Methamphetamine Use Among Adolescents & Young Adults

1. Methamphetamine Use Among Adolescents & Young Adults Rachel Gonzales UCLA Integrated Substance Abuse Programs

2. Presentation Objectives • Examine MA use trends among youth specific to the West • Highlight unique gender differences • Examine plausible risk factors associated with use • Future directions for research

3. What do we know about the problem? • Most widely used sources: • National Survey on Drug Use and Health (NSDUH) • Monitoring the Future Study (MTF) • Youth Risk Behavior Survey (YRBS)

4. Past MonthDrug Use Rates Source: NIDA, Monitoring the Future, Nat’l Results on Adolescent Drug Use, 2004.

5. Measurement Challenges • While beneficial, national surveys tend to underrepresent youth at risk for drug use: • Dropouts and delinquent youth • Homeless and runaways • Foster care youth

6. Other Sources • Adolescent Treatment Programs • Juvenile Justice System • Emergency Room Data • Reveal that MA use is a problem by young people.

7. Primary Drug Problem Among Adolescent & Young Adult Treatment Admissions: 2004 17 years and under 18-25 years old Source: LA County ADPA, July 2003-April 2004

8. Extent of Adolescent Drug Use Mentioned in DAWN ED System, LA-Long Beach, 2002 *Percent of all mentions for each substance

9. Juvenile Justice Data • Since 2000, a significant proportion of juveniles aged 12 to 18 in CA have tested positive for dangerous drugs (including MA, PCP, and LSD) upon arrest. • In the second half of 2002, 22% of male arrestees aged 18 to 21 in Los Angeles County tested positive for MA. Source: Arrestee Drug Abuse Monitoring (ADAM) System

10. Gender Differences MA use has become increasingly problematic among adolescent and young adult females

11. Adolescent (<18) Treatment Admissions by Gender 2004 FEMALES MALES Source: LA county ADP

12. Treatment Studies • Research on drug treatment outcome studies among adolescents is limited. • Very few published studies specific to MA and youth. • Recent articles on MA and youth in Taiwan growing.

13. Matrix Treatment Study N=305 Adolescents 13-18 years old N=90 N=215 Source: Rawson et al., 2005

14. Matrix Treatment Study found: • Older teens (ages 17-18) more likely to use than younger youth. • Greater psychological & legal dysfunction than non-MA users. • More alcohol & drug use during treatment than non-MA users. • Greaterdrop out rates than non-MA users. • No injectors (14% smoke, 12% smoke/snort, 4% snort) Source: Rawson et al., 2005

15. Phoenix House Treatment Found: • MA accounted for 42.3% of teen treatment admissions in 2005. • 16% increase in MA admissions between 2002 and 2005 (172 to 210). • More youth females are presenting for treatment with MA problem than males. Year Boys Girls 2002 25% 43% 2003 23% 51% 2004 27% 53% Source: CBS2 News Story, 2006

17. LA County Treatment Study (N=4,430) Youth 12-24 yrs old • Outpatient or residential treatment from 2000 through 2005. • Compared treatment response of primary Marijuana (MJ) users to Primary MA users. • Admission and Discharge data

18. LA County Youth Treatment Admissions for MA and MJ N = 4,430

19. LA County Sample Descriptives

20. LA County: Treatment Patterns • 89% of MJ users in outpatient treatment • 46% of MA users in residential treatment

21. LA County Study found: • Compared to MJ users MA users more likely to be: • Female • On probation/parole • Older aged (>17) • Have previous treatment episodes • Enrolled in residential treatment • Adherent to treatment: poorer retention Source: Gonzales et al., 2006

22. 3 year CASA study on adolescents 8 to 22 years old found: • Females became dependent upon MA faster. • Females suffered more adverse effects sooner than males. Source: National Center on Addiction and Substance Abuse at Columbia University, 2003

23. Risk Factors for MA Use Largely understudied area

24. Anecdotal Reports • Clinicians indicate low self-esteem, depressive symptoms, & eating disorder make girls especially vulnerable to use and continued misuse of MA • Deviant behavioral problems in males – ASPD, ADHD make males vulnerable to MA use (Yen & Chung, 2006)

25. CASA Study: Female Risk Factors Physical Abuse Sexual Abuse Low Self Esteem MA Abuse Tension Depression Weight Concerns Source: National Center on Addiction and Substance Abuse at Columbia University, 2003

26. Risk Factors among adolescents in Matrix Treatment (Matrix Sample); p<.001

27. Other Factors to Consider • Readily available to youth • Simple, home-made manufacturing • Cheap • Easy access to primary chemicals at local merchants

28. Adolescent Story • Teen resident at Phoenix House said: “When I first tried crystal meth, I automatically fell in love. I had finally found the drug that I was looking for. The stuff was pretty cheap and it was very easy for me to get.” Source: CBS2 News Story, 2006

29. Clinical Characteristics • Cognitive dysfunction • Rapid mood swings • Hyperactivity & Impulsivity • Lesion-marked skin • Depression • Paranoia & Psychoses (auditory hallucinations) Source: Gettig, Grady et al., 2006

30. Risky Behaviors • Agitation & Aggressive Behaviors • Partner Violence • Multiple sex partners & unprotected sex • Suicide Source: Baskin-Sommers & Sommers, 2006

31. Relapse Antecedents for MA Use • Social pressure & Social In-adaptation • Lack of emotional stability • Low educational level • Psychiatric Disorder Status Yen & Chang, 2005 (Taiwanese sample, N=60)

32. Summary: Key Points • Researchers need to be aware of other critical data sources to understand the scope of MA use among youth • It remains unclear which risk factors are occurring for MA use • Treatment should be sensitive to gender differences

33. Future Research • More studies to look at specific risk factors for MA use & relapse • Other study populations should include: • Homeless/runaway youth • Juvenile justice system youth • Child welfare system (foster care) youth • More exploration on MA use & Risky Behaviors • More research on developmental processes

35. Acknowledgments Richard Rawson Michael McCann Beth Rutkowski CA & LA County Department of Alcohol & Drugs

36. Questions? For copies of slides or a reference list, please contact me at: rachelmg@ucla.edu (310) 445-0874 ext. 346