"Harms related to methamphetamine use are a growing public health problem. In 2021, 1.6 million Americans met the criteria for stimulant use disorder (methamphetamine type), hereafter called methamphetamine use disorder (MUD; 1). Recent research indicates methamphetamine overdose mortality and patterns of risky use have increased in recent years, particularly for those with socioeconomic risk factors and comorbidities [1]. Accordingly, methamphetamine-related harms are also a health equity issue. MUD prevalence rates more than doubled in White, Hispanic and Asian/Native Hawaiian/Other Pacific Islander populations from 2015 to 2019, with prevalence in Black people increasing approximately six-fold during that time [1]. Although White people have experienced increased overdose deaths involving methamphetamine, minoritized populations have been especially hard hit [1, 2]. Further, recent evidence points to “twin” opioid and methamphetamine epidemics, particularly in rural communities, where methamphetamine surpassed opioids as the most injected substance [3].
"Each year, approximately 90% of individuals with substance use disorders (SUDs) in the U.S. do not engage in treatment [4]. Further, people who use methamphetamine (PWUM) engage in treatment at particularly low rates [5]. This is especially true in rural areas, where unlike opioids, there are fewer evidence-based treatments for MUD, nor trained behavioral health professionals with which to provide such care [3]. However, this treatment gap is improperly framed as merely a problem of treatment accessibility. According to estimates from the National Survey on Drug Use and Health (NSDUH), of the 39.7 million adults in the US with SUDs who did not receive treatment in 2022, 94.7% reported that they did not perceive a need for treatment or did not desire the exclusively abstinence-based treatment options that were provided [4]. In order to reach individuals who are potentially interested in treatment, it is important to focus on treatment acceptability, which is a critically overlooked aspect of the treatment gap."
Elswick, A., Fallin-Bennett, A., Roper, K.L. et al. An exploration of desired abstinent and non-abstinent recovery outcomes among people who use methamphetamine. Harm Reduct J 22, 7 (2025). https://doi.org/10.1186/s12954-025-01155-6
