Article

Use of methamphetamine by young people: Is there reason for concern?

University of California, Los Angeles, Los Ángeles, California, United States
Addiction (Impact Factor: 4.74). 08/2007; 102(7):1021-2. DOI: 10.1111/j.1360-0443.2007.01899.x
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Available from: Walter Ling, Sep 16, 2014
Use of methamphetamine by young people: is there
reason for concern?
The problem of methamphetamine (MA) use among
adult populations world-wide persists and must be
addressed [1], but there also is a need to examine MA use
among young people [2]. Although epidemiological data
from around the world present a mixed picture, in many
regions of the world MA use by adolescents appears to be
a significant public health problem.
In the United States, federal government statistics
minimize the problem of MA use by adolescents. For
example, a national survey of 12th graders indicates a
downward trend of life-time MA use from 1999 to 2005
(4.7% to 2.5%, respectively) [3]. However, state- and
local-level data from treatment programs in some parts of
the United States reveal that rates of treatment admis-
sions of adolescents with diagnoses of MA abuse and
dependence are more than 20% of all admissions and are
increasing [4]. Although there is tremendous variability
in youth MA rates across Europe, the European Monitor-
ing Centre for Drugs and Drug Addiction (EMCDDA)
sur vey shows that the prevalence of methamphetamine/
amphetamine use in youth aged 15–24 years has been
rising since 1990 [5]. Findings from a Czech Republic
sur vey [European School Survey Project on Alcohol and
Other Drugs (ESPAD)] on 17–18-year-old students in
2003 indicate that nearly 8.4% had used MA (Pervitin) in
their life-time and 5.4% had used in the previous year [6].
Data from Taiwan and northern Thailand also suggest
that MA use is highly problematic among adolescents
[7,8].
According to the 2004 Australian National Drug
Strategy Household Survey, the life-time MA use preva-
lence rate for youth aged 14–19 years is 6.6% [9]. Use in
the previous 12 months was reported to be 4.4%, with
female teenagers (4.9%) slightly more likely to be recent
users than male teenagers (4.0%) [9]. Data from the
Canadian Addiction Survey (2004) show that life-time
MA use among older youth (15–19-year-olds and 20–24-
year-olds) is high—8.3% and 11.2%, respectively [10]. In
Cape Town, South Africa, treatment centres, 42% of
admissions for 15–19-year-olds were for treatment of MA
dependence in the second half of 2006 [11].
SPECIAL CONCERNS ABOUT MA USE BY
ADOLESCENTS
Effects on the developing brain
There is extensive evidence demonstrating MA’s toxicity
on the adult human brain when used at high doses over
extended periods of time [12]. There is concern that MA
abuse by young people, whose brains are still maturing
and developing [13], could result in different types of
neurological and psychiatric consequences. Although, to
date, no published brain imaging studies have reported
on young MA users, a growing body of animal studies is
emerging [14], indicating that MA exposure causes dif-
ferent alterations in central nervous system serotonin
and dopamine functions in adolescent animals than
those produced in adults. Brain imaging studies with
youth are needed to understand the long-term impact of
MA use by young people.
Clinical attributes of young MA users
The limited clinical data which exist on MA-abusing
adolescents suggest that these youth have a significant
amount of psychiatric symptomatology. Several studies
have reported that adolescents in treatment for MA abuse
have higher levels of depressive symptoms and suicidal
ideation than do adolescents in treatment for other sub-
stances (primarily marijuana and alcohol) [15]. Further-
more, MA abuse has been implicated in risky sexual
behavior s (i.e. multiple sex partners and unprotected
sexual intercourse) among youth in the United States
[16].
MA use is especially problematic among girls, as evi-
denced by their much higher rates of admission into
treatment programs compared to boys [3,15]. Yen &
Chong [17] report MA-using Taiwanese girls display
higher rates of mood and eating disorders than do boys.
Rawson & colleagues [15] found that MA-abusing
girls reported higher levels of depression and suicidal
tendencies than did MA-abusing boys.
