The Methamphetamine Epidemic -- Less Than Meets the Eye

News consumers on the US East Coast can be forgiven for nervously glancing over their shoulders in search of that 20-foot wave of crystal meth rolling toward them out of the Midwest, leaving in its wake a shattered landscape of trailer parks turned into toxic dumps, runny-nosed neglected toddlers clutching worn teddy-bears, and good parents turned into crazed, toothless tweakers who take time off from cooking more meth only to commit heinous crimes, steal more supplies, or have sex with their children. After all, this is, with only a little exaggeration, the message trumpeted by an ever louder cacophony of news reports about the "methamphetamine epidemic" sweeping the nation.

Fortunately, there is less here than meets the eye. A review of the standard indicators of drug use, such as the Monitoring the Future (MTF) surveys of students, the National Household Survey (now known as the National Survey on Drug Use and Health), and the Drug Abuse Warning Network (DAWN) of hospital emergency room reports, does not show any rapid increase in methamphetamine use in recent years. In the MTF surveys, 15.4% of 12th graders in 1991 reported ever using amphetamines. By 1998, that figure had inched up to 16.4%, but by last year the figure had declined back to 15.0%, indicating that amphetamine use over the past decade has remained essentially flat. When MTF looked only at methamphetamine, which it separated out from other amphetamines only in 1999, it found that the percentage of seniors who reported ever using the drug actually declined from 8.2% in 1999 to 6.2% in 2004.

Similarly, the National Household Survey actually shows a tiny decline in reported non-medical stimulant use in 2002 and 2003, the most recent years for which data is available. According to the survey, 5.3% of people over 12 reported ever using amphetamines in 2002, while that figure was 5.2% the following year. That same survey found that the number of people who had ever used meth was 1.24 million in 2002 and 1.23 million the following year.

A longer-term review of reported life-time stimulant use from the survey is even more surprising. Going back to 1965, it shows hundreds of thousands of people reporting life-time use each year, peaking in 1974 at 646,000 and then dropping gradually over the next 20 years before bottoming out at 219,000 in 1991. [The drug-taking counterculture of the 1960s caught on quickly. Bob Dylan's slightly exotic speed user with "her fog, her amphetamine, and her pearls" was replaced by the end of the decade by Canned Heat's Amphetamine Annie: "Her mouth worked like a grinding mill, her lips were chapped and sore, she saw things in the windows, she heard things at the door." Ironically, Canned Head main man and lead vocalist Bob "Bear" Hite died of a barbiturate overdose shortly thereafter.] Since the early 1990s, the number of reported life-time users has climbed back to just slightly more than in 1974, peaking at 707,000 in 1999 and declining slightly to 697,000 in 2003. [Again, the new mood was reflected in song, with the Bay area band Primus singing of "Those Damned Blue-Collar Tweakers," whom they noted "are the backbone of this town." The tune is also notable for a swipe at then President Bush the Elder that applies again today: "And Curious George's drug patrol is still out there hunting snipe."]

A more direct measure of meth-related harm, the DAWN emergency room mentions, likewise paints a picture of flat -- not rapidly escalating -- methamphetamine use. According to the DAWN numbers, there were 17,537 methamphetamine mentions in 1994. Last year, that number was 17,696.

"There is no evidence of an increase in meth use. In fact, it's been flat for a decade or more or even declining slightly," said Craig Reinarman, co-editor of the groundbreaking "Crack in America," which debunked many of the myths surrounding that drug, and currently professor of sociology at the University of California at Santa Cruz. "To be fair, 2003 is the last year for which there is good data available, and this flood of meth stories appears to have really taken off in the last six months or so, so it is possible we are missing something. But most of these recent stories appear to be based on little more than anecdotes from law enforcement or social workers. It may be true that there is a small number of meth users who are getting in serious problems, but it looks like the press is falsely extrapolating to create a trend that is not supported by the aggregate numbers," he told DRCNet.

"This is the beginning of a classic scare where you have horrible anecdotes substituted for epidemiological evidence and the media going with those easy stories," Reinarman explained. "Story-based coverage can be very misleading. They pick the most dramatic story with the eye-catching headlines, but those sorts of stories distort the real picture. You don't want to mistake worst case scenarios for the norm, but that is what happens, and it's true of every drug scare. Instead of solid epidemiological evidence that can be tiresome and boring, you get these dramatic anecdotes."

