Issue 27	2006

Methamphetamine/Amphetamine Treatment Admissions in Urban and Rural Areas: 2004

Methamphetamines and amphetamines are central nervous system stimulants. They were the primary, secondary, or tertiary substance of abuse in more than 228,800 admissions, or 12 percent of all treatment admissions, in 2004.^{1, 2} Methamphetamine/amphetamines as a primary substance of abuse accounted for 8 percent of all admissions. Data are from the Treatment Episode Data Set (TEDS), an annual compilation of data on the 1.9 million annual admissions to substance abuse treatment facilities, primarily those that receive some public funding. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once.

This report examines the approximately 209,600 admissions where methamphetamines or amphetamines were the primary, secondary, or tertiary substance of abuse and where the admission record included the treatment location. Five urbanization levels based on the county classification scheme developed by the National Center for Health Statistics (NCHS) were used.^3,4

Large Central Metro—County in a Metropolitan Statistical Area (MSA) of 1 million or more population that contained all or part of the largest central city of the MSA
Large Fringe Metro—County in a large MSA (1 million or more population) that did not contain any part of the largest central city of the MSA
Small Metro—County in an MSA with less than 1 million population
Non-Metro with City—County not in an MSA but with a city of 10,000 or more population
Non-Metro without City—County not in an MSA and without a city of 10,000 or more population

TEDS records indicate where persons entered treatment, not their area of residence. Because not all counties have substance abuse treatment facilities (or for other reasons), people may seek treatment at a facility (and urbanization level) in a location other than the county of their residence. Table 1 compares the levels of urbanization of all counties in the United States with that of counties with treatment facilities reporting substance abuse admissions to TEDS.

Table 1. County Urbanization in the United States and in Counties Reporting Substance Abuse Admissions to TEDS: 2004

	United States	TEDS
Number of Counties	3,100	1,500*
Large Central Metro	2%	4%
Large Fringe Metro	8%	12%
Small Metro	17%	25%
Non-Metro with City	15%	22%
Non-Metro without City	58%	37%

* No (or few) county-level data are available for AZ, ID, IN, PR, WI, and WV. Source: 2004 SAMHSA Treatment Episode Data Set (TEDS).

The national treatment admission rate for methamphetamines/amphetamines was 85 admissions per 100,000 persons aged 12 or older (Figure 1). Non-metropolitan areas with cities had the highest admission rate for methamphetamines/amphetamines—160 admissions per 100,000 persons aged 12 or older, and large fringe metropolitan areas had the lowest admission rate—49 admissions per 100,000 persons aged 12 or older.

Figure 1. Methamphetamine/Amphetamine Admission Rates, by Urbanization: 2004

Source: 2004 SAMHSA Treatment Episode Data Set (TEDS).

Figure 1 Table. Methamphetamine/Amphetamine Admission Rates, by Urbanization: 2004

Urbanization	Admissions per 100,000 Aged 12 or Older
Total U.S.	85
Large Central Metro	86
Large Fringe Metro	49
Small Metro	95
Non-Metro with City	160
Non-Metro without City	66

Source: 2004 SAMHSA Treatment Episode Data Set (TEDS).

In contrast, methamphetamine/amphetamine admissions were most likely to occur in the small metropolitan areas (34 percent) (Figure 2). The two most urbanized areas—large central metropolitan and large fringe metropolitan areas—had the lowest proportions of methamphetamine/amphetamine admissions compared to all other admissions (28 vs. 33 percent and 13 vs. 21 percent, respectively).

Figure 2. Methamphetamine/Amphetamine and All Other Admissions, by Urbanization: 2004

Source: 2004 SAMHSA Treatment Episode Data Set (TEDS).

Figure 2 Table. Methamphetamine/Amphetamine and All Other Admissions, by Urbanization: 2004

Urbanization	Methamphetamine/ Amphetamine Admissions	All Other Admissions
Large Central Metro	28%	33%
Large Fringe Metro	13%	21%
Small Metro	34%	31%
Non-Metro with City	17%	9%
Non-Metro without City	8%	6%

Source: 2003 SAMHSA Treatment Episode Data Set (TEDS).

The mean age of admission for methamphetamine/amphetamine treatment was highest in large central metropolitan areas—31 years—and 30 years for all other urbanization levels. Admissions for methamphetamine/amphetamine aged 18 to 25 years old were proportionately lowest in the most urbanized counties and highest in the most rural counties (26 vs. 32 percent). In contrast, the proportion of 35- to 49-year-old methamphetamine/amphetamine admissions was highest in the most urban counties and lowest in the more rural non-metropolitan areas with a city (34 vs. 28 percent).

Male admissions for methamphetamine/amphetamines were consistently higher than female admissions across all levels of urbanization (most urban: 59 vs. 41 percent; most rural: 60 vs. 40 percent).

