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Hansen ER, Carvalho S, McDonald M, Havens JR. A qualitative examination of recent increases in methamphetamine use in a cohort of rural people who use drugs. Drug Alcohol Depend 2021; 229:109145. [PMID: 34763138 PMCID: PMC8665094 DOI: 10.1016/j.drugalcdep.2021.109145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 10/08/2021] [Accepted: 10/10/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Rising 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. METHODS Semi-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. RESULTS Participants 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. DISCUSSION Recent 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.
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Affiliation(s)
- Elizabeth R Hansen
- University of Kentucky College of Medicine, Department of Behavioral Science, Center on Drug and Alcohol Research, 845 Angliana Avenue, Lexington, KY 40508, USA; University of Kentucky College of Medicine, William R. Willard Medical Education Building, MN 150, Lexington, KY 40536-0298, USA
| | - Shelby Carvalho
- University of Kentucky College of Medicine, William R. Willard Medical Education Building, MN 150, Lexington, KY 40536-0298, USA
| | - Madelyn McDonald
- University of Kentucky Center for Innovation in Population Health, College of Public Health, 111 Washington Avenue, Lexington, KY 40526, USA
| | - Jennifer R Havens
- University of Kentucky College of Medicine, Department of Behavioral Science, Center on Drug and Alcohol Research, 845 Angliana Avenue, Lexington, KY 40508, USA.
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Duhart Clarke SE, Kral AH, Zibbell JE. Consuming illicit opioids during a drug overdose epidemic: Illicit fentanyls, drug discernment, and the radical transformation of the illicit opioid market. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 99:103467. [PMID: 34662847 DOI: 10.1016/j.drugpo.2021.103467] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND North America continues to face an opioid overdose epidemic, driven by persistent increases in illicit fentanyls and fluctuations in potency leading to uncertainty for consumers. This qualitative study was conducted to better understand how people who inject drugs (PWID) came to recognize fentanyl as a growing adulterant of heroin and the subsequent sensory discernment strategies they employed to continue injecting. Our main objective was to investigate how observations and knowledge are combined as homegrown techniques for detecting fentanyl and minimizing risk. Secondary objectives were to examine the impact of growing fentanyl adulteration on individual drug use behavior. METHODS Between April and May 2019, 28 PWID (18 men, 10 women; average age = 38.43 years, SD = 9.26) were purposely recruited from a needle services program in Greensboro, North Carolina. Study participants were interviewed in-person using a qualitative, semi-structured instrument. Interviews were analyzed with a general inductive approach using NVivo12. RESULTS Participants described methods for detecting fentanyl in illicit opioids. Sudden increases in the potency of the 'rush' and sharp decreases in the length of the 'high' were chief indicators along with changes in drug color and texture. Heavy sedation was associated with fentanyl use and histamine-releasing effects characterized as 'pins and needles' were ascribed to injecting fentanyl as a component of the rush. Fentanyl's short high helped explain higher injection frequency and heavy sedation was the leading reason for co-using fentanyl with cocaine/crack or methamphetamine. CONCLUSION PWID have the capacity to recognize changes to the illicit opioid supply. Study participants navigated unpredictable fluctuations in the illicit opioid market by employing homegrown discernment techniques, modifying drug use behavior, and co-using non-opioid drugs. Researchers and policymakers should involve PWID as subject matter experts to help modernize harm reduction for the fentanyl age with practical strategies to boost resiliency and save lives.
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Affiliation(s)
| | - Alex H Kral
- RTI International, Durham, NC, United states
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3
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Coughlin LN, Lin LA, Jannausch M, Ilgen MA, Bonar EE. Methamphetamine use among American Indians and Alaska Natives in the United States. Drug Alcohol Depend 2021; 227:108921. [PMID: 34333282 PMCID: PMC8782253 DOI: 10.1016/j.drugalcdep.2021.108921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent trends show methamphetamine use is increasing in the United States. American Indian and Alaska Native (AI/AN) communities face health disparities compared to the population overall, including some of the highest rates of illegal drug use. Herein, we examined the prevalence of methamphetamine use among AI/ANs and characteristics associated with methamphetamine use among AI/AN people. METHODS We examined past-year methamphetamine use from 2015 to 2019 between AI/ANs and the general non-institutionalized U.S. population using the National Survey of Drug Use and Health. Then, we identify potential subgroups of AI/AN people at elevated risk of methamphetamine use across factors including demographic, social determinants, mental health, and co-occurring substance use. RESULTS A total of 214,505 people, aged 18 or older, were surveyed between 2015 and 2019; 3,075 (0.55%) identified as AI/AN. An estimated 26.2 out of every 1000 AI/ANs used methamphetamine compared to 6.8 out of every 1000 in the general U.S. POPULATION Compared to methamphetamine use in the general population, AI/AN methamphetamine use tends to cluster in rural areas and among those with low income. AI/ANs who use methamphetamine were more likely to be male, middle-aged, low income, have severe mental illness, and misuse other substances than AI/AN people who did not use methamphetamine. DISCUSSION AI/ANs experience a disproportionate amount of methamphetamine use in the U.S. To address this disparity, multifaceted, broad prevention, harm reduction, and treatment efforts are needed that leverage cultural strengths to mitigate the consequences of methamphetamine use.