"We in the field like to say that a Newsweek cover story is the surest sign the epidemic has ended," laughed Dr. David Duncan, chairman of the National Association for Public Health Policy's Council on Illicit Drugs and head of Duncan & Associates, a Kentucky-based epidemiological and statistical consulting firm. "We define an epidemic as an incidence significantly greater than the expected background level," he explained. "Five cases of bubonic plague in Chicago is an epidemic; 500 cases in Calcutta is not."

As for methamphetamine, said Duncan, "By that standard, we have experienced a methamphetamine epidemic for the past 20 years, where we've seen more meth use since the 1970s. But we are clearly on the downswing of the epidemic. Usage has been declining since 1999 and arrests have been going down since 2000. Despite all the publicity, they are actually arresting fewer people than they did five years ago," he told DRCNet. "Technically, it is an epidemic, but it is one that appears to be fading."

But even if meth use isn't on the rise, it's still a highly addictive drug whose users are not amenable to treatment, right? Wrong. "The research shows it's pretty much the same as any other drug," said Duncan. "If you look at usage information, you see that of all the people who ever used the drug, one in 10 used in the past year. Of those, one in 10 used in the past week. And among those past week users, the majority only used it once." It's the same story with treatment, he said. "All the data show the same success rate with meth as any other drug dependence -- except for tobacco, which is by far the most addictive drug. It doesn't matter if you're talking about meth or heroin or alcohol -- in each case most of the people who become addicted wind up getting off the drug."

"The data always lags behind reality," agreed Doug McVay, an analyst for Common Sense for Drug Policy. "By the late 1990s, feds and researchers were studying and publishing about rural meth use and talking about the escalation of the problem in the 1990s. Now, it seems to have leveled off. Instead of an increase in meth use, what we are seeing is an increase in the attention paid to it."

There are several possible reasons for this. While the numbers show that meth use is actually fairly flat in recent years, the wide dissemination of information about how to home-cook the drug, which began with books like "Secrets of Clandestine Meth Manufacture," by "Uncle Fester," and has now exploded via the Internet, has indisputably led to an increase in home meth labs. There appears to be some conflation of the rise in home meth labs with an actual increase in meth use.

"It is not meth use that we need to be so concerned about, but home manufacturing," said Duncan. "It is a serious environmental and public health problem, but it is one that is caused entirely by the war on drugs. If meth users could go to a pharmacy and get pure meth, not only would they be better off, but so would everyone else. This meth lab stuff helps feed the frenzy. It doesn't matter if it's just some guy with a Bunsen burner on his kitchen counter, you still get all these headlines about meth labs."

As for laws aimed at home labs, such as the ones either passed or under consideration in 40 states that restrict the sales of cold remedies containing pseudoephedrine, they are having unintended consequences, said McVay. "If you look at Oklahoma, which led the way with those Sudafed laws, what you are seeing is, yes, a 90% drop in lab busts, but the number of ice seizures has increased five-fold. Ice is the smokeable meth being imported by the Mexican gangs. In terms of overall meth use, these laws really do nothing except protect the market share of the Mexicans."

In addition to concerns over home meth labs -- which, according to the National Drug Intelligence Center account for only 20% of all meth consumed in the country -- the Bush administration's move to cut finding for anti-drug law enforcement task forces through proposed cuts in the Justice Assistance Grants program and the High Intensity Drug Trafficking Areas program has motivated law enforcement and elected officials to scream long and loud about how badly they need that money. For many of them, methamphetamine is exhibit one.

And the rhetoric has been remarkable. "Meth is the biggest threat to the United States, maybe even including al-Qaeda," warned Rep. Tom Osborne (R-NE) during a hearing last month where representatives ripped the Office of National Drug Control Policy over the proposed cuts and over its failure to sufficiently prioritize the "meth menace."

"We've got something right in our lap that is absolutely the worst kind of drug the nation has ever seen," said Umatilla (Oregon) County Commissioner Bill Hansell, president-elect of the National Association of Counties. "To not address it now would be a huge mistake." The association was the author of a much-hyped survey of sheriffs last month where 58% of sheriffs described meth as their worst drug problem.

What has been as remarkable as some of the overheated rhetoric has been the fact that the federal government has been a relative voice of reason compared to cops and congressmen. It is, after all, the Bush administration that initially sought the budget cuts that have excited such outrage. In that same hearing where meth was compared -- unfavorably -- to Al Qaeda, deputy drug czar Scott Burns steadfastly refused to call meth use an epidemic, telling the hearing that police in the Northeast "would laugh at me if I told them there was a meth epidemic." In deference to his congressional overseers, he did, however, call meth "the most destructive, dangerous, terrible drug that's come along in a long time."