The proportion of methamphetamine/amphetamine admissions reporting their race as White increased as the level of urbanization became more rural (Table 2). In contrast, the proportions of both Black and Hispanic methamphetamine/amphetamine admissions were highest in the most urbanized counties and lowest in the most rural counties.

Smoking was the most common route of administration among methamphetamine/amphetamine admissions at every urbanization level (Figure 3). However, the percentage of admissions that smoked these drugs decreased from 62 percent in the most urbanized counties to 48 percent in the most rural counties. The percentage of methamphetamine/amphetamine admissions that injected the drugs was 14 to 15 percent in the large metro areas and 24 to 25 percent in small and non-metro areas..

Figure 3. Methamphetamine/Amphetamine Admissions, by Route of Administration and Urbanization: 2004

Source: 2004 SAMHSA Treatment Episode Data Set (TEDS).

Figure 3 Table. Methamphetamine/Amphetamine Admissions, by Route of Administration and Urbanization: 2004

Source of Referral	Smoking	Injection	Inhalation	Oral	Other
Large Central Metro	62%	15%	16%	6%	1%
Large Fringe Metro	60%	14%	15%	9%	2%
Small Metro	54%	24%	13%	7%	2%
Non-Metro with City	50%	25%	16%	7%	2%
Non-Metro without City	48%	24%	19%	7%	2%

Source: 2004 SAMHSA Treatment Episode Data Set (TEDS).

Methamphetamine/amphetamine admissions in the most urbanized counties were more likely to report daily use compared to admissions in the most rural counties (30 vs. 19 percent). Admissions from the most rural counties, however, were more likely than admissions from the most urbanized counties to have reported no use in the past month (53 vs. 35 percent).

¹ TEDS records up to three substances of abuse: the primary substance of abuse is the main substance reported at the time of admission; secondary/tertiary substances are other substances of abuse also reported at the time of admission. The methamphetamine/amphetamine admissions discussed in this report include all admissions reporting primary, secondary, or tertiary abuse of methamphetamines or other amphetamines. Admissions involving other stimulants are excluded from this report. For information on trends in admissions where methamphetamines/amphetamines were the primary substances of abuse, see Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (Issue 9, 2006). The DASIS report: Trends in methamphetamine/amphetamine admissions to treatment: 1993-2003. Rockville, MD.
² Methamphetamine/amphetamine admissions are discussed together because 3 (OR, TN, and TX) of the 52 States and jurisdictions in TEDS do not distinguish between these drugs as substances of abuse. However, for the States that make this distinction, 83 percent of methamphetamine/amphetamine admissions were for methamphetamine in 2004. AZ and NE classified all methamphetamine/amphetamine admissions as methamphetamine admissions.
³ Eberhardt, M.S., Ingram, D.D., Makuc, D.M., et al. (2001). Urban and Rural Health Chartbook. Health, United States, 2001. Hyattsville, MD: National Center for Health Statistics.
⁴ The classification system used for these reports does not designate any of the five levels as “Rural.” For the purposes of this report, when the terms “rural” or “most rural” are used, it refers to those counties classified as “Non-Metro without a city of 10,000+”. When the term “most urbanized” is used in this report, it refers to those counties classified as “Large Central Metro”.

The Drug and Alcohol Services Information System (DASIS) is an integrated data system maintained by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). One component of DASIS is the Treatment Episode Data Set (TEDS). TEDS is a compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment. The information comes primarily from facilities that receive some public funding. Information on treatment admissions is routinely collected by State administrative systems and then submitted to SAMHSA in a standard format. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once. State admission data are reported to TEDS by the Single State Agencies (SSAs) for substance abuse treatment. There are significant differences among State data collection systems. Sources of State variation include completeness of reporting, facilities reporting TEDS data, clients included, and treatment resources available. See the annual TEDS reports for details. Approximately 1.9 million records are included in TEDS each year. The DASIS Report is prepared by the Office of Applied Studies, SAMHSA; Synectics for Management Decisions, Inc., Arlington, Virginia; and by RTI International in Research Triangle Park, North Carolina (RTI International is a trade name of Research Triangle Institute). Information and data for this issue are based on data reported to TEDS through February 1, 2006. Access the latest TEDS reports at: http://www.oas.samhsa.gov/dasis.htm Access the latest TEDS public use files at: http://www.oas.samhsa.gov/SAMHDA.htm Other substance abuse reports are available at: http://www.oas.samhsa.gov

The DASIS Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available on-line: http://www.oas.samhsa.gov. Citation of the source is appreciated. For questions about this report please e-mail: shortreports@samhsa.hhs.gov

This page was last updated on December 30, 2008.