Prevention and treatment implications
At present, only one study has reported data on preven-
tive interventions aimed at reducing adolescents’ MA use
[18]. Results from this study suggest that effective preven-
tion methods should focus on brief universal interven-
tions, including reducing early initiation of substance use
(i.e. alcohol, marijuana and tobacco), incorporating
skills-building opportunities and alternative activities,
and incorporating family and peer/social support [18].
The following strategies for preventing the use of MA by
youths were suggested by experts on MA use and treat-
ment providers from numerous countries at a United
Nations Office on Drugs and Crime (UNODC) meeting in
2006 [1]: school-based activities (e.g. life skills training,
EDITORIAL
doi:10.1111/j.1360-0443.2007.01899.x
© 2007 The Authors. Journal compilation © 2007 Society for the Study of Addiction Addiction, 102, 1021–1022
Page 1
training of teachers, use of positive reinforcement tech-
niques), careful targeting of high-risk families for pre-
school interventions, using peer-based techniques to
impar t information and skills and empowering commu-
nities in order to reduce drug-related harm.
There is limited understanding of effective treatment
models for youth in the resolution of MA problems.
While there are unique clinical issues associated with
MA use, best practices for treating youth substance
abuse, including integrative methods of treatment using
cognitive behavioral techniques, motivational interview-
ing, family therapy and contingency management,
should be incorporated into treatment models for
MA-based intervention strategies. Gender and cultural
differences also need to be considered when preventing
and treating MA abuse.
CONCLUSIONS
In some parts of the world, MA use by adolescents is a
significant public health concern. Young women appear
to be at special risk for developing MA-related problems
and their use is associated with elevated levels of depres-
sion and suicidal thinking. High-risk sexual behaviors are
associated with MA use, creating increased risk for
sexually transmitted diseases, including HIV and hepa-
titis. There is a paucity of data on specific prevention
and treatment approaches for reducing MA use among
youth; however, general best practice principles are
recommended.
RICHARD A. RAWSON, RACHEL GONZALES,
MICHAEL MCCANN & WALTER LING
UCLA Integrated Substance Abuse Programs, 1640 S.
Sepulveda Blvd, Suite 200, Los Angeles, CA 90025–7535,
USA. E-mail: rrawson@mednet.ucla.edu
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1022 Editorial
© 2007 The Authors. Journal compilation © 2007 Society for the Study of Addiction Addiction, 102, 1021–1022
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  • Source
    • "The street cost of METH has continually decreased over the past decade while the drug's purity and availability have increased, thus making first time use more accessible and more addictive (World Drug Report, 2010). Adolescents may be particularly vulnerable to METH abuse given the drug's growing popularity, availability, potency, and low price, and data from U.S. treatment programs indicate that adolescents comprise more than 20% of those admitted for METH abuse or dependence (Rawson et al., 2007; Gonzales et al., 2008). Drug use generally starts and progresses more rapidly during adolescence. "
    [Show abstract] [Hide abstract] ABSTRACT: Methamphetamine (METH) use has increased substantially in the last 10 years and poses a serious health concern, especially for young populations. Drug abuse primarily begins during adolescence, when uninhibited and excessive and drug intake is a common occurrence; thus, understanding the developmental patterns of addiction during this critical period is an essential step in its prevention. In the present study, the effect of age on the vulnerability to METH abuse was examined using a rat model of bingeing (i.e., escalation). Adolescent and adult rats were compared during short (ShA, 2-h) and long-access (LgA, 6-h) to METH self-administration. On postnatal (PN) days 23 (adolescents) and 90 (adults), rats were implanted with i.v. catheters and trained to lever press for infusions of METH (0.05mg/kg) during 2-h sessions. Once the rats reached a steady rate of METH self-administration, they were divided into ShA or LgA groups and allowed to self-administer METH for 15 additional days. Results indicated that adolescent rats earned significantly more infusions than adults under the LgA condition, but the age groups did not differ during ShA. Adolescents, but not adults, also significantly increased (i.e., escalated) METH self-administration across the 15 days of testing under the LgA condition. Further analysis indicated excessive responding during infusions in the LgA METH-exposed adolescents compared to the other groups, suggesting elevated impulsivity or motivation for drug. These results demonstrate that adolescents are more vulnerable to the escalation of METH than adults during LgA.
