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SARC Supplement No. 4

November 2007

Research to Policy:  California Substance Abuse Research Consortium (SARC) Meetings 2006

Editor’s Introduction: California Substance Abuse Research Consortium 2006 — Beth Rutkowski, M.P.H.; Thomas Freese, Ph.D. & Richard Rawson, Ph.D.

Substance Abuse Research Consortium (SARC): Introduction —Kathryn P. Jett 

Indicators of Methamphetamine Use and Abuse in San Diego County, California: 2001-2005 — Robin A. Pollini, Ph.D. M.P.H. & Steffanie A. Strathdee, Ph.D.

A Collaborative Model for Community Action Against Methamphetamine — Angela Goldberg, M.A. 

Methamphetamine Use Among San Diego County Arrestees —Cynthia Burke, Ph.D. 

Women with Methamphetamine Dependence: Research on Etiology and Treatment — Judith B. Cohen, Ph.D.; Rivka Greenberg, Ph.D.; Joshua Uri, B.A.; Mary Halpin, B.A. & Joan E. Zweben, Ph.D. 

Psychosocial and Behavioral Correlates of Depressed Mood Among Female Methamphetamine Users   —Shirley J. Semple, Ph.D.; Jim Zians, Ph.D.; Steffanie A. Strathdee, Ph.D. & Thomas L. Patterson, Ph.D. 

Criminal Justice Treatment Admissions for Methamphetamine Use in California:  A Focus on Proposition 36 — M. Douglas Anglin, Ph.D.; Darren Urada, Ph.D.; Mary-Lynn Brecht, Ph.D.;  Angela Hawken, Ph.D.; Richard Rawson, Ph.D. & Douglas Longshore, Ph.D. 

The Rise in Treatment Admissions for Methamphetamine Use in Los Angeles County from 2001 through 2005— Desirée Crèvecoeur, Ph.D.; Beth Rutkowski, M.P.H. & Richard A. Rawson, Ph.D. 

A Nine Session Manual of Motivational Enhancement Therapy for Methamphetamine Dependence: Adherence and Efficacy — Gantt P. Galloway, Pharm.D.; Douglas Polcin, Ed.D., M.F.T.; Anousheh Kielstein, M.D.; Michelle Brown, M.F.T. & John Mendelson, M.D.

Health Status of Illicit Stimulant Drug Users in Rural Ohio — Russel S. Falck, M.A.; Jichuan Wang, Ph.D. & Robert G. Carlson, Ph.D.  

Kentucky Rural Stimulant Use: A Comparison of Methamphetamine and Other Stimulant Users — William W. Stoops, Ph.D.; Michele Staton Tindall, Ph.D.; Jennifer R. Havens, Ph.D.; Carrie B. Oser, Ph.D.; J. Matthew Webster, Ph.D.; Allison Mateyoke-Scrivner, M.A.; Patricia B. Wright, R.N., M.P.H.; Brenda M. Booth, Ph.D. & Carl G. Leukefeld, D.S.W.

COVER ART - Surrealistic Pills II by Brad Knudson

Abstracts

Indicators of Methamphetamine Use and Abuse in San Diego County, California: 2001-2005  — Robin A. Pollini, Ph.D. M.P.H. & Steffanie A. Strathdee, Ph.D.

Abstract—San Diego County, California, is a major distribution center for methamphetamine entering the U.S. from Mexico. All available indicators suggest that the use and abuse of methamphetamine increased between 2001 and 2005. Drug treatment admissions for primary methamphetamine use accounted for 49% of all drug treatment admissions in 2005, up from 37% in 2001, with trends showing smaller proportions of female and Hispanic users and a larger proportion of methamphetamine smokers (vs. inhalation or injection). Increases in prevalence of methamphetamine use were documented among arrestees as well; by 2005, 51% of female and 21% of juvenile arrestees tested positive for methamphetamine. The proportion of emergency department visits involving illicit drugs in which methamphetamine was reported increased from 32% in 2004 to 40% in 2005, although this change was not statistically significant, and methamphetamine-related deaths increased 48% between 2001 and 2005. Data from non-federal drug seizures in San Diego County documented an increase from 21% of all drug items analyzed in 2001 to 32% in 2005. In summary, methamphetamine remains the drug of utmost concern in San Diego. The availability of multiple data sources is imperative for constructing valid characterizations of trends in methamphetamine use and abuse and its affect on health.

Keywords—drug treatment, epidemiology, indicators, methamphetamine, San Diego

A Collaborative Model for Community Action Against Methamphetamine — Angela Goldberg, M.A.

Abstract—San Diego County has a long history of chronic use of methamphetamine, and thus also has a track record in organizing an effective community response. This article discusses the formation and structure of the Methamphetamine Strike Force, and discusses its multidisciplinary collaborative problem solving model. Four strategies—prevention, intervention, treatment and interdiction—form a comprehensive set of recommendations that have guided action over the last decade. The Strike Force provides the region with a structure to mobilize its rich in-kind resources towards a shared plan of action. Data, organizing, media, policy and law enforcement are all central to the emerging model.

Keywords—media, methamphetamine, methamphetamine-associated crime, Methamphetamine Strike Force, Report Card

Methamphetamine Use Among San Diego County Arrestees —Cynthia Burke, Ph.D.