There is one indicator that continues a steady climb, and that is the number of people receiving treatment for meth use. That number has increased more than five-fold in the past decade. "While the overall use figures are pretty much flat, we are seeing meth account for more than 20% of all drug treatment in some states, and I suspect that is what is fueling this," said Leah Young, a spokeswoman for the federal Substance Abuse and Mental Health Services Administration. In 1993, there were 21,000 meth treatment admissions; a decade later there were 116,000," she told DRCNet. "Meth is taking up treatment resources like it never did before, and the states are paying attention to it because it seems to have burst on them out of nowhere."

But even the steady increase in the number of people in treatment for meth over the past decade does not necessarily mean more meth users are seeking treatment. Instead, alone with marijuana among all other drugs, a majority of meth users in treatment are there because a judge sent them there in a criminal proceeding. Nearly 51% of all meth users in treatment in 2003 were there as a result of criminal justice system referrals.

While the thrust of this article has been to deflate overstated claims of a "meth epidemic," there is clearly problematic use out there. "We have seen some increased use and we've seen an increase in HIV transmitted by male injection drug users who are having sex with men, and this public health issue is our real concern," said Luciano Colonna, executive director of the Harm Reduction Project, which is sponsoring the First National Conference on Meth, HIV, and Hepatitis C later this month in Salt Lake City. "But we have also seen increased law enforcement attention, more crackdowns, more arrests."

"We have to acknowledge there is enough of a kernel of truth in all these meth stories for people to be concerned," said Reinarman, "but instead of the big picture you get a rush to judgment."

And a distorted picture of who is using the drug and how often. The laser-like focus on the stereotypical tweaker obscures both the reality of who is using meth (and how) and the larger social context of problematic use, said Reinarman. "I don't doubt that some people are ruining their lives with meth, but how representative is it and what else is going on in their lives that could account for extreme and dangerous drug use? This has been a largely rural phenomenon, and these areas have been economically hard-hit. We are looking at people who have lost real jobs that pay enough to get by because of deindustrialization, people who are part of a working class that is seeing its life chances evaporate before its eyes," Reinarman said.

"The white, trailer trash guy with tattoos and a t-shirt, drinking beer, chain-smoking and shooting speed with dirty kids crawling around being neglected is the poster child," said Reinarman, "but there are a lot of different use patterns out there. "There is the middle class white woman who gets it from a psychiatrist's prescription, there are people who binge as a couple every few months, there are students who use it to study. So how representative is the stereotypical speed freak? I don't think anyone knows."

Jason Zeidenberg, executive director of the Justice Policy Institute, has been watching the meth numbers, too, and he added some perspective. "Meth is a real problem for some people, but it is an over-hyped problem. All you have to do is look at the use rates and look at sentencing. When 100,000 people a year die from alcohol, I'm still saying that's the most dangerous drug in America."

I have to get to work, but from many of the comments on this thread it seems that the dangers are something that some people have to discover for themselves.

That said, I'll say one more thing. Do you know what NYC cops called crack neighborhoods? They called them "self cleaning ovens." Trust me, you don't want to live anywhere near a "self cleaning oven."

I lost my best friend from high school to heroin. She ended up getting arrested for various crimes, served 6 months in jail (very hard for a suburban girl from a "good" family), and eventually recovered to be a normal citizen again. Her addiction was a nightmare for all involved, so you have my sympathy for sure. I do understand.

But I'm not so sure her experience was worse than what I've seen alcoholics and their families go through - the arrests for DWI, the screaming, the disappearances, the risk for sexual abuse, etc.

I really don't believe that one is worse than they other. Crank, crack, alcohol ... addicts hurt all who love them.

Here's something I would like your opinion on. Do you think meth would even EXIST if it were not for the drug war? Meth was developed from legal household chemicals to fill a speed demand. Now, if the other drugs were not banned, do you think there would have been a need to develop meth, the "most dangerous and life destroying" drug out there? So isn't prohibition itself responsible for meth even existing? And now that we have a crackdown on meth, don't you think something even more dangerous is going to take its place?

