What do we know about the extent of illicit meth/amphetamine use and dependence? Results of a global systematic review

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Resource Type: Technical Reports

NDARC Technical Report No. 310 (2010)


Aims: Systematically review existing data on the prevalence of meth/amphetamine use and dependence. The aims of this paper are to: (1) describe the available international data on meth/amphetamine use and dependence; and (2) identify priorities for improving the quality and coverage of such estimates.

Methods: Multiple search strategies: a) peer-reviewed literature searches (1990-2008) using methods recommended by the Meta-analysis of Observational Studies in Epidemiology (MOOSE) group; b) systematic searches of online databases; c) Internet searches to find any other evidence of use; d) repeated consultation and feedback from experts around the globe; e) a viral email sent to lists in the HIV and illicit drug fields. Culling and data extraction followed manualised protocols, with in-built systems of cross-checking and internal consistency. Data were extracted and graded according to predefined variables and quality scored. This paper reports the most recent and highest graded prevalence estimate for the general population and school population and reports the proportion of coverage of the world's population for use and dependence estimates, general population and school surveys, age and sex specific estimates, and most recent year of estimates.

Results: There was some evidence of meth/amphetamine use or dependence in 181 countries/territories, comprising 99% of the world's population aged 15-64 years but there were no prevalence estimates in 104 of these countries. This was common in Asia, Oceania and Africa. School surveys were the most common method used (74 countries); general population surveys of meth/amphetamine use had been conducted in 48 countries. Nine countries had estimated the prevalence of dependence since 1990 (8% of the world‟s population 15-64 years). Estimates of past-year use varied extremely widely; past-year dependence estimates were all less than 1% (0.10-0.74%). Age ranges, methodologies and definitions of “amphetamines” differed widely.

Conclusions: There is a global imperative to improve data on the extent of meth/amphetamine use and dependence. There were large gaps in dependence estimates even in high income countries that have the resources and infrastructure to carry out such studies. Public and policy concern about this issue has been increasing largely in the absence of any data on the extent of this “problem”. Any policies or other responses requiring some notion of “scale” are likely to be poorly targeted until this situation changes.