Abstract—Between 1987 and 2003, an objective measure of recent drug use from a high-risk group was collected as part of a federally-funded program called ADAM (Arrestee Drug Abuse Monitoring). The information collected as part of this project supplemented other self-report data collected across the country with the general population. San Diego County was one of the original ADAM sites, and with local funding support was able to maintain the essential aspects of the program uninterrupted when national support was discontinued. In May 2006, the results of data collected in calendar year 2005 as part of a standard interview with adult and juvenile arrestees, urinalysis, as well as a methamphetamine (meth) addendum were presented at the Substance Abuse Research Consortium (SARC) meeting in Pasadena, California. This article provides a summary of these descriptive data, including a profile of recent meth users, reasons for initiating and continuing use, patterns of use, and trends in use over time. Additionally, information regarding juveniles’ perceived risk of meth use and the potential effects meth has on communities is highlighted. Potential policy implications and areas for further research are also discussed.

Keywords—ADAM, arrestee, drugs methamphetamine, San Diego, Substance Abuse Monitoring (SAM), treatment

Criminal Justice Treatment Admissions for Methamphetamine Use in California:  A Focus on Proposition 36 — M. Douglas Anglin, Ph.D.; Darren Urada, Ph.D.; Mary-Lynn Brecht, Ph.D.; Angela Hawken, Ph.D.; Richard Rawson, Ph.D. & Douglas Longshore, Ph.D.
Abstract—Methamphetamine (MA) use is considered as one of the nation’s most pressing drug problems. In California, MA use has outstripped all other drugs in epidemiological extent, law enforcement activities, and treatment services demand. An opportunity for further study of MA use and its treatment emerged from a change in offender sentencing options introduced by California’s Substance Abuse and Crime Prevention Act of 2000 (SACPA). Results indicate that statewide admissions for MA rose from 8.4% in FY 1992/1993 to 34.6% in FY 2004/2005, a four-fold increase over the 13 years. From the year before SACPA implementation to the year after, the percentage of treatment admissions due to MA use increased from 18.8% to 25.6%, an increase largely due to the fact that SACPA admissions were over 50% MA users. With the exception of alcohol, MA users entering treatment through SACPA had higher completion rates (about one third) from community based treatment than users of other primary drugs. This result held true for demographic and other subgroups of MA users. Multivariate regression results illuminate the relative importance of the variables examined. Implication of the findings for policy, intervention services, and research are discussed.
Keywords—drug abuse, methamphetamine, offender drug treatment, Proposition 36, SACPA, substance abuse

The Rise in Treatment Admissions for Methamphetamine Use in Los Angeles County from 2001 through 2005 — Desirée Crèvecoeur, Ph.D.; Beth Rutkowski, M.P.H. & Richard A. Rawson, Ph.D.
Abstract—Drug use trends for people entering county-funded treatment programs from 2001 through 2005 were investigated. The sample was drawn from outpatient counseling, residential treatment, and daycare habilitative programs. Findings center on the rising number of admissions to treatment programs for primary methamphetamine (MA) use, with a focus on participant gender, age, and race/ethnicity. Additional participant characteristics, such as referral source, employment, housing, and health status were also briefly explored. This investigation found that the percentage of admissions to treatment programs for primary MA use has substantially increased in Los Angeles County each year from 2001 through 2005. The groups most affected were young people of Asian, Latino, Native American, and White descent. Additionally, it was determined that women were more likely to enter treatment for primary MA use (relative to other drugs) than were males. National implications of these findings, their limitations, and directions for future research are discussed.
Keywords—drug use trends, methamphetamine, urban demographics

A Nine Session Manual of Motivational Enhancement Therapy for Methamphetamine Dependence: Adherence and Efficacy — Gantt P. Galloway, Pharm.D.; Douglas Polcin, Ed.D., M.F.T.; Anousheh Kielstein, M.D.; Michelle Brown, M.F.T. & John Mendelson, M.D.
Abstract—Motivational enhancement therapy (MET) is a brief therapy shown to be effective for problem drinkers. Because the response to MET for other addictive disorders is mixed, we assessed the utility of increasing the number of sessions in subjects with methamphetamine (MA) dependence. One therapist was trained in a nine-session manual of MET, which was tested over eight weeks in 30 MA-dependent outpatients. Adherence to the manual was assessed by two raters, who reviewed a random sample of 15 audiotaped therapy sessions. Interventions were rated on a seven-point Likert scale for frequency/extensiveness (1=not at all to 7=extensively) and skill level (1 = unacceptable to 7 = high level of mastery). Ratings of adherence were moderate for frequency/extensiveness (4.2  2.2 and 4.3  1.8; Mean  SD) and high for skill level (5.4  0.6 and 5.2  0.4). Subjects attended 7.0  2.5 (78%) of nine sessions. Self-reported days of methamphetamine use decreased from 841/1793 (47%) of the 60 days prior to study entry to 448/1458 (31%) during the study (p = 0.011). MA-positive urine samples decreased from 76/118 (64%) during screening to 93/210 (44%) during treatment (p = 0.015). The MET manual was readily learned, and subjects attended a high proportion of therapy sessions with marked reductions in methamphetamine use.
Keywords—methamphetamine, Motivational Enhancement Therapy, motivational interviewing,
psychotherapy dose