Methamphetamine Use Among Adolescents & Young Adults

Rachel Gonzales, Pre-Doctoral FellowUCLA Integrated Substance Abuse Programs

NPI - Semel Institute for Neuroscience

Presentation Objectives

• Examine MA use trends among youth specific to the West

• Highlight unique gender differences

• Examine plausible risk factors associated with use

• Future directions for research

What do we know about the problem?

• Most widely used sources:

–National Survey on Drug Use and Health (NSDUH)

–Monitoring the Future Study (MTF)

–Youth Risk Behavior Survey (YRBS)

Past Month Drug Use Rates

05

101520253035404550

Alcohol Cigarettes Any IllicitDrug

Marijuana Meth Inhalants

Perc

ent

of R

esp

ondents

8th grade10th grade12th grade

Source: NIDA, Monitoring the Future, Nat’l Results on Adolescent Drug Use, 2004.

Measurement Challenges

• While beneficial, national surveys tend to underrepresent youth at risk for drug use:

Dropouts and delinquent youthHomeless and runawaysFoster care youth

Other Sources

• Adolescent Treatment Programs

• Juvenile Justice System

• Emergency Room Data

– Reveal that MA use is a problem by young people.

12%

2%

59%

2%25%

AlcoholMethamphetamineCocaineMarijuanaOtherHeroin

14%

36%

11%

26%

4%

9%

Primary Drug Problem Among Adolescent & Young Adult Treatment Admissions: 2004

17 years and under 18-25 years old

Source: LA County ADPA, July 2003-April 2004

Juvenile Justice Data

• Since 2000, a significant proportion of juveniles aged 12 to 18 in CA have tested positive for dangerous drugs (including MA, PCP, and LSD) upon arrest.

• In the second half of 2002, 22% of male arrestees aged 18 to 21 in Los Angeles County tested positive for MA.

Source: Arrestee Drug Abuse Monitoring (ADAM) System

Extent of Adolescent Drug Use Mentioned in DAWN ED System, LA-Long Beach, 2002

12-17 year olds* 18-25 year olds*

Inhalants 72.5% 10.0%

Marijuana 12% 11.8%

Meth 8.1% 32.6%

Alcohol 4.7% 17.6%

PCP 4.4% 30.4%

Cocaine 1.9% 15.1%

Heroin 0% 10.0%

*Percent of all mentions for each substance

Gender Differences

MA use has become increasingly problematic among adolescent

and young adult females

Adolescent (<18) Treatment Admissions by Gender July 2003-April 2004

30.9

2.3

41.3

21.7

3.8

0

10

20

30

40

50

60

70

Perc

ent

of

Fem

ale

Resp

ondents

Alcohol Cocaine Marijuana Meth Other

22.1

2.2

66.4

7.71.6

0

10

20

30

40

50

60

70

Perc

ent

of M

ale

Res

pond

ents

FEMALES

MALES

Source: LA county ADP

Treatment Studies

• Research on drug treatment outcome studies among adolescents is limited.

• Very few published studies specific to MA and youth.

• Recent articles on MA and youth in Taiwan growing.

Matrix Treatment Study N=305 adolescents 13 to 18 years old

14.3

63.6

81.3

45.5

30.8

12.18.8

12.1

0

10

20

30

40

50

60

70

80

90

Meth THC Alcohol Poly

Males

Females

Source: Rawson et al., 2005N=90 N=215

Matrix Treatment Study found:

• Older teens (ages 17-18) more likely to use than younger youth.

• Greater psychological & legal dysfunction than non-MA users.

• More alcohol and drug use during treatment than non-MA users.

• Greater drop out rates than non-MA users.

• No injectors (14% smoke, 12% smoke/snort, 4% snort)

Source: Rawson et al., 2005

Phoenix House Treatment Found:

• MA accounted for 42.3% of teen treatment admissions in 2005.

• 16% increase in MA admissions between 2002 and 2005 (172 to 210).

• More youth females are presenting for treatment with MA problem than males.