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Affiliation(s)
- Lara N Coughlin
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Lewei Allison Lin
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA; VA Center for Clinical Management Research (CCMR), Veteran Affairs Ann Arbor Healthcare System, Ann Arbor, MI, 48109, USA
| | - Mary Jannausch
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA; VA Center for Clinical Management Research (CCMR), Veteran Affairs Ann Arbor Healthcare System, Ann Arbor, MI, 48109, USA
| | - Mark A Ilgen
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA; VA Center for Clinical Management Research (CCMR), Veteran Affairs Ann Arbor Healthcare System, Ann Arbor, MI, 48109, USA
| | - Erin E Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
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Ware OD, Manuel JI, Huhn AS. Adults With Opioid and Methamphetamine Co-use Have Lower Odds of Completing Short-Term Residential Treatment Than Other Opioid Co-use Groups: A Retrospective Health Services Study. Front Psychiatry 2021; 12:784229. [PMID: 34955930 PMCID: PMC8692265 DOI: 10.3389/fpsyt.2021.784229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/15/2021] [Indexed: 12/15/2022] Open
Abstract
Objective: There is an increase in persons entering substance use treatment who co-use opioids and methamphetamines in recent years. Co-using these substances may negatively impact treatment retention in the residential setting. We explored predictors of adults completing short-term residential treatment among persons with primary opioid use disorder (OUD) who co-use either alcohol, benzodiazepines, cocaine, or methamphetamines. Methods: This study used the 2019 de-identified, publicly available Treatment Episode Dataset-Discharges. The sample included adults discharged from short-term residential treatment with primary OUD who co-used either alcohol, benzodiazepines, cocaine, or methamphetamines. The final sample size included 24,120 treatment episodes. Univariate statistics were used to describe the sample. Two logistic regression models were used to predict completing treatment. The first logistic regression model included the co-use groups as predictors and the second model added other demographic and treatment-relevant covariates. Results: A slight majority (51.4%) of the sample prematurely discharged from treatment. Compared to the other three co-use groups, the opioid and methamphetamine co-use group had the highest proportion of individuals who were women (45.0%), unemployed (62.5%), current injection drug use (76.0%), living in the Midwest (35.9%), living in the south (33.5%), and living in the west (15.5%). The opioid and methamphetamine co-use group also had the highest proportion of individuals not receiving medications for OUD (84.9%), not having a prior treatment episode (28.7%), and not completing treatment (57.4%). In the final logistic regression model, which included covariates, the opioid and alcohol (OR = 1.18, 95% CI = 1.080-1.287, p < 0.001), opioid and benzodiazepine (OR = 1.33, 95% CI = 1.213-1.455, p < 0.001), and opioid and cocaine (OR = 1.16, 95% CI = 1.075-1.240, p < 0.001) co-use groups had higher odds of completing treatment than the opioid and methamphetamine co-use group. Conclusions: Opioid and methamphetamine co-use may complicate short-term residential treatment retention. Future work should identify effective strategies to retain persons who co-use opioids and methamphetamines in treatment.
