DentalCare Logo

Methamphetamine: Implications for the Dental Team

Course Number: 332

Methamphetamine as a Social Problem

The problems with meth are widespread. Children and the general public may be affected by the fumes from meth labs operating in or near their homes. The prison system is overwhelmed by the dental needs of incarcerated meth users. Hospital emergency departments (ED) report that meth is a significant drug problem. The 2021 National Survey on Drug Use and Health (NSDUH) reported that in 2020, meth-related visits to the ED ranked 3rd at 11.29% (811,464 visits) behind alcohol at 41.7% (2,996,16 visits) and opioids at 14.79% (1,062,864 visits).73 The meth production method known as the shake and bake, one pot, or 2-liter bottle method is resulting in serious burns, overwhelming hospitals with uninsured burn victims. Burn care averages $6,000 per day and the average meth burn victim stays approximately 3 weeks resulting in a bill of $130,000 which is 60% more than other burn victims.90 This influx is causing the closure of burn units.66 Meth labs are frequently guarded by attack dogs or explosive booby-traps. Law enforcement officers are at-risk as they investigate complaints of possible meth labs. The general public faces potential hazards as meth labs are inadvertently discovered during such activities as hunting, fishing, and hiking. Due to the explosive and toxic nature of the manufacturing process, meth labs in homes, hotel rooms, and cars both on the street and in parking lots put the general public at risk. Meth production in a nursing home room in Ohio resulted in a fire that killed one person and injured 6 others. It is believed that at least 3 visitors and 1 resident knew about the meth production which used the 2-liter bottle method.33 At least 2 libraries in Colorado and parts of the Englewood Civic Center were closed in January 2023 due to meth contamination after reports of people smoking meth in the restrooms.

Crimes, including identity theft, are increasingly associated with meth users. While identity theft is normally associated with elaborate computer schemes, when officials in Colorado and other western states looked at a rise in meth use and a rise in mailbox break-ins and theft of documents from garbage cans, a connection became apparent. Because meth users are awake for days and can fixate on small details, identity theft is the perfect drug habit support system. Meth users are able to look for check or credit card numbers and then convert the stolen identities to money, drugs or ingredients to make more meth. Theft, domestic violence and rape are also associated with meth users and producers.47 Meth is the substance that contributes most to violent crimes.73 A system of obtaining cold pills known as ‘smurfing’ is on the rise.37 Meth producers recruit people to go to every store in an area and purchase the limit of cold medicine. They punch out the pills from the blister pack into a bucket. The purchaser pays $7-8 a pack yet earns $40-50. There are willing participants lured by the economy and the promise of easy money. Meth incidents decreased by almost ⅔ from 2005-2007 with the advent of tracking laws. From 2007-2009, meth incidents increased 62% over the prior two years, largely due to smurfing.65

Dealing with meth is expensive. Oklahoma estimates that the typical meth lab case costs the state $350,000. Added to that are the costs of training law enforcement officers, incarceration and treatment of the user, and child welfare services that can easily add an additional $50,000. Furthermore, meth lab cleanup is complicated and expensive. According to the National Drug Intelligence Center, the manufacture of one pound of meth creates five to seven pounds of toxic waste that is as dangerous as the drug. When the toxic waste is dumped, protected lands and ground water are contaminated. This contamination places domestic and wild animals and humans at risk for sickness and death. In 2009, the RAND Corporation published a national estimate of the economic burden of meth use.95 Using data from 2005, they estimated that $23.4 billion is spent yearly in the US due to meth abuse. Included are such costs as the burden of addiction, premature death, drug treatment, and aspects of lost productivity, crime and criminal justice, health care, production and environmental hazards, and child endangerment.81 Meth abuse also contributes to increased transmission of infectious diseases, such as hepatitis and HIV/AIDS, and makes communities vulnerable to social ills such as new crime waves, unemployment, and child neglect or abuse.40

Meth users can be seduced by the intensity of the initial high – a high many users say is unlike anything they have experienced before. Most of the pleasurable effects of methamphetamine are believed to result from the release of very high levels of the neurotransmitter dopamine. Dopamine is involved in motivation, the experience of pleasure, and motor function, and is a common mechanism of action for most drugs of abuse. The elevated release of dopamine produced by methamphetamine is also thought to contribute to the drug’s deleterious effects on nerve terminals in the brain.10 Almost immediately, users build up a tolerance for the drug causing the user to adjust the quantity, frequency or method of intake in an attempt to recreate that first high. The user may binge, using a gram of meth every 2-3 hours for several days until they exhaust their supply or are too disoriented to continue. This binge is known as a ‘run.’

Polysubstance use (using more than one type of substance), and related overdose have become more common recently, particularly involving opioids such as fentanyl, and stimulants such as methamphetamine. When methamphetamine is mixed or taken in consecutively with fentanyl or another opioid, this is often referred to as "speedballing" or "goofballing". This combination of drugs significantly increases the risk of overdose especially from respiratory depression.43

Public awareness has been raised recently with the various anti-meth campaigns. Texas, Montana and Oregon have been leaders in these public awareness campaigns. Meth is considered by many to be the world’s most dangerous drug. However, a survey conducted by the Meth Project indicated that 24% of teens believe meth has positive benefits including making you feel happy, helping you deal with boredom and helping you lose weight. These results underscore the continuing need for meth education programs. A focused program of the Montana Meth Project reduced meth use among Montana teens by 45% between 2005 and 2008 while use nationally did not decrease. Additionally, meth related crimes dropped by 50% and workers testing positive for meth dropped by 70%. As part of a federal grant, Ohio has begun a program called Face:Meth. This program strives to educate employees to spot purchases that might indicate someone is gathering ingredients to make meth.6 In September 2015, the US Department of Justice awarded a total of $6.1 million in grant money, through the COPS (Community Oriented Policing Services) Anti-Methamphetamine Program (CAMP), to California, Iowa, Missouri, New Mexico, New York, Ohio and Tennessee to help stem the manufacture of meth and related crimes. In 2021, the grant money increased to $13.35 million and was distributed to nine states including Florida, Iowa, Massachusetts, New Jersey, New York, Oklahoma, Pennsylvania, Tennessee and Virginia.96

The “Not Even Once” campaign focuses on reaching youth at their level to promote the dangers of substance abuse. Since youth find a sense of belonging in subcultures, this program promotes healthy lifestyles by enjoying alternative adrenaline-fueled pursuits without drugs and alcohol. At events centered on surfing, skateboarding and music, the promoters encourage social youth responsibility while learning new sports skills.

There are two emerging trends in the meth phenomenon. The 2018 NDTA reports that drones are increasingly being used to distribute meth.85 In 2020, two Arizona residents were arrested in Yuma for flying 24.9 pounds of meth across the border, using a drone. Drones have also been used to drop other illicit drugs. While disadvantages of drone use include the noise level and limited battery life and payload weight, it is predicted that technological advances will most likely address these issues. The advantages of drone use include GPS tracking and remote/autopilot features. Since the operator is away from the area where the drugs are dropped, the likelihood of being caught decreases. The second trend, reported in the 2018 World Drug Report, is the use of the darknet to sell meth.93 Although the scale is limited, it is increasing. From 2011-2016, the sale of meth on the darknet was estimated at $44 million per year. A newer study in early 2016 estimated that sales have increased to $170 - 300 million per year. While strides are being made in shutting down meth sales on the darknet, it remains an area of concern.