Year Boys Girls

2002 25% 43%

2003 23% 51%

2004 27% 53%

Source: CBS2 News Story, 2006

2005 Tarzana Treatment Centers Admissions by Drug of Choice, Gender, and Age

0%

10%

20%

30%

40%

50%

60%

70%

Alcoho

l

Cocain

e/Crac

k

Heroin

Mari

juan

a

Meth

amph

etamin

esOthe

r

Primary Drug

Per

cent

Adm

issi

ons

Female age 12-17 (n=293)

Male age 12-17 (n=546)

MA Admission Trends: LA County 2000-05

93%

7%

93%

7%

88%

12%

79%

21%

74%

26%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

00 01 01 02 02 03 03 04 04 05

No Meth Use

Meth Use

Source: LA County ADP, 2006

N=5,527

Gender Differences: LA County

67%

33%

90%

10%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Female (N=1,637) Male (N=3,890)

No Meth Use

Meth Use

Source: LA County ADP, 2006

N=5,527

MA Use by Ethnicity: LA County

26%

2%

23%

10%

17%16%

0%

5%

10%

15%

20%

25%

30%

Whi

te (n

=107

8)

Black

(n=5

63)

Asian

(n=1

95)

Nativ

eAm

(n=2

9)

Latin

o (n=3

380)

Other

(n=2

75)

Meth Use

Source: LA County ADP, 2006

N=943

3 year CASA study on adolescents 8 to 22 years old found:

• Females became dependent upon MA faster.

• Females suffered more adverse effects sooner than males.

Source: National Center on Addiction and Substance Abuse at Columbia University, 2003

Risk Factors for MA Use

Largely understudied area

• Clinicians indicate low self-esteem, depressive symptoms, & eating disorder make girls especially vulnerable to use and continued misuse of MA

• Deviant behavioral problems in males – ASPD, ADHD make males vulnerable to MA use (Yen & Chung, 2006)

Anecdotal Reports

MA Abuse

Low SelfEsteem

Sexual Abuse

Depression

Weight Concerns

Tension

Physical Abuse

CASA Study: Female Risk Factors

Source: National Center on Addiction and Substance Abuse at Columbia University, 2003

Risk Factors among adolescents in Matrix Treatment

40

65

18

48

0

10

20

30

40

50

60

%

Depression Suicidality

Males Females

(Matrix Sample); p<.001

Other Factors to Consider

• Readily available to youth

• Simple, home-made manufacturing

• Cheap

• Easy access to primary chemicals at local merchants

Adolescent Story

• One teen resident at Phoenix House who shared his story of MA addiction said:

“When I first tried crystal meth, I automatically fell in love. I had finally found the drug that I was looking for. The stuff was pretty cheap and it was very easy for me to get.”

Source: CBS2 News Story, 2006

Clinical Characteristics

• Cognitive dysfunction

• Rapid mood swings

• Hyperactivity & Impulsivity

• Lesion-marked skin

• Depression

• Paranoia & Psychoses (auditory hallucinations)

Risky Behaviors

• Agitation & Aggressive Behaviors

• Partner Violence

• Multiple sex partners & unprotected sex

• Suicide

Relapse Antecedents for MA Use

• Social pressure & Social In-adaptation

• Lack of emotional stability

• Low educational level

• Psychiatric Disorder Status

Yen & Chang, 2005 (Taiwanese sample, N=60)

Summary: Key Points

• Researchers need to be aware of other critical data sources to understand the scope of MA use among youth

• It remains unclear which risk factors are occurring for MA use and between the sexes

Future Research

• More studies to look at specific risk factors for MA use & relapse

• Other study populations should include:– Homeless/runaway youth– Juvenile justice system youth– Child welfare system (foster care) youth

• Issues of HIV Risk Behaviors and Violence

• Developmental processes

Acknowledgments

Richard Rawson

Beth Rutkowski

CA Department Alcohol & Drugs

LA County Department Alcohol & Drugs

Jim Peck

For copies of slides or a reference list, please contact me at:

rachelmg@ucla.edu

(310) 445-0874 ext. 346

Questions?