3% injected methamphetamine. Controlling for other factors, higher adjusted odds ratios for past-year use were found among men; persons aged 26-34, 35-49, and ≥50 years; and those with lower educational attainment, annual household income <$50,000, Medicaid only or no insurance, those living in small metro and nonmetro counties,† and those with co-occurring substance use and co-occurring mental illness. Additional efforts to build state and local prevention and response capacity, expand linkages to care, and enhance public health and public safety collaborations are needed to combat increasing methamphetamine harms.

Impact of Mobile Phone-Based Interventions on Methamphetamine Use and High-risk Sexual Behaviors in Men Who Have Sex with Men (MSM): A Systematic Review.

BackgroundToday, increased use of methamphetamine in homosexual men is associated with high-risk sexual behaviors and (HIV) epidemic. Mobile phone-based interventions are an accessible and rapid method to provide healthcare services to this population. This study aimed to systematically review the effects of mobile phone-based interventions on methamphetamine use and high-risk sexual behaviors in homosexual men.MethodsThis systematic review was conducted by two researchers via searching in PubMed, Google Scholar, Web of Science, Scopus, and PsycINFO databases to retrieve the published articles regarding the effects of mobile phone-based interventions on the control of methamphetamine use and high-risk sexual behaviors.FindingsAmong 250 unique articles that were retrieved, only five cases met all the inclusion criteria of the study. Accordingly, some of the applied interventions included text messaging (n = 4) and mobile apps (n = 1). In this regard, the use of text messaging significantly decreased the rates of methamphetamine use, condomless anal intercourse (CAI), and HIV transmission among homosexual men.ConclusionAccording to the results, short-term interventions based on text messaging could decrease the rates of methamphetamine use and the high-risk sexual behaviors associated with HIV infection in homosexual men. Despite the positive impact of these interventions, long-term follow-ups are required for individuals using methamphetamine in different communities.

A nationally representative analysis of “twin epidemics”: Rising rates of methamphetamine use among persons who use opioids

BackgroundRecent data suggest increases in methamphetamine potency, affordability, and availability in the US. Other data indicate rising rates of methamphetamine use among patients seeking treatment for opioid use disorder. The extent to which similar increases in methamphetamine use have occurred for populations outside of a treatment context and for those reporting other substance use is unknown. PurposeThe current analysis used a nationally representative data source to evaluate recent trends in past month methamphetamine use based on opioid use history. MethodsData from the 2015–2017 National Survey on Drug Use and Health (NSDUH) were analyzed for yearly variations in past month methamphetamine use by opioid use history. Sensitivity analyses assessed if these trends were specific to methamphetamine use and to persons reporting opioid use. ResultsSignificant increases in past month methamphetamine use were observed for persons reporting past month heroin use, past year heroin use disorder, and past year prescription opioid use disorder. Among individuals reporting past month heroin use, for example, methamphetamine use tripled from 9.0% in 2015 to 30.2% in 2017. These associations were specific to methamphetamine with little change in other substance use. Similar increases in methamphetamine use were not observed for populations reporting other illicit substance use with the exception of prescription tranquilizers. ConclusionsThese results provide data corroborating evidence of emergent concerns related to methamphetamine use in the US. Such findings highlight the importance of considering global drivers of substance use to avoid cyclic waves of new and emerging substance use crises.

Estimating Prevalence of Illicit Drug Use in Yunnan, China, 2011-15.

Background and Aims: Yunnan has been one of the provinces most afflicted by illicit drug use in China. However, there have been few systematic studies on the prevalence of illicit drug use in the area.Method: Using data on illicit drug users registered in the police system, this study aims to estimate the population size of illicit drug users and the annual prevalence of drug use in Yunnan from 2011 to 2015 using Zelterman's capture-recapture method.Results: In the 15–64 year-old population, the estimated prevalence rate of any illicit drug use was 0.81% (0.76–0.86%) in 2011 and 0.94% (0.90–0.98%) in 2014, representing a significant increase. The prevalence rate of heroin use decreased from 0.67% (0.63–0.73%) in 2011 to 0.57% (0.53–0.61%) in 2015, while the prevalence rate of methamphetamine use doubled from 0.20% (0.17–0.24%) in 2011 to 0.48% (0.46–0.50%) in 2015. The mean age of the 141,702 identified illicit drug users in Yunnan from 2011 to 2015 was 32.2 years, and the majority were male, low educated, and peasants; nearly half were single and ethnic minorities. The ratio of the number of identified illicit drug users to the number of hidden users increased from 1:12 in 2011 to 1:5 in 2015.Conclusion: The prevalence of illicit drug use in Yunnan has been increasing. Although the prevalence of heroin use decreased, methamphetamine use increased dramatically from 2011 to 2015. Preventive strategies that are more effective in reducing illicit drug use are urgently needed in Yunnan.

