Unweighted and weighted prevalence of methamphetamine use, any past-180-day nonfatal overdose, and number of lifetime nonfatal overdoses.Īmong the 3048 participants, 1737 (57%) were male, 2576 (85%) were White, and 225 (7.4%) were American Indian the mean (SD) age was 36 (10) years. Use of methamphetamine alone, opioids alone, or both. Data analysis was performed from May 2021 to January 2022. A modified chain-referral sampling strategy identified seeds who referred others using drugs. Participants included rural PWUD who reported any past-30-day injection drug use or noninjection opioid use to get high. To estimate the prevalence of methamphetamine use and its correlates among people who use drugs (PWUD) in rural US communities and to determine whether methamphetamine use is associated with increased nonfatal overdoses.įrom January 2018 through March 2020, the National Rural Opioid Initiative conducted cross-sectional surveys of PWUD in rural communities in 10 states (Illinois, Kentucky, New Hampshire, Massachusetts, North Carolina, Ohio, Oregon, Vermont, West Virginia, and Wisconsin). Overdoses continue to increase in the US, but the contribution of methamphetamine use is understudied in rural communities. Efforts to improve MOUD care and overdose prevention strategies are needed for this population. Future research should examine how specific policies and treatment models impact MOUD outcomes for these patients, and seek to understand the perspectives of MOUD providers and people who use both opioids and methamphetamine/amphetamines. Overall, existing research suggests people who use methamphetamine/amphetamines may have lower receipt of MOUD, retention in MOUD, and opioid abstinence during MOUD.

Most studies examining opioid abstinence during other types of MOUD treatment had small samples. Studies generally found negative associations with opioid abstinence during treatment among patients receiving methadone or sustained-release naltrexone implants, though observed associations may have been confounded by other polysubstance use. Studies generally found negative associations with retention most studies finding no association had small samples, and these studies tended to examine shorter retention timeframes and describe provision of adjunctive services to address substance use. Studies generally found that methamphetamine/amphetamine use or use disorder was negatively associated with receiving methadone and buprenorphine 2 studies suggested positive associations with receiving naltrexone. Thirty-nine studies met inclusion criteria. Study characteristics and findings were summarized for each class of outcomes.

Screening, inclusion, data extraction and bias assessment were conducted independently by 2 authors.

Study data were extracted using a standardized template, and risk of bias was assessed for each study. English-language studies of people with documented OUD/opioid use that reported a quantitative association between methamphetamine/amphetamine use or use disorder and an outcome of interest were included. We searched 3 databases (PubMed/MEDLINE, PsycINFO, CINAHL Complete) from to using key words and subject headings, and hand-searched reference lists of included articles. This systematic review identified studies that examined associations between methamphetamine/amphetamine use or use disorder and 3 classes of outcomes: (1) receipt of MOUD, (2) retention in MOUD, and (3) opioid abstinence during MOUD. It is therefore important to understand whether and how use of these substances may impact receipt of, and outcomes associated with, medications for OUD (MOUD). Methamphetamine/amphetamine use has sharply increased among people with opioid use disorder (OUD).

Methamphetamine vs amphetamine