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Affiliation(s)
- Orrin D Ware
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jennifer I Manuel
- Silver School of Social Work, New York University, New York, NY, United States
| | - Andrew S Huhn
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Lin LA, Saitz R. What Will it Take to Stem the Tide? Understanding and Addressing the Needs of People With Addiction Involving Multiple Substances. J Addict Med 2021; 15:1-2. [PMID: 32530886 DOI: 10.1097/adm.0000000000000667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Lewei Allison Lin
- VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI (LAL); Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI (LAL); Department of Community Health Sciences, Boston University School of Public Health, Boston, MA (RS); Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA (RS) and Grayken Center for Addiction, Boston Medical Center, Boston, MA (RS)
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Kuitunen-Paul S, Roessner V, Basedow LA, Golub Y. Beyond the tip of the iceberg: A narrative review to identify research gaps on comorbid psychiatric disorders in adolescents with methamphetamine use disorder or chronic methamphetamine use. Subst Abus 2020; 42:13-32. [PMID: 32870121 DOI: 10.1080/08897077.2020.1806183] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Methamphetamine use disorder (MUD) frequently begins in adolescence, often accompanied by other psychiatric or mental disorders. Up to now, no comprehensive review about MUD and comorbid disorders in adolescents is available. We thus aimed to review the literature on comorbid mental disorders and MUD in adolescents in order to identify future research topics. Method: A PubMed search was conducted in July 2019. Relevant comorbidities were defined as attention-deficit disorder with/without hyperactivity, anxiety disorders, depression, eating disorders, post-traumatic stress disorder, psychosis, borderline personality disorder, conduct disorder and antisocial personality disorder, as well as other substance use disorders. For each comorbidity, we summarized prevalence rates, findings on comorbidity mechanisms, and recommended treatment options, if applicable. Results: Few articles focused on MUD in adolescents. Prevalence rates differed largely between comorbid disorders, with tobacco use disorder, conduct disorder, post-traumatic stress disorder, anxiety disorders, and attention-deficit disorders being the most prevalent comorbidities while eating disorders were rare. Examined onset patterns and comorbidity mechanisms indicated three groups of comorbidities: preexisting disorders self-medicated with methamphetamine, disorders induced by chronic methamphetamine use, and disorders arising due to risk factors shared with MUD. Reviewed comorbidities were frequently associated with worse treatment outcomes. Conclusions: The limited evidence is in stark contrast to the presumably high prevalence and relevance of comorbid mental disorders in adolescents with MUD. Suggestions for future research topics, informed by adult findings, include genetic vulnerabilities, biological changes, and consequences of different use patterns. Surprisingly few MUD treatment programs explicitly integrate comorbid mental disorder modules.
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Affiliation(s)
- Sören Kuitunen-Paul
- Research Group Stress and Addiction, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Research Group Stress and Addiction, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Lukas A Basedow
- Research Group Stress and Addiction, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Yulia Golub
- Research Group Stress and Addiction, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Turvey CL, Lund BC, Jones D, Arndt S. Community Treatment for Opioid Use Disorders in Urban and Rural Veterans. J Rural Health 2020; 36:167-176. [DOI: 10.1111/jrh.12406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Carolyn L. Turvey
- Department of Veterans AffairsOffice of Rural Health Rural Resource Center Iowa City Iowa
- Iowa City VA Health Care SystemComprehensive Access and Delivery Research and Evaluation Center Iowa City Iowa
- Department of PsychiatryUniversity of Iowa Roy J. and Lucille A. Carver College of Medicine Iowa City Iowa
| | - Brian C. Lund
- Iowa City VA Health Care SystemComprehensive Access and Delivery Research and Evaluation Center Iowa City Iowa
- Department of EpidemiologyUniversity of Iowa College of Public Health Iowa City Iowa
| | - DeShauna Jones
- Iowa Consortium for Substance Abuse Research and EvaluationUniversity of Iowa Iowa City Iowa
| | - Stephan Arndt
- Department of PsychiatryUniversity of Iowa Roy J. and Lucille A. Carver College of Medicine Iowa City Iowa
- Department of BiostatisticsUniversity of Iowa Roy J. and Lucille A. Carver College of Medicine Iowa City Iowa
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Daniulaityte R, Silverstein SM, Crawford TN, Martins SS, Zule W, Zaragoza AJ, Carlson RG. Methamphetamine Use and Its Correlates among Individuals with Opioid Use Disorder in a Midwestern U.S. City. Subst Use Misuse 2020; 55:1781-1789. [PMID: 32441178 PMCID: PMC7473491 DOI: 10.1080/10826084.2020.1765805] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: U.S. is experiencing a surging trend of methamphetamine use among individuals who use opioids. More research is needed to characterize this emerging "twin epidemic." Objectives: The study aims to identify social and behavioral characteristics associated with methamphetamine use among individuals with opioid use disorder (OUD) in the Dayton, Ohio, area, an epicenter of the opioid crisis and an emerging frontier of methamphetamine epidemic. Methods: 357 adult individuals with current OUD were recruited using targeted and respondent-driven sampling. Structured interviews collected information on social and drug use characteristics. Multivariable Logistic Regression was used to identify characteristics associated with the past 6-month use of methamphetamine. Results: 49.7% were female, and 88.8% were non-Hispanic whites. 55.6% used methamphetamine in the past 6-months, and 84.9% reported first use of methamphetamine after initiation of illicit opioids. Methamphetamine use was associated with homelessness (aOR = 2.46, p = .0001), lifetime history of diverted pharmaceutical stimulant use (aOR = 2.97, p < .001), injection route of heroin/fentanyl use (aOR = 1.89, p = .03), preference for fentanyl over heroin (aOR = 1.82, p = .048), lifetime history of extended-release injectable naltrexone (Vivitrol)-based treatment (aOR = 2.89, p = .003), and more frequent marijuana use (aOR = 1.26, p = .04). Discussion: The findings point to the complexity of motivational and behavioral pathways associated with methamphetamine and opioid co-use, ranging from self-treatment and substitution behaviors, attempts to endure homelessness, and greater risk taking to experience euphoria. More research is needed to understand the causal relationships and the association between methamphetamine and Vivitrol use. Public health responses to the opioid crisis need to be urgently expanded to address the growing epidemic of methamphetamine use.
