Methamphetamine-2023
Methamphetamine
Overview
Methamphetamines are powerful stimulants chemically related to
amphetamines. Methamphetamines can be taken orally, smoked, injected, or
snorted, and are available as a crystalline powder or in rock-like chunks.
Smoking or injecting the drug creates a rapid reaction in the brain, causing a
feeling of intense pleasure after use. After ingestion, methamphetamine
causes the brain to increase the amount of the neurotransmitter dopamine.3
The rapid release of dopamine, combined with methamphetamine’s short
“rush,” lead to high rates of substance use disorders (SUD) among users.
Prolonged use of methamphetamine can change the structure of the brain as
normal reactions to dopamine cease to function.4
Though primarily produced and used illicitly, a legal, Food and Drug
Administration (FDA)-approved form of methamphetamine can be prescribed
to treat attention deficit hyperactivity disorder (ADHD) or obesity.
5 However,
prescriptions are rare, and doses of the FDA-approved drug are much lower
than illicit forms.5 Methamphetamine is classified as a Schedule II drug, and
prescriptions cannot be automatically refilled.
According to the National Survey on Drug Use and Health (NSDUH), 1.6
million Americans used methamphetamine in 2021, a 45.5% increase
from 2019, when 1.1 million individuals used methamphetamine. Those who
use methamphetamine tend to be older, with 92% of people who used
methamphetamine in 2021 being over the age of 26.
2 Additionally, the Centers
for Disease Control and Prevention (CDC) reported that in 2021, 32,537
individuals died of a psychostimulant overdose, primarily methamphetamine.
6
Death rates have been increasing steadily since 2014.
6
Public Health Impact
Illicit methamphetamine use poses a significant threat to public health. Longterm methamphetamine use is associated with anxiety, paranoia, confusion,
psychosis, weight loss, dental problems, and skin sores caused by
persistent scratching. Methamphetamine use has also been linked to the
spread of HIV and Hepatitis B and C, as users may share needles. Other
health effects include increased wakefulness and physical activity, decreased
appetite, increased respiration, rapid heart rate, irregular heart-beat, and
increased body temperature.4
Overdose is a very serious risk for anyone who uses methamphetamine
because the resulting acute cardiac distress and potential chronic medical
events, including psychotic conditions, can be fatal. According to a study by
the National Institute on Drug Abuse (NIDA), overdose deaths involving
methamphetamine among people aged 18-64 in the United States nearly
tripled from 2015 to 2019.7 Additionally, the researchers found that the number
of overdose deaths involving psychostimulant drugs other than cocaine, which
largely consisted of methamphetamine, rose 180% from 5,526 to 15,489 over
that same period.
7 Provisional CDC data for the 12-months ending in April
2023 reports 34,313 drug overdose deaths involving psychostimulants with a
potential for misuse, the majority of which also involved methamphetamine.8
Methamphetamine Use: A
Closer Look
Treatment Admissions: In 2020, 11.8%
(167,722) of individuals admitted to treatment
in the U.S. reported methamphetamines as
their primary substance of use.1
National Survey on Drug Use and Health
(NSDUH) 2021 Data:
Past Month Use of Illicit Drugs, U.S. Population2
Illicit Drugs Use
% (estimate)
Marijuana 13% (36,363,000)
Opioids 1.0% (2,791,000)
Cocaine 0.7% (1,833,000)
Tranquilizers or
Sedatives
0.5% (1,373,000)
Hallucinogens 0.8% (2,234,000)
Methamphetamine 0.6% (1,617,000)
Inhalants 0.3% (830,000)
Past Month Use, Methamphetamine By Age2
Age Use
% (estimate)
12-17 0.87% (14,000)
18-25 5.57% (90,000)
26-49 50.46% (816,000)
50 or older 43.1% (697,000)
Past Month Use, Methamphetamine By Gender,
12 and Older2
Gender Use
% (estimate)
Female 39.0% (630,000)
Male 61.0% (987,000)
Treatment Admissions,
Methamphetamine/Amphetamines*
By Race/Ethnicity, 12 and Older1
Primary
Race/Ethnicity
Use
% (estimate)
White 77.0% (133,354)
Black 6.7% (11,643)
Asian 0.8% (1,429)
Am. Indian/AK
Native
3.3% (5,788)
Native Hawaiian or
Other Pacific
Islander
0.7% (1,247)
Other 11.4% (19,669)
Hispanic 17.5% (30,453)
*Amphetamine admissions include admissions for both
methamphetamine and amphetamine but are primarily
for methamphetamine. Methamphetamine constitutes
about 95% of combined methamphetamine/
amphetamine admissions.
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The risk of overdose death from methamphetamine use is compounded by the co-use, intentional or accidental, of
methamphetamine with synthetic opioids, primarily heroin and illicitly manufactured fentanyl (IMF), due to the
opposing impacts of the increased arousal from methamphetamine and sedation from opioids raising the risk of
overdose.9 Provisional CDC data reports that 61.2% of methamphetamine overdose deaths in 2021 co-involved
heroin or fentanyl- an all-time high.