Do you think we can ever stop people from wanting to become intoxicated through chemical means? Do you think you can ever kill the demand for such substances? And if not, how do you plan to keep criminals from supplying the demand?

This article is total BS and is written from an a priori agenda rather than being based on an honest appraisal of the problem. Note that there are no quotes from police with on-the-street experience, although the article does mention that 58% of sheriffs think that meth is the worst drug problem. I have nothing to do with people who are involved with drugs yet this epidemic has even affected me.

>>>All I know is that Meth is the very worst drug I have ever seen, or imagined. Worse than alcohol, how it destroys people lives.>>>

No, PEOPLE destroy PEOPLE'S lives. Why do members of this board want to fall into the victimization mindset.

I was just walking along, minding my business when this big boogeyman called "Meth" came along and dragged me against my will to ingest it and then do bad things.

Whether it is by choice of taking a stupid stupid drug, or by using that drug as an excuse to do stupid stupid things, the DRUG didn't DO anything.

What qualifies you as a "suspected meth person"?

I have to get to work, but this is too good not to answer.

A)I have a weakness for fancy rental cars. I'll admit it, but it's only a moderately expensive vice. So I was driving a fancy-ass rental car.

B)I don't like shaving or wearing a suit and tie. So I tend to look scruffy.

C)I'm from NYC and don't drive often, so I tend to drive with some hesitation. Plus, most of the small towns in this great country didn't lay out their streets on the very sensible grid pattern like NYC, so I tend to get lost (a lot).

D)I often plan my arrivals by car at night, often very late at night.

So, what the cops see is a scruffy guy in an expensive car with out of state plates driving oddly late at night and covering ground he's already covered. I can't blame them.

She tested positive for METH.... and you are claiming she's the victim???? Have you actually ever had to deal with addicted parents???? I have.. there isn't a one of em that isn't guilty of neglect and child endangerment.... You cannot provide for your child when you are willing to do ANYTHING for your next hit.. or completely incompacitated by your current high.

Meth is NOT a recreational drug.

Profiling was invented by a genius cop down in Florida who came up with a large list of things to look for in drug trafficking...needless to say, all cops, not being geniuses, stuck to the most obvious things on that list.

That said, all cops (and I've known quite a few) play "Where's Waldo?" when on patrol. They're looking for things that don't belong.

>>>Are you saying we should do nothing about the problem?>>>

Nope, that is not what I'm saying at all. I'm saying that the government uses scare statistics alot of times. I'm also saying I want people to be responsible for their actions and stop using "the devil (drug) made me do it" crap. It is not unknown that drugs do bad things. You start using, you accept the consequences, but no need to inflate statistics either.

>>>You are willing to sacrifice a few hundred thousand amercians to make your politcal point?>>>

How am *I* sacrificing anyone or anything? Am *I* responsible for a few hundred thousand people and the things they decide to put in their body? I think not. If a person decides to do drugs that make them do stupid things, I should have the right to defend myself from that stupid person. If they decide to do drugs until they die, that is their choice.

Don't let anyone kid you- there IS a huge Meth problem. My son-in-law got on that crap and it was like a bomb went off in our family. We learned a lot in the process, one of the things we learned is that a lot of meth users are maintainers, meaning they use small amounts to increase their energy so they can work longer hours, and accomplish more. These people come from ALL walks of life, truck drivers, electricians, teachers, nurses- you name it. Respectable, upstanding people you would not think twice about. People you probably admire because they are able to do so much. The problem arises when some who don't have the tolerence or whatever to maintain and they use and abuse until they ruin their life and everyone else around them. Meth is easy and cheap to get, so it is easy for kids to get, but most of the people we found out were using in our area were 25-35 year old adults.

I can assure you my SIL did not take any surveys, or ever go to the ER-he was not a student, he was a young adult with his own business and a family. He would not have shown up in this persons research, he did however end up causing every problem you can imagine an addict causing until he was forced into rehab last year. He is no longer my SIL, but so far he is clean. The most frightening thing about Meth is it's widespread use, and the opinion of rehab counselers who say less than 10% ever stay clean after they "fall off the cliff." Rehab people told us it is a harder addiction to deal with than heroin.

Before any of you pooh-pooh the meth problem in this country, ask someone in law enforcement about the problem. In my area LE told us the problem was beyond belief- in the small towns around here they bust many meth labs and deal with all the crime and other problems meth causes. I have heard the problem is huge in some areas and not a real problem in others, but it really is a problem.

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