Prevalence of methamphetamine/amphetamine usage and demographics of users in Ontario based on laboratory drug screen results

Objectives — To estimate the prevalence of methamphetamine/amphetamine use in Ontario based on laboratory drug screening results, and to describe the socio-demographic characteristics of methamphetamine/amphetamine users.

Methods — A cross-sectional study of persons tested with urine drug screens (UDS) for methamphetamine/amphetamine from an electronic database of laboratory test results from selected community and hospital-based laboratories across Ontario during 2017–2018. Persons who filled a prescription for stimulants within 120 days before testing were excluded. We used descriptive statistics to summarize the characteristics of those who tested positive for methamphetamine/amphetamine use, relative to those who tested negative.

Results — A total of 215,529 persons were tested for methamphetamine/amphetamine, with 26,392 (12.2% of those tested) and 0.17% of the population within the catchment area, testing presumptive positive. Of those who tested positive; most were between the ages of 20 and 40 years, but 19.5% were over 50 years of age; 41.1% were women, 40.5% were in the lowest income quintile; and 27.0% and 29.2% also tested positive for opioids and cocaine, respectively. Within the 2 years before their first UDS, those testing positive had markedly higher mean frequencies of primary care visits 46.5 (SD=54.2), emergency department visits 5.0 (SD=11.0), and hospitalizations 0.8 (SD=2.1).

Conclusions — Methamphetamine/amphetamine use is associated with poverty and a large burden on the health care system. Use among women and in those over 50 years of age may have been underestimated in previous studies, and concurrent opioid and cocaine use is common. Drug testing results can inform the assessment of the population demographics of drug use.