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. Author manuscript; available in PMC: 2022 Jun 15.
Published in final edited form as: Epidemiol Rev. 2020 Jan 31;42(1):154–166. doi: 10.1093/epirev/mxaa011

Table 4.

Clinical Studies on Increasing Methamphetamine Use Among Individuals Using Opioids and Opioid Use Among Individuals Using Methamphetamine, United States

First Author, Year
(Reference No.)
Design and Data Population Primary Outcome Key Findings
Al-Tayyib, 2017 (24) Serial cross-sectional analysis of individuals recruited from National HIV Behavioral Surveillance System Aged 18 years or older, had injected drugs during the preceding 12 months, resided in Denver, Colorado, metropolitan area Differences among heroin injection, methamphetamine injection, and combined injection Reports of methamphetamine as the most frequently injected drug increased from 2.1% (2005) to 29.6% in (2015); 296 of the 592 participants reported injecting both heroin and methamphetamine in the past 12 months.
Cicero, 2020 (46) Serial cross-sectional analysis of individuals entering treatment centers for opioid use disorder, 2011–2018 Individuals admitted to one of 270 substance use treatment centers in the Key Informant network belonging to the Survey of Key Informants’ Program (n = 15,741) Temporal trends in opioid drug use, nonopioid drug use, and polysubstance use Prevalence of methamphetamine use significantly increased by 85%. The average number of unique, nonopioid drugs used in the past month significantly increased for people who use heroin/nonprescription fentanyl, from 2.3 to 2.5.
Ellis, 2018 (30) Serial cross-sectional analysis of individuals entering a substance use treatment program, 2011–2017 Individuals ≥18 years of age admitted to substance use treatment centers in the Key Informant network belonging to the Survey of Key Informants’ Program (n = 13,521) Prevalence and motivation for opioid and methamphetamine use Percentage of people who use opioids reporting methamphetamine use doubled from 18.8% (second quarter 2011) to 34.2% (first quarter 2017), with increases attributed to increased community accessibility as well as appeal of high from dual use.
Glick, 2018 (44) Serial cross-sectional analysis of PWID in King County, Washington, 2009–2017 Clients of Seattle and King County NSEP and Seattle-Area NHBS Injection Drug Use (NSEP, n = 2,135, 2009–2017) (NHBS, n = 1,709, 2009–2015) Trends in methamphetamine use and injection equipment sharing in King County among MSM and non-MSM PWID Percentage of people who inject methamphetamine reporting combined use with opioids increased from 18% in 2009 to 31% in 2017 among MSM and from 10% to 53% among non-MSM.
Jones, 2019 (42) Serial cross-sectional analysis of individuals responding to the National Surveys on Drug Use and Health, 2015–2018 Individuals ≥12 years of age that were interviewed in person about the use of drugs, alcohol, and tobacco (n = 171,766) Prevalence and characteristics of methamphetamine use Odds of reporting past-year prescription opioid misuse were significantly elevated for adults reporting methamphetamine use (aOR = 2.17, 95% CI: 1.66, 2.84) and past-year heroin use (aOR = 5.10, 95% CI: 3.63, 7.17).
Jones, 2020 (47) Serial cross-sectional analysis of TEDS, 2008–2017 Individuals ≥12 years of age admitted to substance use treatment centers receiving federal funding (n = 15,747,334) Trends and characteristics associated with methamphetamine use at treatment admission Reports of smoking as the route of use of methamphetamine decreased to 58.8% of admissions from 67.3%. Injection was reported in 28.4% of admissions, up from 17.5%. Reports of heroin use increased from 5.3% of admissions to 23.6%, and prescription opioids increased from 3.8% to 8.3%.
Jones, 2020 (48) Serial cross-sectional analysis of TEDS, 2008–2017 Individuals ≥12 years of age admitted to substance use treatment centers receiving federal funding (n = 3,547,977) Heroin treatment admissions involving methamphetamine Percentage of heroin treatment admissions reporting methamphetamine use increased from 2.1% (2008) to 12.4% (2017), with highest prevalence among individuals 12–24 years of age.

Abbreviations: aOR, adjusted odds ratio; CI: confidence interval; HIV, human immunodeficiency virus; MSM, men who have sex with men; NHBS, National HIV Behavioral Surveillance; NSEP, needle and syringe exchange program; PWID, people who inject drugs; TEDS, Treatment Episode Data Set.