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Affiliation(s)
| | - Sydney M Silverstein
- Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, USA
| | - Timothy N Crawford
- Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, USA
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, New York, USA
| | - William Zule
- Center for Global Health, International, Research Triangle Park, Durham, North Carolina, USA
| | - Angela J Zaragoza
- Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, USA
| | - Robert G Carlson
- Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, USA
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Vidal S, Décary-Hétu D. Shake and Bake: Exploring Drug Producers’ Adaptability to Legal Restrictions Through Online Methamphetamine Recipes. JOURNAL OF DRUG ISSUES 2018. [DOI: 10.1177/0022042617751685] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite numerous regulations, methamphetamine consumption persists; its availability has even increased in the United States. Methamphetamine is produced in small labs and super labs that are differentiated by the quantity of drug they generate and by how they are embedded in trafficking networks. The stagnant statistics regarding methamphetamine consumption and lab seizures suggest that laws have been ineffective, partly due to the producers’ adaptability. To understand this adaptation, methamphetamine recipes collected online will be analyzed through a qualitative methodology. Emphasis will be placed on the impact of the American legislation toward synthetic drug production. This article describes how methamphetamine producers have adapted to get around the regulations. The producers synthesize the regulated precursors by extracting them from processed products. To comply with the quotas imposed by law, the producers limit their quantities used. This article suggests that producers keep abreast of legislations and perfect the recipes accordingly.
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Flynn KC, Hoffer LD. Transitioning illicit drug preferences and emerging user identities in Ohio: The proliferation of methamphetamine use among African Americans. J Ethn Subst Abuse 2017; 18:67-88. [PMID: 28678637 DOI: 10.1080/15332640.2017.1325809] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Understanding the social dynamics of local methamphetamine markets is critical to improving community health and reducing social costs associated with illicit drug use. We examine a local drug market in Summit County, Ohio, wherein methamphetamine users ascribe themselves different ethnic identities from those long associated with the drug elsewhere in the United States. Qualitative interviews with 52 study participants demonstrate that very poor and homeless White males and females are now using methamphetamine; however, even more surprising is that 31 of the participants identified themselves as poor or homeless, male or female African, Native, biracial, or multiracial Americans. The drug use trajectory of these 31 participants in particular involved a transition from a historical preference for crack to a present one for methamphetamine and, in some cases, a preference for concurrent use of methamphetamine and heroin. Many of these methamphetamine users also emphasized their ethnic identity to distinguish themselves as nonproducers of methamphetamine in comparison to Whites, who are commonly associated with methamphetamine production. Findings appear to suggest an emergent means of identity management resulting from the ethnic diversity of users in this methamphetamine market. These findings may have relevance in other communities with similar demographics and drug markets and may hold important implications for drug treatment, policy-making, and law enforcement professionals' work associated with methamphetamine users, producers, and distributors.
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Affiliation(s)
| | - Lee D Hoffer
- a Case Western Reserve University , Cleveland , Ohio
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11
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Cunningham S, Finlay K, Stoecker C. Is Mississippi's prescription-only precursor control law a prescription to decrease the production and raise the price of methamphetamine? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:1144-9. [PMID: 26187186 DOI: 10.1016/j.drugpo.2015.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 05/14/2015] [Accepted: 05/28/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND In 2010, Mississippi became the second state to require a prescription to purchase pseudoephedrine-based medications. Proponents of "prescription-only" laws argue that they are necessary to disrupt methamphetamine markets, but critics note the costs to legal consumers of cold medications may offset some of the laws' intended benefits. OBJECTIVE We evaluated the effect of prescription-only restrictions for methamphetamine precursors on state-level methamphetamine lab seizures and methamphetamine prices. METHODS We used a synthetic control approach to create a control state comparable to Mississippi and then used permutation testing to determine if the resulting difference was statistically significant. RESULTS We found that Mississippi's prescription-only law removed 2637 small methamphetamine labs in the two years after the law became effective, which represents a 77% reduction in small labs relative to the synthetic counterfactual. We found no evidence that the law impacted methamphetamine prices. CONCLUSION We conclude that while prescription-only laws can reduce the number of domestic small methamphetamine labs in operation, methamphetamine availability is unlikely to be materially impacted.
