History of Methamphetamine

Although methamphetamine has existed for more than a century, today's methamphetamine epidemic differs substantially from earlier waves of abuse. Modern illicit methamphetamine is typically produced by transnational criminal organizations, is highly purified, relatively inexpensive, and widely available throughout the United States. Dental professionals are increasingly likely to encounter patients affected by methamphetamine use disorder, making recognition of its oral and systemic manifestations more important than ever. Understanding the evolution of methamphetamine provides important context for recognizing its impact on patient care today.^2,3,20,30,34

Methamphetamine has existed as a drug since the late 1800s. Below is a brief historical timetable for meth.^20,34

• 1887 – A German scientist first synthesized amphetamine.^20,34

• 1919 – Following its synthesis in Japan in 1919, methamphetamine was investigated and marketed for a variety of medical conditions—including asthma, narcolepsy, depression, and weight loss—before its significant abuse potential became fully recognized. Methamphetamine crosses the blood-brain barrier more readily than amphetamine, producing more pronounced central nervous system effects and a greater potential for abuse.^3,20

• 1940s–1950s – During World War II, American, British, and German soldiers used methamphetamine to combat fatigue, while Japanese Kamikaze pilots also received the drug. After the war, surplus methamphetamine entered civilian markets in Japan, where the Yakuza facilitated widespread distribution. Truck drivers, students, and women seeking weight loss also contributed to increasing nonmedical use.^20,34

• 1960s – Limited public awareness allowed methamphetamine abuse to expand. Outlaw motorcycle gangs began manufacturing the drug, giving rise to the term crank because it was reportedly hidden in motorcycle crankcases. As intravenous methamphetamine use spread through the "speed freak" subculture, increasing episodes of violent and erratic behavior prompted greater medical and regulatory attention.^20,34

• 1970s – Increasing misuse resulted in federal restrictions on legal production, contributing to expanded illicit manufacture. Most clandestine laboratories were located in the western and southwestern United States because precursor chemicals were readily available from Mexico. Rural locations were frequently selected to avoid detection of chemical odors generated during production.^20,34

• 1980s – A purer, smokable form of methamphetamine emerged in Hawaii.^20,34

• 1990s – Simplified manufacturing methods made methamphetamine easier to produce and more potent. Use spread throughout the Midwest, prompting increased legislative and law enforcement efforts to reduce methamphetamine manufacture and distribution.^20,34

• 2000–2004 – Domestic clandestine laboratories increased substantially, and Oklahoma became the first state to restrict access to key precursor chemicals.³²

• 2005 – The Combat Methamphetamine Epidemic Act established federal restrictions on the sale of pseudoephedrine-containing products, including behind-the-counter placement, purchaser identification, purchase limits, and sales logs.³²

• 2007 – The Methamphetamine Remediation Research Act directed the U.S. Environmental Protection Agency (EPA) to develop voluntary guidelines for cleanup of former methamphetamine laboratories.³⁶

• 2008 – The Substance Abuse and Mental Health Services Administration (SAMHSA) convened a national summit addressing the unique needs of justice-involved populations, LGBTQ+ individuals, and women affected by methamphetamine use.⁴

• 2011–2012 – Although media attention shifted toward prescription opioid misuse, methamphetamine use continued to increase. Methamphetamine laboratory activity resurged, and seizures along the U.S.–Mexico border reached their highest levels in several years.^2,30

• 2012–2016 – Law enforcement and treatment data demonstrated continued increases in methamphetamine trafficking and use nationwide. Liquid methamphetamine trafficking emerged as a growing challenge because of its ease of concealment. During this period, opioid-related overdose deaths also increased substantially, particularly involving prescription opioids, heroin, and illicitly manufactured fentanyl.^2,30

• 2017–2020 – Congress enacted the Methamphetamine Response Act, requiring the federal government to designate methamphetamine as an emerging drug threat and develop a coordinated national response. During this period, overdose deaths involving methamphetamine increased markedly, particularly among individuals using methamphetamine together with illicit fentanyl.^2,31

• 2020–Present – The illicit methamphetamine landscape has shifted dramatically. Today, most methamphetamine available in the United States is produced by large transnational criminal organizations rather than domestic clandestine laboratories. Increased purity, lower cost, and widespread availability have contributed to rising stimulant use and increasing numbers of overdose deaths, particularly among individuals using methamphetamine together with illicit fentanyl.^2,6,30,34