Methamphetamine exposures reported to United States poison control centers, 2000-2019

Objective To investigate characteristics and trends of methamphetamine exposures reported to United States (US) poison control centers. Methods Data from the National Poison Data System were analyzed. Results From January 1, 2000 through December 31, 2019, US poison control centers managed 54,199 cases involving methamphetamine as the first-ranked substance. Adults 20-39 years old accounted for more than half (56.3%) of cases. There were 1,291 deaths, of which 43.0% involved multiple-substance exposures. Among multiple-substance exposures in which methamphetamine was the first-ranked substance, stimulants and street drugs (excluding methamphetamine) were most commonly also present (22.7%), followed by opioids (19.0%). The substance class associated with the most fatalities was opioids (n = 243, 26.6%). The rate of methamphetamine exposures per 100,000 US population increased from 0.6 to 1.1 from 2000-2005, then decreased from 1.1 to 0.4 from 2005-2007, followed by an increase from 0.4 to 2.6 from 2007-2019. From 2007-2019, the rate significantly increased in all US regions, and among all age groups, except among 6-12-year-olds. Also, the rates of single-substance and multiple-substance exposures each increased significantly (both p < 0.0001) from 2007-2019, as did the overall methamphetamine fatality rate per 100,000 US population (0.0036 to 0.022, p < 0.0001). From 2000-2019, the proportions of cases resulting in admission to a health care facility and serious medical outcome increased from 30.2% to 47.8% (p < 0.0001) and from 37.6% to 54.0% (p < 0.0001), respectively. Conclusions The rate of exposure to methamphetamine in the US declined initially following passage of the Combat Methamphetamine Epidemic Act of 2005. However, since 2007, the rate and severity of exposures to methamphetamine have increased, primarily driven by individuals 20 years or older. Increased prevention efforts are needed, including prevention of methamphetamine initiation among adolescents and young adults, improved access to effective treatment for co-occurring mental health and substance use disorders, and prevention of unintentional exposures among children.