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Affiliation(s)
- Scott Cunningham
- Department of Economics, Baylor University, Waco, TX, United States
| | - Keith Finlay
- Department of Economics, Tulane University, New Orleans, LA, United States
| | - Charles Stoecker
- Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States.
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McDermott MJ, Drescher CF, Smitherman TA, Tull MT, Heiden L, Damon JD, Hight TL, Young J. Prevalence and sociodemographic correlates of lifetime substance use among a rural and diverse sample of adolescents. Subst Abus 2014; 34:371-80. [PMID: 24159908 DOI: 10.1080/08897077.2013.776000] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Data are limited regarding the prevalence of substance use among adolescents in rural and ethnically diverse communities. This study examined rates and sociodemographic correlates of lifetime substance use among adolescents in Mississippi, a rural state that is the poorest in the country (21.3% poverty rate) and has the largest proportion of African Americans per capita (36.3%). METHODS Participants in this cross-sectional study were 6349 adolescents (6th through 12th grade) who reported on lifetime tobacco, alcohol, marijuana, cocaine, inhalant, hallucinogen, and methamphetamine use. RESULTS Lifetime smoking (10.2% to 44.5%), alcohol (23.2% to 72.0%), and marijuana use (7.9% to 39.2%) increased steadily when comparing students in 6th to 12th grade. Substances with more serious abuse potential (cocaine [6.7% to 11.1%], inhalants [12.2% to 17.9%], hallucinogens [4.4% to 12.1%], and methamphetamine [3.0% to 6.7%]) displayed more modest increases across grade. Adolescents who classified their race/ethnicity as "Other" (i.e., not white, black/African American, Asian, or Hispanic/Latino/Latina) demonstrated more than 2-fold increased likelihood of methamphetamine use (odds ratio [OR] = 2.42), and increased risk for use of any illicit substance (OR = 1.49). In general, males demonstrated an increased risk for use across substances (OR = 1.15-1.94), and higher income was associated with a decreased likelihood of illicit substance use (OR = 0.51-0.67). Living in a more populated area was associated with an increased likelihood of alcohol (OR = 1.43), marijuana (OR = 2.11), and cocaine use (OR = 2.06), and use of any illicit substance (OR = 1.54). CONCLUSIONS Mississippi adolescents reported higher rates of lifetime cocaine, inhalant, hallucinogen, and methamphetamine use across all grade levels compared with national surveys. Male gender, low income, and residence in more populated areas were associated with increased use of several substances. Findings demonstrate the need for prevention and intervention programs targeting impoverished rural and ethnically diverse communities.
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Affiliation(s)
- Michael J McDermott
- a Department of Psychology , University of Mississippi , University , Mississippi , USA
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Abstract
Recent media portrayals of methamphetamine (meth) suggest that its use is relatively rare among Black drug users. Our aim with the current research is to explore the reasons why Black women stimulant users abstain from using meth. We rely on semi-structured interviews with 33 Black women whose drug of choice was cocaine and who had never or rarely used meth. These women said that they did not use meth because they had limited access to the drug, feared the chemicals used in production, disliked the immediate sensations, and feared the long-term consequences on their health. The limited access to meth led these stimulant users to rely on stereotypes of meth that the drug is made from toxic materials and that it causes rapid deterioration in users’ appearances. We argue that these factors contribute to meth use being stigmatized in Black communities, thereby acting as a protective factor in discouraging use among Black stimulant users.
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Zule WA, Poulton WE, Coomes CM, Mansergh G, Charania M, Wechsberg WM, Jones HE. Results of a pilot study to reduce methamphetamine use and sexual risk behaviors among methamphetamine-using men who have sex with men (MSM) not currently in treatment. J Psychoactive Drugs 2013; 44:351-8. [PMID: 23457885 DOI: 10.1080/02791072.2012.736794] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Methamphetamine use, which has been linked to unprotected anal intercourse and incident HIV infection, is an important contributor to HIV transmission among men who have sex with men (MSM). The purpose of this study was to develop and pilot test a single-session motivational interviewing (MI) intervention for reducing HIV risk among an out-of-treatment sample of MSM who use methamphetamine. MSM who use methamphetamine (n = 39) were recruited in 2008 and 2009 in North Carolina. They completed baseline data collection and a single-session MI intervention. Eighty percent completed a follow-up interview two months after enrollment. Men reported reductions in methamphetamine use during the previous 60 days from an average of 9.4 days at baseline to 3.3 days at follow-up (p < 0.05) and unprotected anal intercourse from an average of 4.8 sex partners during the previous 60 days at baseline to 2.9 at follow-up (p < 0.05). Self-reported unprotected anal intercourse at last sex with a nonprimary partner decreased significantly (from 81% at baseline to 25% at follow-up; p = 0.001). These results suggest that a single-session MI intervention may be useful for reducing methamphetamine use and sexual risk among MSM who use methamphetamine, especially in settings where multisession interventions are not feasible.