    Full-text · Article · Feb 2012 · Drug and alcohol dependence
  • Source
    • "Tacit in the use of educational corrections is the notion that MA usage does not have an effect on educational attainment or exposure, because if it did, correcting for level of education would potentially remove variance which is attributable to MA dependence itself. Despite the implicit assumption that MA dependence does not impact educational exposure, it is noteworthy that MA and other substance use disorders are commonly considered developmental disorders (Rawson et al., 2007; Compton et al., 2007; Chambers et al., 2003), with MA use often beginning in the late teen years (Hser et al., 2008; Rawson et al., 2007). As such, it is possible that MA use could affect educational engagement and subsequent educational attainment, particularly at secondary and post-secondary educational levels. "
    [Show abstract] [Hide abstract] ABSTRACT: We sought to test the hypothesis that methamphetamine use interferes with both the quantity and quality of one's education, such that the years of education obtained by methamphetamine dependent individuals serves to underestimate general cognitive functioning and overestimate the quality of academic learning. Thirty-six methamphetamine-dependent participants and 42 healthy comparison subjects completed cognitive tests and self-report measures in Los Angeles, California. An overall cognitive battery score was used to assess general cognition, and vocabulary knowledge was used as a proxy for the quality of academic learning. Linear regression procedures were used for analyses. Supporting the hypothesis that methamphetamine use interferes with the quantity of education, we found that (a) earlier onset of methamphetamine use was associated with fewer years of education (p<.01); (b) using a normative model developed in healthy participants, methamphetamine-dependent participants had lower educational attainment than predicted from their demographics and performance on the cognitive battery score (p<.01); and (c) greater differences between methamphetamine-dependent participants' predicted and actual educational attainment were associated with an earlier onset of MA use (p≤.01). Supporting the hypothesis that methamphetamine use interferes with the quality of education, years of education received prior to the onset of methamphetamine use was a better predictor of a proxy for academic learning, vocabulary knowledge, than was the total years of education obtained. Results support the hypothesis that methamphetamine use interferes with the quantity and quality of educational exposure, leading to under- and overestimation of cognitive function and academic learning, respectively.
    Full-text · Article · Dec 2011 · Drug and alcohol dependence
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    • "Methamphetamine use has reached epidemic proportions in many regions of the United States and elsewhere (Rawson et al., 2007). The drug's effects on energy and alertness, as well as appetite suppression for weight loss, are particularly attractive to adolescents and young adults (Iritani et al., 2007). "
    [Show abstract] [Hide abstract] ABSTRACT: Methamphetamine can be neurotoxic to the adult brain; however, many individuals first use methamphetamine during adolescence, and the drug's impact on this period of brain development is unknown. Therefore, we evaluated young methamphetamine users for possible abnormalities in brain metabolite concentrations. Anterior cingulate cortex (ACC), frontal white matter (FWM), basal ganglia, and thalamus were studied with localized proton magnetic resonance spectroscopy in 54 periadolescent (ages 13-23 years) methamphetamine users and 53 comparison subjects. The concentrations of major brain metabolites and their associations with age, sex and cognition were assessed. FWM total-creatine correlated with age in methamphetamine-using males and comparison females, but not comparison males or methamphetamine-using females, leading to a drug by sex by age interaction (p=0.003) and ACC choline-containing compounds (CHO) correlated with age only in comparison males leading to a drug by sex by age interaction (p=0.03). Higher ACC CHO was associated with faster performance on the Stroop Interference task in the control males. Male methamphetamine users had slowest performance on the Stroop Interference task and did not show age-appropriate levels of ACC CHO. The altered age-appropriate levels of ACC CHO and poorer executive function in male methamphetamine users suggest methamphetamine abuse may interfere with brain maturation. These periadolescents did not have the abnormal neuronal markers previously reported in adult methamphetamine users, suggesting that neuronal abnormalities may be the result of long-term use or interference in normal cortical maturation, emphasizing the need for early intervention for young methamphetamine users.
    Full-text · Article · Jul 2011 · Drug and alcohol dependence
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