10 Compared to the 180% rise in overdose deaths involving psychostimulants
other than cocaine from 2015 to 2019, overdose deaths involving psychostimulants other than cocaine with
opioids increased 266% from 2,306 to 8,438 over that same period.
7
The steady year-over-year rise in methamphetamine use poses a substantial public health risk. NIDA found that
from 2015 to 2019, the number of people who reported using methamphetamine increased by 43% despite the
180% increase in overdose deaths involving methamphetamine.7 NIDA also found that the number of people who
reported methamphetamine use and opioid misuse had an accompanying proportional increase of 24% from 2015
to 2019.
7 Further, NIDA’s data shows that over that same four-year period, those reporting frequent
methamphetamine use, defined as 100 days or more per year, rose by 66%.7 This increase was also seen in
concurrent methamphetamine and cocaine use, with a 60% increase in use reported between 2015 and 2019.7
Methamphetamine Treatment
Although methamphetamine use can have devastating consequences, evidence-based treatment strategies exist
to help individuals recover. NIDA identifies behavioral therapies, such as cognitive-behavioral therapy (CBT) and
contingency management, as effective treatments for methamphetamine use disorders. Individuals in CBT learn
to anticipate problems and enhance their self-control through the development of coping strategies, including the
exploration of positive and negative consequences of substance use; self-awareness to recognize potential
cravings; and, strategies to cope with those cravings.11 Contingency management, an incentive-based
intervention, involves giving individuals tangible rewards to reinforce positive behaviors, such as producing a
negative drug test.
12 Additionally, individual and family education; a supportive therapeutic relationship; drug
testing; and 12-step programs, are also useful in managing methamphetamine use.
12 All of these interventions
are included in the manualized Matrix model.
No FDA-approved medication currently exists to treat methamphetamine use disorder. NIDA is conducting
research on medications to treat methamphetamine and other stimulant use disorders. Medications are currently
being tested that inhibit self-administration of methamphetamine, though no human trials have been conducted.
Other studies are working on approaches that utilize the immune system to neutralize methamphetamine in the
bloodstream before it reaches dopamine receptors. This approach includes vaccinating patients to produce
antibodies that fight methamphetamine molecules. Research continues to progress in this area.12
Geographic Trends in Methamphetamine Use
Methamphetamine treatment admission rates
were higher in 2010 than in 2020 in five States.
However, 20 States experienced greater than a
100% increase in admission rates between 2010
and 2020. The West North Central region (IA,
KS, MN, MO, NE, ND, SD) had the highest
methamphetamine treatment admission rates in
2020 (211 per 100,000 population aged 12 and
older), maintaining its position as the region of
the U.S. with the highest methamphetamine
treatment admission rates since it surpassed the
Pacific region in 2014.
1
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The Role of State Alcohol and Drug Agencies in Prevention, Treatment, and Recovery
State Alcohol and Drug Agency directors design, manage, and evaluate the publicly funded SUD prevention,
treatment, and recovery system in each State. State Directors provide leadership by promoting standards of care,
evidence-based services, and continuous quality improvement innovations. State Directors also ensure that public
dollars are dedicated to programs that work through the use of performance data management and reporting,
contract monitoring, corrective action planning, on-site reviews, and technical assistance.
Key Federal Programs and Agencies
SAMHSA’s Substance Use Prevention, Treatment, and Recovery Services (SUPTRS) Block Grant is a
formula grant awarded to every U.S. State and Territory. The SUPTRS Block Grant accounts for an estimated
52% of State Alcohol and Drug Agencies’ expenditures on primary prevention.13 SUPTRS Block Grant funds
enabled more than 1.5 million Americans to receive treatment services in 2022. In addition, more than 11.8 million
Americans received SUPTRS Block Grant-funded prevention services in individual-based programs, and more
than 370 million (duplicated count of persons) were served in population-based programs in 2022.
14
In 2021, at
discharge from block grant-funded programs, 50% of clients reported abstinence from illegal drug use, 77% were
abstinent from alcohol use, 91% had stable housing, and 94% had no arrests during the prior 30 days.
15
Congress appropriated $2,008,079,000 for the SUPTRS Block Grant in FY 2023.
16
The State Opioid Response (SOR) Grant, which is administered by SAMHSA and managed by the State
Alcohol and Drug Agencies, is used to provide prevention, treatment, and recovery services for individuals with an
opioid use disorder (OUD). Specifically, SOR aims to address the opioid crisis by increasing access to
medication-assisted treatment (MAT), reducing unmet treatment need, and reducing opioid overdose related
deaths. Beginning in FY 2023, services to address stimulant use—which includes methamphetamine use—
became an allowable use of the SOR grants. Congress appropriated $1.575 billion for SOR in FY 2023.
16
SAMHSA’s Center for Substance Abuse Prevention (CSAP) leads efforts to prevent substance use. CSAP’s
Strategic Prevention Framework – Partnerships for Success (SPF-PFS) Program provides funding for States to
develop comprehensive statewide approaches to address SUD-related issues unique to that State. Congress
appropriated $237 million for CSAP in FY 2023.