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Affiliation(s)
- William A Zule
- Substance Abuse Treatment Evaluations and Interventions Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 7709-2194, USA.
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Oser C, Leukefeld C, Staton-Tindall M, Duvall J, Garrity T, Stoops W, Falck R, Wang J, Carlson R, Sexton R, Wright P, Booth B. Criminality Among Rural Stimulant Users in the United States. CRIME AND DELINQUENCY 2011; 57:600-621. [PMID: 21686091 PMCID: PMC3115620 DOI: 10.1177/0011128708325048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Despite the increase in media attention on "meth cooking" in rural areas of the United States, little is known about rural stimulant use, particularly the criminality associated with stimulant use. Data were collected from community stimulant users in rural Ohio, Arkansas, and Kentucky (N=709). Findings from three logistic regression models indicate that younger stimulant users (x =32.55, SD = 10.35), those with more convictions, and those who used crack frequently were significantly more likely to have been arrested for committing a substance-related crime, a property crime, or another crime in the 6-months before entering the study. Implications include the need for longitudinal studies to further understand rural stimulant use as well as increasing community and corrections-based drug abuse prevention and treatment interventions for stimulant users who live in rural areas.
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Affiliation(s)
- Carrie Oser
- Assistant Professor, Department of Sociology, 1531 Patterson Office Tower, University of Kentucky, Lexington, KY, 40506, , Phone: 859-323-3792, Fax: 859-323-1193
| | - Carl Leukefeld
- Professor, Department of Behavioral Science, 111 College of Medicine Office Building, University of Kentucky, Lexington, KY, 40506, , Phone: 859-257-2355, Fax: 859-323-1193
| | - Michele Staton-Tindall
- Assistant Professor, College of Social Work, 672 Patterson Office Tower, University of Kentucky, Lexington, KY, 40506, , Phone: 859-257-2483, Fax: 859-323-1193
| | - Jamieson Duvall
- Post-doctoral Fellow, Department of Behavioral Science, 643 Maxwelton Court, University of Kentucky, Lexington, KY, 40506, , Phone: 859-533-1233, Fax: 859-323-1193
| | - Thomas Garrity
- Professor, Department of Behavioral Science, 120 College of Medicine Office Building, University of Kentucky, Lexington, KY, 40506, , Phone: 859-323-6100, Fax: 859-323-5350
| | - William Stoops
- Post-doctoral Fellow, Department of Behavioral Science, 105 College of Medicine Office Building, University of Kentucky, Lexington, KY, 40506, , Phone: 859-257-5388, Fax: 859-323-5350
| | - Russel Falck
- Assistant Professor, Center for Interventions, Treatment and Addictions Research, Department of Community Health, Medical Sciences Building, 110, Wright State University, Dayton, OH, 45435, , Phone: 937-775-2066, Fax: 937-775-2214
| | - Jichuan Wang
- Professor, Center for Interventions, Treatment and Addictions Research, Department of Community Health, Medical Sciences Building 110, Wright State University, Dayton, OH, 45435, , Phone: 937-775-2066, Fax: 937-775-2214
| | - Robert Carlson
- Professor and Director, Center for Interventions, Treatment and Addictions Research, Department of Community Health, Medical Sciences Building 110, Wright State University, Dayton, OH, 45435, , Phone: 937-775-2066, Fax: 937-775-2214
| | - Rocky Sexton
- Research Assistant Professor, Department of Community Health, Medical Sciences Building 110, Wright State University, Dayton, OH, 45435, , Phone: 937-775-2066, Fax: 937-775-2214
| | - Patricia Wright
- Project Director, Division of Health Services Research, Department of Psychiatry, University of Arkansas for Medical Sciences, HSR&D Center for Mental Healthcare Outcomes and Research Central Arkansas Veterans Healthcare System, 5800 W. 10th St, Suite 605, Little Rock, Arkansas, 72204, , Phone: 501-686-5483, Fax: 501-686-8154
| | - Brenda Booth
- Professor, Division of Health Services Research, Department of Psychiatry, University of Arkansas for Medical Sciences, HSR&D Center for Mental Healthcare Outcomes and Research Central Arkansas Veterans Healthcare System, 5800 W. 10th St, Suite 605, Little Rock, Arkansas, 72204, , Phone: 501-686-5483, Fax: 501-686-8154
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Daniulaityte R, Falck R, Wang J, Carlson RG, Leukefeld CG, Booth BM. Predictors of depressive symptomatology among rural stimulant users. J Psychoactive Drugs 2010; 42:435-45. [PMID: 21305908 PMCID: PMC3320035 DOI: 10.1080/02791072.2010.10400706] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study examined sociodemographic and drug-related predictors of depressive symptoms among a rural, multistate sample of not-in-treatment stimulant drug users (n=710). Participants were recruited using respondent-driven sampling in Ohio, Arkansas, and Kentucky. The Patient Health Questionnaire (PHQ-9) was used to measure symptoms of depression. Moderate to severe depressive symptomatology was reported by 43.0% of the sample. Cumulative logistic regression analysis showed that daily and nondaily crack use as well as the daily use of cocaine HCl increased the odds of depressive symptoms. Methamphetamine use had no significant association with depression. The daily use of marijuana, the illicit use of tranquilizers, light/moderate cigarette smoking, and injection drug use also increased the risk of depressive symptoms. Living in Kentucky or Ohio (compared to Arkansas), having unstable living arrangements, and being White, female, and older were related to higher odds of depressive symptoms. These results suggest that a host of drug and nondrug factors need to be considered when addressing depressive symptoms in stimulant users.