Cohort study of HIV-positive and -negative methamphetamine users

BackgroundThe effects of methamphetamine (MA) on caries have been well documented. Little, however, is known about its effects on the periodontium. The authors conducted this study to determine the prevalence and severity of periodontal disease in an urban population of HIV-positive MA users. MethodsThis cross-sectional survey was conducted in one of the most populous urban areas of Los Angeles County, California, beset with high rates of MA use. Participants were recruited by a combination of street outreach methods, referral from drug treatment centers, and word of mouth. Participants were eligible if they were older than 18 years, spoke English or Spanish, used MA in the past 30 days, were willing to undergo a dental examination and psychosocial assessments, and were willing to provide a urine sample. Periodontal assessments were completed for 541 participants by 3 trained and calibrated dentists. ResultsThe prevalence and severity of periodontal disease were high in this population of HIV-positive and -negative MA users. Cigarette smoking and age were identified as risk factors. ConclusionsThe HIV-positive and -negative cohorts were remarkably similar, suggesting that their lifestyles contributed more to their destructive periodontal disease than their MA use. Practical ImplicationsMA users are at high risk of developing destructive periodontal disease and badly broken-down teeth. Clinicians should plan accordingly for timely management of the patients' care, knowing that MA users have extensive periodontal and restorative treatment needs.

Characteristics of Australian adolescent females in residential treatment who report using methamphetamines.

To investigate factors associated with methamphetamine use in adolescent females referred to an Australian residential treatment service. A mixed-methods explanatory sequential design was undertaken. Cross-sectional analysis of existing pre-treatment data for adolescent females aged 13-18 years (median 16.48 years) attending a treatment program between 2009 and 2015 (n = 267) was undertaken, followed by a focus group and in-depth interviews of key staff. Female methamphetamine-users (n = 127, 47.6%) were significantly more likely than non-methamphetamine-users at pre-treatment to be in unstable living arrangements, where they moved frequently (P = 0.025), lived in more unstable (not rented or privately owned) accommodation (P = 0.012) and had problematic family situations (P = 0.004). They were more likely than non-methamphetamine-users to be to be poly-drug users (P < 0.001) and to have ever attempted suicide (P = 0.029). Cumulative trauma by someone known to the adolescent was the main predictor for female methamphetamine use (odds ratio 3.077). Qualitative data provided context and depth to quantitative findings, with an emphasis on trauma as a precursor to methamphetamine use. The qualitative interviews also highlighted changes made in service provision, given the increasing rates of methamphetamine use. High levels of trauma and mental health problems in this population support the notion that traumatic childhood experiences are strongly associated with problematic alcohol and other drug use, particularly, methamphetamine use, at a young age. Increased attention to decreasing family violence, abuse and neglect is required and in clinical practice, a trauma-informed model of care is recommended.

Methamphetamine treatment outcomes among gay men attending a LGBTI-specific treatment service in Sydney, Australia.

Gay and bisexual men (GBM) report higher rates of methamphetamine use compared to heterosexual men, and thus have a heightened risk of developing problems from their use. We examined treatment outcomes among GBM clients receiving outpatient counseling at a lesbian, gay, bisexual, transgender and intersex (LGBTI)-specific, harm reduction treatment service in Sydney, Australia. GBM receiving treatment for methamphetamine use from ACON’s Substance Support Service between 2012–15 (n = 101) were interviewed at treatment commencement, and after 4 sessions (n = 60; follow-up 1) and 8 sessions (n = 32; follow-up 2). At each interview, clients completed measures of methamphetamine use and dependence, other substance use, injecting risk practices, psychological distress and quality of life. The median age of participants was 41 years and 56.4% identified as HIV-positive. Participants attended a median of 5 sessions and attended treatment for a median of 112 days. There was a significant reduction in the median days of methamphetamine use in the previous 4 weeks between baseline (4 days), follow-up 1 (2 days) and follow-up 2 (2 days; p = .001). There was a significant reduction in the proportion of participants reporting methamphetamine dependence between baseline (92.1%), follow-up 1 (78.3%) and follow-up 2 (71.9%, p < .001). There were also significant reductions in psychological distress (p < .001), and significant improvements in quality of life (p < .001). Clients showed reductions in methamphetamine use and improved psychosocial functioning over time, demonstrating the potential effectiveness of a LGBTI-specific treatment service.

Sexual Activities in Methamphetamine Users: A Qualitative Study on a Sample of Iranian Methamphetamine Users in Tehran

It is known that psychostimulants including methamphetamine have a great effect on sexual behaviors. Since the rate of methamphetamine use has recently increased in Iranian population, there are concerns that this may drive up sexual risky behaviors among users. The result could shift the dominant mode of HIV transmission from drug injection to sexual contact in the country. The intention of the current study, which is the first one in Iran, was to restate the threat to the decision makers in the country.

