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322 EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Panel on Methamphetamine Abuse: NIDA-Supported Research Studies (IDEAL). Pediatric Research 55, No. 4. Part 2, 72A (2004). Grant, P.; LaGasse, L.; Derauf, C.; Shah, R.; Smith, L.; Arria, A.; Huestis, M.; Strauss, A.; Haning, W.; DellaGrotta, S.; Liu, J.; and Lester, B. Prenatal methamphetamine use and maternal health care characteristics: Preliminary results from the Infant Development, Environment, and Lifestyle Study (IDEAL). Pediatric Research 55, No. 4. Part 2, 72A (2004). LaGasse, L.; Derauf, C.; Grant, P.; Shah, R.; Smith, L.; Arria, A.; Huestis, M.; Strauss, A.; Haning, W.; DellaGrotta, S.; Fallone, M.; Liu, J.; and Lester, B. Prenatal methamphetamine exposure and neonatal cry acoustic analysis: Preliminary results from the Infant Development, Environment, and Lifestyle Study (IDEAL). Pediatric Research 55, No. 4. Part 2, 72A (2004). Smith, L.M.; LaGasse, L.L.; Derauf, C.; Grant, P.; Shah, R.; Arria, A.; Huestis, M.; Haning, W.; Strauss, A.; DellaGrotta, S.; Liu, J.; and Lester, B. Intrauterine growth of infants exposed to prenatal methamphetamine: Preliminary results from the Infant Development, Environment, and Lifestyle Study (IDEAL). Pediatric Research 55, No. 4. Part 2, 72A (2004). Smith, L.M.; LaGasse, L.L.; Derauf, C.; Grant, P.; Shah, R.; Arria, A.; Huestis, M.; Haning, W.; Strauss, A.; DellaGrotta, S.; Fallone, M.; Liu, J.; and Lester, B.M. Prenatal methamphetamine (MA) use and neonatal neurobehavioral outcome: Preliminary results from the Infant Development, Environment, and Lifestyle Study (IDEAL). Pediatric Research 55, No. 4. Part 2, 606A (2004). Wouldes, T., LaGasse, L., Sheridan, J., Lester, B. Maternal Methamphetamine Use During Pregnancy and Child Outcome: What Do We Know? New Zealand Med J. 117;No. 1206:U1180, (2004). For inquiries concerning this report, please contact Barry Lester, Ph.D., Women and Infants Hospital, Infant Development Center, 79 Plain Street, 2nd Floor, Providence, RI 02903, Phone: 401- 453-7640, Fax: 401-453-7646, E-mail: barry_lester@brown.edu. Evidence-Based Approaches for Addressing Methamphetamine Use Among Gay Urban Males Cathy J. Reback, Ph.D. Findings from a study of 162 gay and bisexual men enrolled in outpatient treatment for methamphetamine abuse or dependence included… • Drug abuse treatment interventions were found to be effective in reducing methamphetamine use and human immunodeficiency virus (HIV) risk behaviors of methamphetamine abusers… – At baseline, the mean number of sexual partners in the prior 30 days was 8.6, compared with 2.9 at 52-week follow-up – Participants demonstrated a threefold decrease in methamphetamine use (verified by urinalysis) and unprotected anal intercourse at 1-year followup. • Combined contingency management (CM) and cognitive behavioral therapy (CBT) produced maximal short-term reductions in drug use and moderate effects on high-risk sex behaviors. • Gay-specific CBT produced maximal short-term high-risk sex reduction and moderate drug use reduction. STUDY METHODS Sample The study sample consisted of 162 self-reported gay or bisexual men who were enrolled in a Hollywood, California, outpatient treatment program for methamphetamine abuse. All men met the DSM-IV criteria for methamphetamine abuse or dependence. The participants were recruited for treatment through advertisements at gay venues and in the gay media, as well as through agency referrals. Men who responded were scheduled for an intake interview, completed an admission form, and began the informed consent process (approved by the Friends Research Institute West Coast Institutional Review Board). Participants ranged in age from 19 to 57, with an average age of 37. Most were White (80.2 percent) Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Panel on Methamphetamine Abuse: NIDA-Supported Research Studies and highly educated (mean years of schooling=14.7). On average, respondents reported a lifetime use of methamphetamine of 8.3 years. Nearly 38 percent reported a history of injection drug use, and 60.5 percent were HIV-infected. Interventions Following screening, participants were randomly assigned to one of four treatment conditions: contingency management (CM), cognitive behavioral therapy (CBT), CM + CBT, and gay-specific CBT (GCBT). The first three interventions targeted only drug use, and no instructions were given regarding sexual risk behaviors. The GCBT integrated the standard CBT with referents to cultural norms and values of an urban gay lifestyle and an emphasis on HIVrelated issues. Treatment was scheduled for a 16- week duration. Groups met for 90 minutes, three evenings each week. Nearly 59 percent of the sample completed the 16-week intervention to which they were assigned. Data Collection Quantitative data were obtained from all participants at baseline, at 16 weeks, at 6 months, and at 1 year following treatment initiation. In addition to the Admission Form that collected demographic, substance use, treatment history, sexual behavior, and medical and psychiatric background data at baseline, Exhibit 1. Outcomes by Treatment Condition Measure CM n=42 two other instruments were used: the Substance Use Inventory and the Behavior Questionnaire– Amphetamine (BQA). Urinalysis was used to verify self-reported drug use. Qualitative interviews were conducted with 34 of the participants at baseline, 16 weeks, and 1 year. STUDY FINDINGS At baseline, 85.2 percent of the men responded that methamphetamine (i.e., “crystal”) use and sex were integrally connected, and “always” or “often” go together. Nearly 76 percent reported engaging in sex in the prior 30 days while high on methamphetamine. On average, these men had 8.6 unique sexual partners during that 30-day period. Sex was considered “compulsive” by 69.1 percent of the participants. By 1-year followup, the mean number of sexual partners was significantly lower (2.9, p
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NATIONAL INSTITUTE ON DRUG ABUSE EP
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Foreword This publication includes
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EPIDEMIOLOGIC TRENDS IN DRUG ABUSE
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2 EPIDEMIOLOGIC TRENDS IN DRUG ABUS
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Epidemiology of Drug Abuse: CEWG Ar
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• The city of Atlanta has become
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In the first 6 months of 2004, trea
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eports (exhibit 2), while African-A
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population) than in 2002 (17.2 per
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16 EPIDEMIOLOGIC TRENDS IN DRUG ABU