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Affiliation(s)
- Raminta Daniulaityte
- Center for Interventions, Treatment, and Addiction Research, Department of Community Health, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, USA.
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17
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Gizzi MC, Gerkin P. Methamphetamine use and criminal behavior. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2010; 54:915-936. [PMID: 19910511 DOI: 10.1177/0306624x09351825] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This research seeks to broaden our understanding of methamphetamine's (meth's) place within the study of drugs and crime. Through extensive court records research and interviews with 200 offenders in local jails in western Colorado, this research contributes to the creation of a meth user profile and begins to identify the place of meth in the drug-crime nexus. The study compares the criminal behavior of meth users with other drug users, finding that meth users are more likely than other drug users to be drunk or high at the time of arrest and claim their crimes were related to drug use in other ways. A content analysis of criminal records demonstrates that meth users have more extensive criminal records and are more likely than other drug users to commit property crimes.
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Affiliation(s)
- Michael C Gizzi
- Department of Criminal Justice Sciences, Illinois State University, Normal, IL 61790-5250, USA.
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Sexton RL, Carlson RG, Leukefeld CG, Booth BM. "Tweaking and geeking, just having some fun": an analysis of methamphetamine poems. J Psychoactive Drugs 2010; 42:377-83. [PMID: 21053760 DOI: 10.1080/02791072.2010.10400700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
There is a body of methamphetamine-themed poetry that speaks regretfully of the highly negative experiences of those in recovery from methamphetamine (MA) addiction or who feel trapped in an MA-using lifestyle. During ethnographic research in western Kentucky, the author collected two MA-themed poems from active MA users that differ from other MA poetry. They describe misadventures that occur during MA "binges." However, the text and tone of the poems are comically ironic and represent optimism rather than regret toward MA use. Analyzing these poems provides valuable insights into local patterns of MA use, related terminology, and attitudes toward MA use.
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Affiliation(s)
- Rocky L Sexton
- Department of Anthropology, Ball State University, Muncie, IN 47306, USA.
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Zule WA, Coomes CM, Karg R, Harris JL, Orr A, Wechsberg WM. Using a modified intervention mapping approach to develop and refine a single-session motivational intervention for methamphetamine-using men who have sex with men. Open AIDS J 2010; 4:132-40. [PMID: 20657716 PMCID: PMC2908891 DOI: 10.2174/1874613601004030132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 11/15/2009] [Accepted: 11/25/2009] [Indexed: 11/22/2022] Open
Abstract
There is an ongoing need for the development and adaptation of behavioral interventions to address behaviors related to acquisition and transmission of infectious diseases and for preventing the onset of chronic diseases. This paper describes the application of an established systematic approach to the development of a behavioral intervention to reduce sexual risk behaviors for HIV among men who have sex with men and who use methamphetamine. The approach includes six steps: (1) a needs assessment; (2) preparing matrices of proximal program objectives; (3) selecting theory-based methods and practical strategies; (4) producing program components and materials; (5) planning for program adoption, implementation, and sustainability; and (6) planning for evaluation. The focus of this article is on the intervention development process; therefore the article does not describe steps 5 and 6. Overall the process worked well, although it had to be adapted to fit the sequence of events associated with a funded research project. This project demonstrates that systematic approaches to intervention development can be applied even in research projects where some of the steps occur during the proposal writing process rather than during the actual project. However, intervention developers must remain flexible and be prepared to adapt the process to the situation. This includes being ready to make choices regarding intervention efficacy versus feasibility and being willing to select the best intervention that is likely to be delivered with available resources rather than an ideal intervention that may not be practical.
