Pulse Check: Trends in Drug Abuse
November 2002

METHAMPHETAMINE⁺

Methamphetamine is reported as an emerging or intensifying problem in 10 cities: Columbia (SC), Denver, Detroit, El Paso, Memphis, Miami, New York, St. Louis, Seattle, and Sioux Falls (see Highlights Exhibit 6). Furthermore, sources believe the drug contributes to the most serious consequences in eight cities, particularly in the West: Billings, Denver, Honolulu, Los Angeles, Memphis, St. Louis, Sioux Falls, and Seattle (see Highlights Exhibits 3 and 4). It is considered the most widely abused drug by sources in Billings, Denver, Honolulu, and Memphis. Since the last reporting period, law enforcement sources believe methamphetamine has replaced powder cocaine in Denver and marijuana in Memphis, as the drug contributing to the most serious consequences (see Highlights Exhibit 5).

Exhibit 1.
How available is methamphetamine across the 20 Pulse Check cities (spring 2002)?

d

METHAMPHETAMINE: THE DRUG

How available is methamphetamine, in its various forms, across the country? (Exhibits 1 and 2) Methamphetamine is still not very available according to many (16 of 40) law enforcement and epidemiologic/ ethnographic sources. However, 13 sources consider it widely available, particularly throughout the West, and 11 consider it somewhat available.

Exhibit 2. How has methamphetamine availability changed (fall 2001 vs spring 2002)?

d

Locally produced methamphetamine seems slightly more available than Mexican methamphetamine across the Pulse Check cities: 21 sources rate the local product as either somewhat or widely available, whereas only 17 sources give those ratings to the Mexican product.

Since the last reporting period, methamphetamine availability (all varieties combined) has remained stable, according to the majority (25 of 40) of law enforcement and epidemiologic/ethnographic sources in 17 sites. The remaining sources (15 in 12 sites) believe it has increased. No declines are reported for any varieties.

Only four sources (in Billings, Denver, Los Angeles, and Memphis) believe that Mexican methamphetamine has increased. By contrast, locally produced methamphetamine has increased in 12 cities: Billings^L, Boston^L, Chicago^L, Denver^L, Detroit^E, Los Angeles^E, Memphis^L,E, Miami^E, New York^L, Portland (ME)^L, Sioux Falls^E, and Washington, DC^E.

Availability of “ice,” nearly 100 percent pure methamphetamine, is generally stable, but it has increased in Billings, Denver, Honolulu, and Memphis—the only cities where it is considered somewhat or widely available.

What are street-level methamphetamine prices and purity levels across the country? (Exhibit 3) Gram prices are most commonly reported at about $100, but they range from $20–$60 in Seattle to $330 in Chicago. The highest reported purities are in Honolulu and Seattle. In Seattle, locally produced methamphetamine is more pure than Mexican methamphetamine, which continues to be diluted with methylsulfonylmethane (MSM). Mexican national traffickers are also starting to cut methamphetamine with MSM in Los Angeles, but purity there has nevertheless increased at the ounce level (from 15–20 percent to 30–35 percent) since the last reporting period. Only one other shift is reported since the last period: in Honolulu, the 1/4 gram price of ice, also known as “clear,” declined by 20 percent. All other prices and purity levels are stable.

How is methamphetamine referred to across the country? (Exhibit 4) Methamphetamine continues to be called by long-standing names, such as “meth,” “speed,” “crank,” and “crystal.” Other slang terms are often based on the color, consistency, appearance, or weight of the local product. Only a few terms are newly reported during this period (but are not necessarily new), including the following: “crystal methedrine” (Boston^N); “CR” (Sioux Falls^L); “fast” (Denver^L); “geeter” and “work” (Billings^N); and “peanut butter,” “pink hearts,” “poppers,” “rock,” “tweak,” and “yellow jackets” (St. Louis^E).

Since the last reporting period, the number of small, local methamphetamine labs increased in nine Pulse Check cities... Despite the increases, however, availability levels remain low in many of these cities: Boston, MAL: Four box labs were seized. None had ever been seized before. Chicago, ILL: Clandestine labs were seized for the first time. Denver, COL: Seizures of box labs, especially in hotels or motels where they now have interdictions, have increased. Detroit, MIE: The number of clandestine labs has increased. Los Angeles, CAL: The number of small labs continues to increase, but large operations still predominate. Miami, FLE: Seven small labs were seized for the first time. Portland, MEL: An increase in labs over the past 2 or 3 years involves mostly Mexican migrant workers, some transplanted from the Southwest. Most of that methamphetamine, however, is believed to be going to Canada, rather than the local streets. St. Louis, MOE: While stationary labs still predominate, mobile labs are growing in popularity. Cooking in cars and trucks helps producers in two ways: it eludes identification by law enforcement; and motion helps the chemical reaction. Motels are a new production setting during this reporting period: the temporary nature of these setups, again, challenges disruption efforts. Clandestine labs are also set up in Federal parklands, where toxic byproducts pose a danger to hikers and campers. Sioux Falls, SDL,E: Both local box labs and large operations have increased. Production has shifted from the cold method to the nazi method.