16
SAMHSA’s Center for Substance Abuse Treatment (CSAT) works to improve and expand existing SUD
treatment programs under the SUPTRS Block Grant. Congress appropriated $574 million for CSAT in FY 2023.
16
The Office of National Drug Control Policy (ONDCP) provides federal leadership on SUD prevention,
treatment, and recovery policy. ONDCP also administers two grant programs: High Intensity Drug Trafficking
Areas (HIDTA) and Drug-Free Communities (DFC). The HIDTA program assists federal, State, local, and tribal
law enforcement that operate in areas determined to be critical drug trafficking regions of the United States. The
DFC program provides grants to community coalitions to strengthen the infrastructure among local partners to
create and sustain a reduction in local youth substance use and SUD. Congress appropriated $471 million for
ONDCP in FY 2023.
16
For more information, contact: Robert Morrison, Executive Director, at rmorrison@nasadad.org, or Daniel Diana, Legislative Coordinator, at
ddiana@nasadad.org.
Special thanks to Shalini Wickramatilake for her contributions to this fact sheet.
1919 Pennsylvania Avenue, NW, M-250 • Washington, DC 20006 • T: 202-293-0090 • F: 202-293-1250 • Website: www.nasadad.org
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References
1. Center for Behavioral Health Statistics and Quality (CBHSQ), Substance Abuse and Mental Health Services Administration (SAMHSA). (2022). Treatment Episode Data Set (TEDS) 2020.
Admission to and Discharges from Publicly Funded Substance Use Treatment Facilities. https://www.samhsa.gov/data/sites/default/files/reports/rpt38665/2020_TEDS%20Annual%20Report508%20compliant_1182023_FINAL.pdf.
2. SAMHSA. (2022). Key Substance Use and Mental Health Indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (NSDUH).
https://www.samhsa.gov/data/sites/default/files/reports/rpt39443/2021NSDUHFFRRev010323.pdf.
3. National Institute on Drug Abuse (NDA). (2019). Methamphetamine DrugFacts. http://www.drugabuse.gov/publications/drugfacts/methamphetamine.
4. NIDA. (2019). What are the long-term effects of methamphetamine misuse? https://nida.nih.gov/publications/research-reports/methamphetamine/what-are-long-term-effects-methamphetaminemisuse.
5. Food and Drug Administration (FDA). (2007). Desoxyn: Methamphetamine Hydrochloride Tablets, USP. http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/005378s026lbl.pdf.
6. NIDA. (2023). Drug Overdose Death Rates. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates.
7. Han, B, Compton, W. M., & Jones, C. M. (2021). Trends in Methamphetamine Use, Use Disorder, and Related Overdose Deaths Among Adults in the United States. JAMA Psychiatry,
78(12):1329-1342. https://www.doi.org/10.1001/jamapsychiatry.2021.2588.
8. CDC. (2023). Provisional Drug Overdose Death Counts. National Vital Statistics System. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm.
9. Doyle, S. (2020). Opioid Overdose Crisis Compounded by Polysubstance Use. Pew Charitable Trusts. https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2020/10/opioid-overdosecrisis-compounded-by-polysubstance-use#:~:text=Opioid%20use%20concurrent%20with%20the,either%20drug%20is%20used%20alone.
10. CDC. (2023). Multiple Cause of Death, 2021. CDC Wide-ranging Online Data for Epidemiologic Research (WONDER).
https://wonder.cdc.gov/controller/datarequest/D157;jsessionid=F51210F6222767EF61C3796470B1.
11. NIDA. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). https://nida.nih.gov/sites/default/files/675-principles-of-drug-addiction-treatment-a-research-basedguide-third-edition.pdf.
12. NIDA. (2019). What treatments are effective for people who misuse methamphetamine? https://nida.nih.gov/publications/research-reports/methamphetamine/what-treatments-are-effective-peoplewho-misuse-methamphetamine.
13. SAMHSA. (2020). Substance Use Prevention Treatment and Recovery Services (SUPTRS) Block Grant (BG) State Agency Reported Expenditures by Target Activity within Sources of Funds:
2020. Web Block Grant Application System (WebBGAS). https://bgas.samhsa.gov/Module/BGAS/Reports/ReportList?tempsession=a7a91c74-5f73-4305-86da-8cacd0bf850b&reportKey=1.
14. SAMHSA. (2022). Prevention Persons Served by Age Group and Gender – Individual Programs. WebBGAS. https://bgas.samhsa.gov/Module/BGAS/Page/Reports.aspx.
SAMHSA. (2022). Prevention Persons Served by Age Group and Gender – Population-Based Programs. WebBGAS. https://bgas.samhsa.gov/Module/BGAS/Page/Reports.aspx.
15. SAMHSA. (2021). Substance Use Prevention, Treatment, and Recovery Services Block Grant – Program Profile – National Outcome Measures (NOMs).
https://bgas.samhsa.gov/Module/BGAS/Page/Reports.aspx.
16. Consolidated Appropriations Act, 2023, Public Law No. 117-328. (2022). https://www.congress.gov/bill/117th-congress/house-bill/2617/text.