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Affiliation(s)
- William A Zule
- Behavioral Health and Criminal Justice Research Division, RTI International, 3040 Cornwallis Rd., Research Triangle Park, NC 27709-2194, USA
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Carlson RG, Sexton R, Wang J, Falck R, Leukefeld CG, Booth BM. Predictors of substance abuse treatment entry among rural illicit stimulant users in Ohio, Arkansas, and Kentucky. Subst Abus 2010; 31:1-7. [PMID: 20391264 PMCID: PMC2856131 DOI: 10.1080/08897070903442459] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Illicit drug use in the rural United States is increasingly common, yet little is known about drug users' treatment-seeking behaviors. This study identifies predictors of substance abuse treatment entry over 24 months among 710 illicit stimulant users in rural areas of Ohio, Arkansas, and Kentucky. Active users of powdered cocaine, crack cocaine, and/or methamphetamine (MA) were recruited using respondent-driven sampling. Participants completed structured interviews at baseline and follow-up questionnaires every 6 months for 24 months. Data were analyzed using the Cox proportional hazards model. The paper is informed by the Anderson-Newman Model. Overall, 18.7% of the sample entered treatment. Ohio or Kentucky residence, perceived need for substance abuse treatment, higher Addiction Severity Index (ASI) legal problem composite scores, prior substance abuse treatment, and tranquilizer use were positively associated with treatment entry. Nondaily crack cocaine users and marijuana users were less likely to enter treatment. The findings can help inform rural substance abuse treatment program development and outreach.
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Affiliation(s)
- Robert G Carlson
- Boonshoft School of Medicine, Center for Interventions, Treatment, and Addiction Research, Wright State University, Dayton, Ohio 45435, USA.
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21
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Sexton RL, Carlson RG, Leukefeld CG, Booth BM. An ethnographic exploration of self-reported violence among rural methamphetamine users. J Ethn Subst Abuse 2009; 8:35-53. [PMID: 19266373 DOI: 10.1080/15332640802683409] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Baseline and follow-up qualitative interviews with methamphetamine users in rural Kentucky and Arkansas examined their involvement in drug-related violence. Twelve baseline participants reported methamphetamine-related violence, whereas 20 reported violence linked to other substances. In follow-up interviews conducted 12 to 24 months later, four participants reported methamphetamine-related violence and three reported violence associated with other substances. Violence was rarely directly attributed to methamphetamine's psychoactive effects. Rather, violence was associated with disputes over methamphetamine or its use, paranoia, ill-tempers, and hallucinations during methamphetamine "binges." Implications of the findings for additional research and interventions are discussed.
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Affiliation(s)
- Rocky L Sexton
- Department of Community Health, Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA.
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22
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Sexton RL, Carlson RG, Leukefeld CG, Booth BM. Barriers to formal drug abuse treatment in the rural south: a preliminary ethnographic assessment. J Psychoactive Drugs 2008; 40:121-9. [PMID: 18720660 DOI: 10.1080/02791072.2008.10400621] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This article describes barriers to obtaining drug abuse treatment in the rural South using qualitative interviews conducted with 86 illicit stimulant users recruited in rural Arkansas and Kentucky between 2003 and 2005. Fifty-nine (69.0%) of the interviewees had never entered drug abuse treatment. Sixteen (19.0%) participants reported current perceived need for treatment, while seven (8%) were ambivalent about seeking it. Interview data suggest five interrelated categories of barriers to accessing drug abuse treatment: (1) geographical, (2) organizational, (3) economic, (4) social, and (5) psychological. The study findings can inform further examination of rural treatment barriers and have important implications for developing strategies to overcome these obstacles.
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Affiliation(s)
- Rocky L Sexton
- Center for Interventions, Treatment and Addictions Research, Department of Community Health, Wright State University Boonshoft School of Medicine, Dayton, OH 45435, USA.
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23
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Daniulaityte R, Carlson RG, Kenne DR. Methamphetamine Use in Dayton, Ohio: Preliminary Findings from the Ohio Substance Abuse Monitoring Network. J Psychoactive Drugs 2007; 39:211-21. [DOI: 10.1080/02791072.2007.10400607] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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