Methamphetamine strategy requires evaluation

We read with interest about the strategy recently developed in the York Region of Toronto to curb methamphetamine use, which is based on Vancouver's 4-pillar drug strategy.¹ We recently reported that more than 70% of Vancouver's street-involved youth have used methamphetamine.² We have also seen a significant growth in methamphetamine use among Vancouver's injection drug users, from 2% in 1998 to more than 15% in 2006. These trends have been observed despite Vancouver's 4-pillar strategy, although we should acknowledge that the enforcement pillar has consumed the overwhelming majority of the local resources devoted to the strategy.

Thus, we wonder if Cronkwright Kirkos and colleagues might be overly optimistic when they state that the supply of methamphetamine can be suppressed “through active and intelligence-led strategic police enforcement.” Unlike heroin and cocaine, which must be farmed illicitly in foreign countries before it is imported, methamphetamine can be inexpensively produced locally from common precursor chemicals. Given the failure to keep heroin and cocaine off North America's streets,³ the likelihood that law enforcement will curb the growth in the supply of methamphetamine is exceedingly small.⁴

We also raise caution about untested modes of drug prevention. A study commissioned by the US National Institutes of Health evaluated the United States' national youth antidrug media campaign and found little evidence of direct favourable effects on youth. Instead, higher exposure to the campaign was associated with a weakening of social norms against illicit drugs.⁵ Despite ongoing federal funding for such initiatives in Canada, a lack of benefit and evidence of potential harm have also been consistently observed with the drug education tool known as DARE (Drug Abuse Resistance Education).⁶