For Methamphetamine, Other Drugs, Reliable Use Estimates Hard to Come By

The process involved in compiling the latest data on U.S. illegal drug spending proves as telling as the numbers themselves. Researchers at RAND report that particularly in the case of methamphetamine, a shrinking number of reliable data sources makes it difficult to capture national drug use trends with great accuracy.

“We need pragmatically to think of ways to generate and share data more efficiently and effectively,” Greg Midgette, lead author of the latest RAND study and an adjunct policy researcher for the organization, tells Addiction Professional. Midgette, an assistant professor of criminology and criminal justice at the University of Maryland, adds, “We have really outdated data. We've pulled estimates for 2016, and that's the best we can do.”

Released on Aug. 20, the report on illicit drug spending serves as an update to a study RAND conducted for the Office of National Drug Control Policy (ONDCP) in 2014, with that report having included drug use estimates through 2010. The latest report shows that Americans' spending on marijuana, cocaine, methamphetamine and heroin combined approached a total of $150 billion in 2016, fast approaching estimated annual spending on alcohol.

Midgette says one of his key takeaways from the overall data is that “while the opioid crisis is a big deal, ... we can't ignore the stimulants, particularly methamphetamine.” There has been a steady increase in the amount of methamphetamine seized from 2007-16, and a corresponding increase in use from 2010-16, the study indicates.

For cocaine, steep declines in consumption rates in the late 2000s began to slow by the middle of the current decade, and by 2015 there were 2.4 million individuals using the drug at least four days per month.

Gaps in data

Arriving at reliable national estimates often involves trying to synthesize a number of imperfect data sources. The National Survey on Drug Use and Health, for example, does not capture all drug users in its analysis. In general, “Uncertainty around estimates has grown,” Midgette says.

For methamphetamine, the Arrestee Drug Abuse Monitoring (ADAM) system had been seen in the past as a critical tool for capturing trends. The U.S. Department of Justice oversaw ADAM prior to 2004, when it was discontinued for a few years and then brought back under ONDCP in 2007. But the effort ended again in 2013.

The RAND report's executive summary states that “bringing back the ADAM program or some version of it would be enormously useful, particularly if it included objective (biological) consumption measures.”

Midgette says that while there are numerous credible estimates for alcohol consumption, it is much more difficult to quantify illicit drug markets. For example, even though states that have legalized recreational use of marijuana are engaged in massive data collection efforts, much of the rest of the country is still relying on self-report and treatment admissions data for its numbers on marijuana, he says.

The RAND report states that for all of the drugs studied, total consumption and spending are being driven largely by a minority of users who engage in use for at least 21 days each month.