According to most national surveys, use of the addictive illicit drug methamphetamine has dropped significantly over the past 5 years, with especially strong declines noted since 2005.

However, in recent months, reports about a possible resurgence of the drug—and the highly toxic home labs in which it can be manufactured— have surfaced in major media outlets including The New York Times and ABC News. Earlier this year in Tulsa, Oklahoma, where thousands of meth labs have been busted in the past decade, Mayor Kathy Taylor convened a Town Hall meeting to awaken the community to a new threat—a “one-pot” method of cooking meth that was portable, simple and quickly gaining popularity among a new generation of meth cooks around the country. Meth lab seizures nationwide are on the rise for the first time since 2003, with the number of labs discovered up 14 percent in 2008 versus the previous year.

To assess the status of the meth threat in the United States, we turned to one of the country’s foremost substance abuse experts and a pioneer in treatment research for methamphetamine addiction, Richard A. Rawson, Ph.D., Associate Director of UCLA Integrated Substance Abuse Programs and Professor-in-Residence at the UCLA Department of Psychiatry. Rawson shared his thoughts on how meth use is reported, the problem of “regional” drug threats, and his concerns about increased lab activity.

Over the past 20 years, the data we have used to estimate the severity of the meth problem have been very confusing. Data from surveys, including the National Survey on Drug Use and Health (the Household Survey, conducted by the Substance Abuse and Mental Health Services Administration) and the Monitoring the Future Survey (funded by NIDA), have consistently suggested the meth problem is limited to several specific regions of the US and is not truly a major national public heath problem. However these surveys rely on accurate self reporting, which may create underestimates and they don’t gather data from homeless people, transient people, or those in psychiatric facilities or prison. This almost guarantees that the actual number of meth users is being underreported--in fact, some say the underestimate may be by a factor of 3 or 4 times the real number.

Other measures of the problem, including treatment program admissions, reports from local governmental officials (National Organization of County Administrators) and police officials consistently have argued that in many parts of the US, meth is a major public health problem. I’ve always felt that if the meth problem that was in cities like San Diego, Honolulu, Des Moines and Oklahoma City had been occurring in New York City or within the Beltway, the meth problem would have been viewed as a national catastrophe on par with the crack problem in the 80s. It is easier for the national media and federal policy makers tend to recognize a problem when its on their doorstep, than when it is primarily somewhere far away in rural America.

All that said, I do think the precursor laws limiting consumer access to pseudoephedrine have dramatically reduced the number of meth labs in the US and have helped decrease the supply in parts of the country where drug cartel supplies aren’t well established. Also, all indicators do show that there has been a real reduction in new users. However, that doesn’t mean the problem has gone away. Hopefully it is improving, but as with the economic recovery, while turning the corner is great, there are many casualties who are still out there addicted to meth. Many are in prison and face a high risk of relapse upon release, and in many communities, there is a core of meth-addicted individuals who will make sure the supply continues and the problem persists. The economic burden of meth is overwhelming—from the costs of combating meth-related crime to lab cleanup, addiction treatment, lost productivity and health care, a recent RAND study estimated that the meth problem costs the United States $24 billion every year.

If we look at the history of methamphetamine use in the US, we have seen that precursor regulations do reduce meth supplies. This happened in 1989, 1995 and 1997. However, after each of these reductions, the drug traffickers adapted strategies for producing and supplying meth and there was a rebound in the problem. In fact, in 2008 we saw an uptick in meth lab seizures after a 4 year pattern of decreases. In some states, like Missouri, lab seizures are up considerably.

Just as the cocaine epidemic decreased dramatically in the 90s and almost disappeared in many parts of the US, in the inner cities of America, cocaine/crack is still a massive public health problem. Similarly, the meth problem may not be bringing in a new bunch of 16 year-olds and that’s progress, but in Southern California and much of the Midwest, meth will remain a substantial problem for the foreseeable future. We have inadequate amounts of treatment currently available for treating meth users and the promising epidemiological data should not be seen as victory. Many people currently need treatment who don’t have treatment available and many will continue to need treatment. This is not the time to declare “Mission Accomplished”. Many communities are still struggling with the problem of meth and many families and individuals still are searching for treatment.