Trends in primary methamphetamine-related admissions to youth residential substance abuse treatment facilities in Canada, 2005-2006 and 2009-2010.

OBJECTIVE: During the last decade, methamphetamine use and issues surrounding its toxicity have triggered major concern in the Canadian government, leading to significant changes in drug policy and funding strategies to limit the societal impact of methamphetamine-related harms. This concern appears justified by research which found in 2005-2006 that 21% of all youth admissions to inpatient substance abuse treatment centres in Canada were due primarily to methamphetamine abuse. Given these patterns of treatment use and targeted governmental initiatives, an open question is whether the demand for methamphetamine treatment found in 2005-2006 has decreased. Our study aims to provide follow-up estimates of admissions for 2009-2010, as well as important trend information for these periods. METHOD: We developed a comprehensive list of all Canadian residential youth substance abuse treatment facilities. The executive director of each facility was asked about the site's annual caseload, and the proportion of cases primarily due to methamphetamine abuse within the past 12 months. RESULTS: Our survey data for the periods of 2005-2006 and 2009-2010 show marked reductions in admissions. In 2009-2010, we found that about 6% of all admissions were due primarily to methamphetamine abuse, a substantial drop from the 21% reported in our 2005-2006 study. CONCLUSIONS: Our data show a significant national reduction in methamphetamine-related admissions. Other reports show that methamphetamine-related treatment admissions in the United States and Mexico declined sharply during 2005-2008, reportedly in association with Mexico's methamphetamine precursor chemical controls, raising the possibility that the controls may also be associated with the declines reported here.

A national survey of primary methamphetamine-related admissions to youth residential substance abuse treatment facilities in Canada, 2005 to 2006.

OBJECTIVE: Adolescent methamphetamine use has become a key issue for Canadian media and governments. Empirical studies, however, have not yet established the national scope of adolescent methamphetamine use or its impact on treatment services in Canada. The objective of the current study was to provide results from a national survey of primary methamphetamine-related admissions to Canadian residential substance abuse treatment facilities for youth. METHOD: We developed a comprehensive list of all Canadian residential substance abuse treatment facilities for youth, and then, we asked the executive director (or equivalent) of each facility about the site's annual caseload and the proportion of primary methamphetamine-related admissions during the previous 12 months. RESULTS: Responses were received from 46 of the 50 centres on our final master list. About 20% (1109/5169) of all national admissions to youth residential substance abuse treatment facilities were reported to be primarily due to methamphetamine use. A large majority of primary methamphetamine-related admissions occurred in British Columbia and Alberta. CONCLUSIONS: Adolescent methamphetamine use has had a major impact on entries into residential substance abuse treatment facilities in British Columbia and Alberta, while only a few centres outside these 2 western provinces have experienced elevated rates of primary methamphetamine-related admissions. Given the paucity of studies on adolescent methamphetamine treatment, future research needs to focus on developing effective clinical strategies in this area.

Mobility patterns of Aboriginal injection drug users between on- and off-reserve settings in northern British Columbia, Canada.

OBJECTIVES: In Canada, public health policymakers and Aboriginal health service leaders have warned that the reciprocal movement of Aboriginal injection drug users (IDUs) between urban and rural settings may serve as a critical vector for the continuing spread of HIV among Aboriginal peoples. The current study aimed to describe the mobility patterns of Aboriginal injection drug users between on- and off-reserve locations in northern British Columbia. STUDY DESIGN: Retrospective medical-chart review of inpatient detoxification records. METHODS: We employed a medical-chart review of all self-reported Aboriginal IDUs (n = 302) admitted at least twice to an adult inpatient hospital-based substance-abuse detoxification treatment centre between 4 January 1999 and 31 December 2005, and analysed place-of-residence transitions between on- and off-reserve settings. RESULTS: Over the course of the 7-year study period, 26% (n = 73) of Aboriginal IDUs changed their primary residence from an off-reserve to an on-reserve location. Almost all (96%, n = 23) of those living on-reserve at their first IDU-related admission had moved to an off-reserve setting at a subsequent visit. CONCLUSIONS: The high rates of reciprocal movement between on- and off-reserve locations are a critical public health concern. The results show that the problems associated with both IDU and infectious disease are not limited to urban centres. Our results stand as a clear call for support of Aboriginal-directed, culturally appropriate and accessible services to reduce IDU-related harms. The specifics of such programs are a topic for Aboriginal health care leaders and the communities themselves to discuss, develop and implement.