Crystal in the Gem City

Crystal in the Gem City: Characterizing a Methamphetamine Outbreak in the Area of a High Prevalence of Illicit Fentanyl Use

Raminta Daniulaityte, PI; Sydney M. Silverstein, WSU-PI/Co-I; Kylie Getz, Research Assistant 

While substantial public health resources are being devoted to the devastating consequences of the opioid crisis, methamphetamine availability and use have increased significantly in many parts of the country. There is a critical lack of understanding of the initiation pathways, motivations, adverse health consequences, and substance abuse treatment needs of MA users in the context of the unprecedented increases in MA availability in the Dayton area. Preliminary evidence indicates the emergence of a “twin epidemic” with illicit opioid users engaging in polydrug use practices and/or transitioning to MA use.  There is also a growing concern about increased cases of MA being contaminated with NPFs and other drugs. In addition to tracking forensic data on overdose deaths and seized drugs, research is needed to analyze urine toxicology of active MA users to better understand polydrug use practices and cross-contamination issues. Further, to obtain a more complete characterization of the outbreak, it is critical to expand beyond the parameters of the “twin epidemic” to understand how MA availability is impacting drug users who are not associated with the heroin/NPF use scene.

The overall purpose of this study is to characterize the MA outbreak through mixed methods research that integrates qualitative/structured interview data, urine toxicology, and forensic data on seized drugs and unintentional overdose deaths in the Dayton area. The study builds on an established interdisciplinary partnership between researchers at the Center for Interventions, Treatment and Addictions Research (CITAR) and the Montgomery County Coroner’s Office/Miami Valley Regional Crime Lab (MCCO/MVRCL).. The Specific Aims of the study are to:

1. Characterize knowledge, attitudes and behaviors related to MA use among 90 active MA users (30 “CURRENT heroin/NPF”; 30 “PAST heroin/NPF”; 30 “NEVER heroin/NPF”) and conduct preliminary analyses of similarities and differences between the three subgroups through integration of ethnographic and structured interview data.
2. Analyze urine toxicology and assess concordance with self-reported use of MA, NPFs, heroin and other drugs among 90 active MA users.
3. Analyze forensic data to characterize MA trends in the Dayton area.

This study uses a concPbecause the findings will provide preliminary key indicators to help substance abuse treatment services and public health authorities gain perspective on emerging MA trends in the context of the opioid epidemic.

Publications

Daniulaityte, R., Silverstein, S. M., Getz, K., Juhascik, M., McElhinny, M., & Dudley, S. (2022). Lay knowledge and practices of methamphetamine use to manage opioid-related overdose risks. International Journal of Drug Policy, 99, 103463.

Silverstein, S. M., Daniulaityte, R., Getz, K., & Zule, W. (2021). “It’s Crazy What Meth Can Help You Do”: Lay Beliefs, Practices, and Experiences of Using Methamphetamine to Self-Treat Symptoms of Opioid Withdrawal. Substance use & misuse, 56(11), 1687-1696.