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data from the Drug Abuse Warning Ne
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than age 18, compared to 4 percent
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More often than not, marijuana use
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Solomon, L.; Flynn, C.; Muck, K.; e
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• Logan International Airport and
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In 2002, heroin/morphine was indica
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The FY 2004 racial distribution for
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• Emergency department (ED) drug
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monly mentioned secondary drug amon
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Between 2001 and 2003, the Illinois
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In the NIHU Study, 20 percent of pa
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Ecstasy remained available in most
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66 and analyzed by the Division of
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ounce in the Denver metropolitan ar
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18 at the time of admission to trea
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Injecting had been the most common
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alcohol; 651 involved alcohol-in-co
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The economy in Hawai'i, after a dec
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Methamphetamine remains the leading
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methamphetamine, representing 76.5
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Of interest in this chart is the ag
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98 weighted DAWN data released by S
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A total of 5,425 cocaine arrests wa
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data, however, rising from 1.5 perc
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According to NDIC, California and M
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and 15 items were identified as pse
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most frequently reported secondary
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esidents are living with advanced H
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112 EPIDEMIOLOGIC TRENDS IN DRUG AB
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(DAWN) that monitors emergency depa
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Beginning in 2003, SAMHSA’s natio
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65 percent were older than 34. The
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the 1,198 drug abuse ED reports in
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“Crystal” or smokeable methamph
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tion was injection (62.9 percent),
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included reports of ED cases involv
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From November 10 to 16, 2004, 18 me
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NFLIS between October 2003 and Sept
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from 12.2 percent in the first half
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156 2003. Anecdotal information on
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Brownsville, and El Paso. African-A
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ground economy, it was estimated th
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According to street interviews, mos
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that crack sells for about $28,000-
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Benloton, X-man, 911, Lean Back, Se
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DAWN ME mentions for marijuana-invo
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ecstasy. MDMA ED mentions may be st
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the deaths, while Whites constitute
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2000 reported that the average hero
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for this drug, making olanzapine th
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ADHS/DBHS reported that more than o
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Marijuana is widely available in Ar
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212 2004. Data from 2000-2002 DAWN
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purity dropped to 14.4 percent in 2
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No recent GHB incidents or deaths w
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correspond to decreases in total ad
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228 reports in drug-related visits;
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Marijuana Arrests for marijuana-rel
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positivity. UHS staff believe, on t
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236 are not estimates for the repor
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were evident. Excluding missing dat
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The characteristics of other opiate
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June 2004 (exhibit 6c). A minority
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Deaths involving depressants were a
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imipramine) are an older class of m
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The term “lag” refers to the pe
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costs $1,200-$1,500, compared with
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ties. In the DFW area, Mexican mari
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The 2004 secondary school survey re
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nio and two 2-ounce bottles cost $1
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Page 296 and 297: York and Miami (Pach et al. 2002).
Page 298 and 299: In 2003, heroin was the primary sub
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Page 309: International Report
Page 312 and 313: Among GTC patients, marijuana was t
Page 314 and 315: Others (63.8 percent) were using a
Page 323: Panel on Methamphetamine Abuse: NID
Page 333: Appendix A New Drug Abuse Warning N
Page 336 and 337: DAWN LIVE! The new DAWN includes ca
Page 339 and 340: Participant List National Institute
Page 341 and 342: Janie B. Dargan, M.S.W. Policy Anal
Page 343: Martin P. Paulus, M.D. Associate Pr
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