Concerns about heroin, cocaine and methamphetamine: Prevalence and correlates of at-risk users from 2015 National Survey on Drug Use and Health

Associations of Lifetime Nonmedical Opioid, Methamphetamine, and Kratom Use within a Nationally Representative US Sample

Co-use of non-medical opioids (NMO) and methamphetamine is increasing. So too is the use of the psychoactive botanical "kratom," including among people with NMO and methamphetamine use histories. We assessed characteristics associated with respondent groups who reported lifetime methamphetamine and/or kratom use within a nationally representative US sample using 2019 National Survey on Drug Use and Health data from respondents reporting lifetime NMO use (diverted prescription opioids, heroin). Weighted prevalence estimates for demographic, mental health, and substance use outcomes were determined. Logistic regression examined associations between group membership and outcomes. Among this sample of respondents with lifetime NMO use, 67.6% (95% CI = 65.6-69.4%) reported only NMO use; 4.6% (3.9-5.4%) reported NMO+Kratom; 24.7% (22.7-26.7%) reported NMO+Methamphetamine; and 3.2% (2.5-3.9%) reported NMO+Methamphetamine+Kratom. Compared to those in the NMO-only group, the NMO+Kratom group was more likely to report past-year serious mental illness (SMI; OR = 2.27), suicidality (OR = 1.89), and past-month psychological distress (OR = 1.88). The NMO+Methamphetamine+Kratom group was more likely to report past-year SMI (OR = 2.65), past-month psychological distress (OR = 2.06), and unmet mental health needs (OR = 2.03); increased odds for drug injection, opioid withdrawal, and perceived treatment need also emerged. Risk factors were observed for all groups but were greatest among those reporting use of all three substances.

Gender Differences in Methamphetamine Use Initiation and Trajectory of Use Among People Who Use Methamphetamine in a Mexico-U.S. Border City

INTRODUCTION

Methamphetamine (meth) is a stimulant increasing in use and its prevalence has not yet been determined on the Mexico-U.S. border. Few studies highlight gender differences in meth use, trajectory, and initiation by gender. Ciudad Juárez, Mexico, across the border from El Paso, Texas, has an established stimulant using population and lies on drug trafficking route. This study assessed gender differences in drug and meth use patterns among people meth people use meth.

MATERIAL AND METHODS

This cross-sectional study included 150 people with recent meth use, age 21 years or older, and living in Ciudad Juárez. Measures collected included sociodemographic characteristics, cross-border mobility, drug and meth use characteristics. Statistically (p-value<0.05) and marginally (p-value<0.10) significant gender differences were determined using appropriate bivariate tests.

RESULTS

The sample included 45 cisgender women, five transgender women, and 100 cisgender men with a mean age of 30.9 years. Men had significantly higher rates of snorting meth by nose in powder or rock forms while trans/women more frequently using meth in pill form. Men had higher rates of crossing the border for work, with meth and to obtain meth. Trans/women reported higher rates of acquiring meth from main sexual partner and initiating meth use in Mexico.

DISCUSSION

There are gender differences in patterns of meth use and initiation.

CONCLUSIONS

Sample of people who use meth in general population can be achieved. These findings point to a need for evidence-based meth use reduction treatment programs that are culturally appropriate and tailored for gender.

NBQX attenuates relapse of nicotine seeking but not nicotine and methamphetamine self-administration in rats

OBJECTIVE

Pharmacological manipulations of glutamatergic ionotropic receptors have been suggested as a promising target for addiction treatment. Antagonists of AMPA/kainate receptors were shown to reduce alcohol intake or alcohol-seeking in various animal models. In this study, we evaluated the effect of NBQX, an AMPA/kainate receptor antagonist, on methamphetamine (METH) and nicotine self-administration in rats.

METHODS

Male Wistar rats were trained to self-administer METH (0.08 mg/kg per infusion, session of 90 min) and nicotine (0.03 mg/kg per infusion, session of 60 min) under the fixed ratio 1 schedule of reinforcement. The maintenance training was 2 weeks. During the second week, NBQX was injected subcutaneously at doses of 5 or 10 mg/kg 20 min before the session or intravenously (IV) at doses of 1 and 5 mg/kg 10 min before the session. Following the maintenance training, rats were subjected to forced abstinence for 2 weeks and 1 day of the drug-free relapse-like session with IV NBQX treatment performed as before.

RESULTS

Although NBQX did not affect nicotine maintenance, it significantly suppressed the drug-paired responding in the relapse session. Regarding METH, NBQX did not exert a significant effect at either phase of the study.

CONCLUSIONS

These findings suggest selective involvement of AMPA/kainate receptors in the relapse of nicotine seeking after a period of forced abstinence.

Methamphetamine Use: A New Wave in the Opioid Crisis?

BACKGROUND

The ongoing drug crisis in the United States continues to be headlined with numbers of deaths related to opioid overdose. Less known to the public and health care providers is the rise in methamphetamine use, often in conjunction with opioids or adulterated with fentanyl. An old practice with a new twist is the use of methamphetamine in conjunction with an opioid such as heroin.

PURPOSE

Although there are no Food and Drug Administration-approved medications to treat individuals with stimulant use disorders, a review of available studies suggests a few promising medications that may be helpful for patients in early recovery from methamphetamine.

OUTCOME

Some individuals are more likely to respond to medications such as long-acting naltrexone, bupropion, and mirtazapine, who have light-to-moderate use of methamphetamine. Naloxone kits should be considered for all patients who are actively using stimulants because of a high potential of adulterated methamphetamine.