Association between known recent HIV infections and methamphetamine use (ASK HIM study) in Melbourne between 2011 and 2013: a case-control study

Australia’s HIV prevalence is concentrated primarily in men who have sex with men (MSM). The number of new HIV infections has gradually increased over the last 10 years to 1253 cases in 2012 and 1235 cases in 2013. The number of new HIV infections in the state of Victoria rose to over 300 per year in 2011–13. Prahran Market Clinic diagnosed ~20% of the newMSM cases. The rate of methamphetamine use is higher in MSM than in the general population and the use of methamphetamine in MSM has been shown to increase the risk behaviours for acquiring HIV. To investigate if there is an association between methamphetamine use and HIV infections, we compared methamphetamine use in MSM subjects recently diagnosed with HIV infection (from 2011 to 2013) to methamphetamine use in HIV-negative matched MSM subjects who underwent HIV testing in the same period. We undertook a survey among patients attending the Prahran Market Clinic to look at this association. Surveys were distributed to MSM diagnosed with HIV between 2011 and 2013 attending Prahran Market Clinic. Subjects were invited to fill in a questionnaire about their methamphetamine use over the 12 months before the HIV diagnosis. Control subjects were recruited from age-matched MSM attending the clinic who had a negative HIV test in the same period. Both HIV-positive subjects and control subjects were asked the same questions, except that the questionnaires for the HIV-positive subjects also asked if they thought that their methamphetamine use had been a significant cause of their HIV infection. Overall, 65 questionnaires were completed by HIV-positive subjects and 146 by control subjects. There was a significantly higher rate of methamphetamine use in the subjects recently diagnosed with HIV compared with the HIV-negative controls (Table 1). All the results were statistically significant when comparing the two groups using 95% confidence intervals. Most of the HIV-positive subjects who had used methamphetamine thought that their methamphetamine use was a significant cause of their HIV infection (Table 1). The rate of methamphetamine use by MSM having an HIV test in our survey was higher than that found in other Australian community surveys (33% vs 9–13%), which may reflect the higher methamphetamine use rate of MSM presenting for HIV testing compared with the general MSM community. This study is limited by the low subject numbers, although the cohort represents ~10% of the total MSM diagnosed with HIV in Victoria in this period. The questionnaire was brief and did not enquire about other drug or alcohol use, but the question

American Indian methamphetamine and other drug use in the Southwestern United States.

To investigate the extent of methamphetamine and other drug use among American Indians (AIs) in the Four Corners region, we developed collaborations with Southwestern tribal entities and treatment programs in and around New Mexico. We held nine focus groups, mostly with Southwestern AI participants (N = 81) from three diverse New Mexico communities to understand community members, treatment providers, and clients/relatives views on methamphetamine. We conducted a telephone survey of staff (N = 100) from agencies across New Mexico to assess perceptions of methamphetamine use among people working with AI populations. We collected and analyzed self-reported drug use data from 300 AI clients/relatives who completed the Addiction Severity Index (ASI) in the context of treatment at three diverse addiction treatment programs. Each focus group offered a unique perspective about the effect of drugs and alcohol on each respective community. Though data from the phone surveys and ASIs suggested concerning rates of methamphetamine use, with women more adversely affected by substance use in general, alcohol was identified as the biggest substance use problem for AI populations in the Southwest. There appears to be agreement that methamphetamine use is a significant problem in these communities, but that alcohol is much more prevalent and problematic. There was less agreement about what should be done to prevent and treat methamphetamine use. Future research should attend to regional and tribal differences due to variability in drug use patterns, and should focus on identifying and improving dissemination of effective substance use interventions.

“High on My Own Supply”: Correlates of Drug Dealing among Heterosexually Identified Methamphetamine Users

Although rates of methamphetamine use continue to increase throughout the United States, little is known about the individuals who sell methamphetamine at the street level. This exploratory study examined the prevalence and correlates of drug-dealing behavior in a sample of 404 heterosexually identified methamphetamine users who were participants in a sexual risk reduction intervention in San Diego, California. Twenty-nine percent of participants (N = 116) reported "dealing" methamphetamine in the past 2 months. In a multivariate logistic regression, methamphetamine dealing was associated with being male (OR = 1.99; 95% CI 1.16-3.39), younger age (OR = 1.87 per year; 95% CI 1.10-3.17), more frequent use of methamphetamine (OR = 2.69; 95% CI 1.59-4.57), injecting methamphetamine (OR = 3.10; 95% CI 1.79-5.37), and higher hostility scores (OR = 1.07 per unit increase; 95% CI 1.01-1.13). These characteristics, particularly intensity of drug use and hostility, may be associated with greater resistance to drug treatment and lower success in treatment programs.