Methamphetamines have caused deleterious effects, especially in the Midwest, and a new report from the University of Nebraska–Lincoln’s Rural Drug Addiction Research Center suggests that evidence-based interventions may be necessary to address rising adverse health outcomes in the state related to the drug’s use.
The report, authored by center researchers Ryan Herrschaft, Bergen Johnston and Patrick Habecker, examined national data sets to determine overall methamphetamine usage rates, treatment admissions and overdose deaths.
According to the research, methamphetamines are involved in more deaths than synthetic opioids in Nebraska. From 2018 to 2019, Nebraska experienced a 58.8% increase in psychostimulant-involved overdose deaths.
“In 2018, 1.7 per every 100,000 Nebraskans died of a methamphetamine-involved overdose, while in 2019, that rate had increased to 2.7 per every 100,000 Nebraskans,” Herrschaft said. “That jump is in line with increases we see at the federal and regional level. Across practically all of the United States, overdose deaths have increased in recent years, especially overdose deaths involving synthetic opioids and methamphetamine.”
Nebraska’s rate of methamphetamine overdose death is lower than the Midwest and the United States overall, the report noted.
Methamphetamine treatment admissions rose more than 200% in a 10-year period from 2008 to 2018, most notably among older adults. For example, in people 50 and older, there was a 556.1% increase in treatment admissions, and a 302.28% increase in admissions among adults aged 40-49. Herrschaft said this is a notable trend in the state, where resources for mental health care are limited.
“A study from Wani et al (2020) and colleagues on the utilization of emergency departments found gaps in the supply of behavioral health workers across the state of Nebraska,” he said. “These researchers found evidence of strain on the behavioral health treatment system in 2013, when rates of admissions were far lower than they are now. According to a report released by the Behavioral Health Education Center of Nebraska, BHECN, 87.1% of counties (81 out of 93) in Nebraska are designated Mental Health Professions Shortage Areas and 33 counties have no behavioral health providers.”
The research uncovered another trend that treatment providers should note.
“Admissions have increased by larger-than-average degrees among many of Nebraska’s more marginalized populations, including racial minorities,” Herrschaft said. “As marginalized groups experience an increased burden from psychostimulant-related harms, it is very important that substance use treatment providers tailor their offerings to suit all Nebraskans.”
Overall methamphetamine usage in Nebraska was harder to determine, although it seems to be trending upward.
“From the National Survey on Drug Use’s 2016-2017 pooled data, they estimated that between 0.24% and 0.87% of Nebraskans 26 and older had used methamphetamine in the past year, while in their 2018-2019 data, they estimated that between 0.28% and 1.16% of Nebraskans used methamphetamine,” Herrschaft said. “So while their estimates are trending upwards, it is difficult to say with certainty whether or not more Nebraskans are using methamphetamine now than in 2016.”
The research team is continuing to compile data to determine drug usage in Nebraska and the surrounding region. It is important, they noted, to continue monitoring trends to guide interventions that could improve health outcomes
“I think Nebraskans need to know that substance use and fatal overdoses are happening here and it is affecting our loved ones and communities,” Herrschaft said.
There are steps that can be taken to reduce overdose deaths. With appropriate legal provisions, public health officials could establish supervised consumption facilities, and Herrschaft recommended that all people be trained in administering naloxone, a commercial drug that can reverse an opioid overdose.
“Overdose deaths continue to climb despite our current efforts,” Herrschaft said. “The most recent data from the CDC suggests that in the 12-month period from May 2019 to May 2020, there were an estimated 91,862 overdose deaths (in the United States). What we have done to this point does not appear to be stopping people from dying. We may wish to explore more innovative approaches to substance use in this country if we wish to stop these deaths.”