Meth: The Overstated Addiction

The Department of Justice has declared today National Methamphetamine Awareness Day. What better way to observe it than taking a break from the hype? Rather than repeating the popular fiction about methamphetamine (that use is skyrocketing, that only stepped up policing will counter the trend, and that addiction is untreatable), let's take a moment today to consider the evidence.

First, methamphetamine use is not prevalent. Although some 12 million Americans have tried methamphetamine, this is far fewer than the number who have tried inhalants (23 million), hallucinogens (34 million), cocaine (34 million), or marijuana (96 million). Of those who have tried methamphetamine, only 1.5 million have used the drug in the last year; and only 583,000 have used it within the last 30 days.

There is no indication that methamphetamine use is increasing. The proportion of Americans who use methamphetamine on a monthly basis has hovered in the range of 0.2 percent-0.3 percent since 1999. In fact, according to the 2005 Monitoring the Future survey, the percentage of high school seniors who reported using methamphetamine in the last year fell to a low of 2.5 percent in 2005. (Use of depressants, meanwhile, increased from a low of 2.8 percent in 1992 to around 7 percent in 2005.)

Second, policing is not "taking care" of methamphetamine. While limits on purchases of precursors have pushed many illicit labs out of our neighborhoods, the drug is still being manufactured -- just now it's across the border. Indeed, methamphetamine is now as available and cheap as it has ever been. This comes as no surprise. As long as demand for an illegal drug exists, there will be supply to meet it.

While policing has failed to curtail use of methamphetamine, it has successfully overloaded our jails and prisons. In the 1980s-90s, California followed national trends by relying increasingly on punishment and prisons as its primary response to arrests for illicit drug use. The total number of people imprisoned in California for drug possession quadrupled between 1988 and 2000, peaking at 20,116.

It was in response to this trend that California voters decided to change tactics. In 2000, 61 percent of California voters passed Proposition 36, the treatment-instead-of-incarceration law, which provides treatment to over 35,000 Californians convicted of nonviolent low-level drug offenses each year. Over half (53 percent) of Prop. 36 participants -- over 19,000 people -- enter treatment for methamphetamine abuse each year.

Prop. 36 has provided valuable evidence that methamphetamine addiction is quite treatable. According to state data on Prop. 36, methamphetamine users have a treatment completion rate of 35 percent, higher than users of cocaine/crack (32 percent) or heroin (29 percent). Although this was an important learning opportunity for policymakers, it was not news to treatment specialists. In fact, there have been at least twenty recent studies showing the efficacy of methamphetamine treatment.

The next step for policymakers is to provide treatment on demand, so that people suffering from addiction have access to treatment outside of the criminal justice system. It is both cheaper and better for public safety to provide treatment to those who need it sooner rather than later.

Other evidence shows that California's public health measures have not gone far enough. Although the Governor signed the Pharmacy Syringe Sale and Disease Prevention Act in 2004, well under half of California's 58 counties have implemented the program to allow nonprescription purchases of up to ten syringes at pharmacies. This is literally killing some of our state's most vulnerable residents.

According to the California Society of Addiction Medicine, 30-50 percent of those with newly identified HIV-infection use methamphetamine. Increasing the availability of sterile syringes through syringe exchange programs, pharmacies, and other outlets is proven to reduce unsafe injection practices, curtail transmission of HIV/AIDS and hepatitis, increase safe disposal of used syringes, and help intravenous drug users obtain drug education and treatment.

The truth about methamphetamine is that its use is not growing exponentially, that addiction is treatable, and that the risks it poses to public health can be mitigated.