Availability and Effectiveness of Programs to Treat Methamphetamine Abuse

Statement for the Record

Mr. Chairman and Members of the Committee:

Thank you for inviting the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health (NIH), an agency of the U.S. Department of Health and Human Services (HHS), to participate in this important hearing. As the world's largest supporter of biomedical research on drug abuse and addiction, we have learned much about the behavioral and health effects of methamphetamine (meth) abuse, as well as effective ways to treat those addicted. I am pleased to be here today to present an overview of what the science has taught us about meth - a stimulant drug that can have devastating medical, psychiatric, and social consequences.

NIDA has been conducting research on meth for more than 20 years. During this period, NIDA has been tracking meth abuse and supporting multifaceted research aimed at better understanding how the drug affects the brain and behavior and how we can effectively prevent and treat meth abuse and addiction.

Prevalence of Methamphetamine in the United States

Although several national surveys, including the National Survey on Drug Use and Health (NSDUH), conducted by HHS's Substance Abuse and Mental Health Services Administration (SAMHSA), and NIDA's Monitoring the Future (MTF) survey, do not report overall increases in meth abuse, evidence from emergency departments and treatment programs attest to the growing impact of meth abuse in the country. NIDA's Community Epidemiology Work Group (CEWG), which monitors drug abuse problems in sentinel sites across the Nation, has alerted us to increased meth abuse and associated problems in new areas around the country in recent years. In fact, data from SAMHSA's Treatment Episode Data Set (TEDS) show that in 1993 only 4 states reported high rates of treatment admissions (i.e., >50 per 100,000 population) for meth/amphetamine addiction; by 2003, this number increased to 18, more than a third of the States. The total number of people seeking treatment Nationwide increased almost fourfold within a similar timeframe. Further, meth/amphetamine abuse-related emergency department visits across the country have increased more than 50 percent between 1995 and 2002.

What Methamphetamine Does to the Brain and Body

Methamphetamine is a Schedule II stimulant, which means it has a high abuse potential and is available only by prescription. Only a few clinical indications justify its medical use, such as to treat narcolepsy and attention deficit hyperactivity disorder (ADHD), although it is rarely used for the latter. However, it is the illicit use of meth, usually manufactured in "super labs" or by "home cooks", which is the core of the problem of meth abuse. As a powerful stimulant, meth, even in small doses, can increase wakefulness and physical activity and decrease appetite. Meth comes in many forms and can be snorted, swallowed, injected, or smoked, the preferred method of abuse varying by geographical region and changing over time. In recent years, faster routes of administration (e.g., smoking and injecting) have become more common, amplifying meth's addiction potential and adverse consequences.

Meth acts by affecting many brain structures but mainly those that contain the neurotransmitter dopamine, due to similarities in their chemical signatures. Meth increases the release of dopamine, producing the "rush" and/or "high" associated with its abuse. As the most potent of the stimulant drugs, amphetamines elicit more dopamine release than other drugs