METHAMPHETAMINE: THE MARKET

Who sells methamphetamine? Sellers continue to be predominantly independent operators, according to law enforcement and epidemiologic/ ethnographic sources. Organized sales structures, however, are reported in Billings, Detroit, and El Paso, while both types of structures are reported in Chicago, Denver, Los Angeles, Memphis, Philadelphia, St. Louis, and Seattle. Sometimes, as in Denver and St. Louis, independent sellers tend to sell locally produced methamphetamine, while organized groups sell the Mexican product.

Young adults (18–30 years) are generally the predominant seller groups. However, adults (>30 years) are mentioned in Honolulu, Philadelphia, Portland (ME), and St. Louis, while both groups are mentioned in Billings, Boston, and Sioux Falls. Adolescents (13–17 years) sell methamphetamine in New Orleans (where they are the predominant group), Los Angeles, and Memphis.

Similar to reports in the last few Pulse Checks, more than half of respondents believe methamphetamine sellers are very likely to use the drug. In many cases, as in El Paso, sellers process their own methamphetamine, so they are particularly likely to use it.

Exhibit 3.
How much does methamphetamine cost in 13 Pulse Check cities?

City		Gram price	Other price/unit
South	Columbia, SCL	$175	NR
	Columbia, SCE	NR	$40/ 1/2oz liquid
	El Paso, TXL	NR	$20/ 1/4 oz g
	Memphis, TNL	$125	NR
	Memphis, TNE	$100	NR
	New Orleans, LAL	$100	NR
Midwest	Chicago, ILL	$330	NR
	Detroit, MIE	$100	NR
	St. Louis, MOL	$100	NR
	St. Louis, MOE	(outside city) $37–$100	$700–$1,300/oz
	Sioux Falls, SDL	NR	(“eightball”) $150–$225/ 1/8 oz $9,000–$11,000/lb
West	Billings, MTL	(powder) $100 (crystal) $125	NR
	Denver, COL	$100–$150	NR
	Denver, COE	a$90–$110	b$700–$1,200/oz
	Honolulu, HIL	$200–$300	$50–$100/ 1/4 g
	Honolulu, HIE	$100–$200	c$50/ 1/4 g
	Los Angeles, CAL	NR	d(“teener”) $125/ 1/16oz
	Los Angeles, CAE	NR	e$500–$700/oz (“eightball”) $100–$120/ 1/8 oz (“teener”) $60/ 1/16 oz
	Seattle, WAL	f$20–$60	f$350–$650/oz
	Seattle, WAE	$20–$60	NR
Reported purities a10–20% b10–20% c95% d40% e30–35% f95% nazi method; 75% red phosphorus method NR=not reported Sources: Law enforcement and epidemiologic/ethnographic respondents

What types of crimes are related to methamphetamine sales? (See Highlights Exhibit 7) In general, the level of criminal activity appears to be relatively stable since the last Pulse Check. Similar to findings in the last Pulse Check, methamphetamine accounts for 33 percent of domestic violence among drug sellers, as reported by law enforcement and epidemiologic/ethnographic respondents—compared with 28 percent for powder cocaine, 19 percent for crack, 11 percent for heroin, and 8 percent for marijuana. It also accounts for substantial percentages of nonviolent crime (20 percent), violent crime (16 percent), prostitution (15 percent), and gang-related crimes (12 percent) among sellers. Examples of reported violent crimes include turf wars and shootings in Sioux Falls. Examples of nonviolent crimes include theft of precursors or other materials to set up labs (in El Paso and Memphis), gun possession (in Los Angeles), and burglary or theft (in Billings, Los Angeles, St. Louis, and Sioux Falls).

What other drugs do methamphetamine sellers sell? Methamphetamine dealers sell no other drugs according to respondents in eight cities: Chicago^L, Columbia (SC)^L, El Paso^L, Los Angeles^L, Memphis^L, Philadelphia^L, Portland (ME)^L, and St. Louis^L,E. Among those who do sell other drugs, they include:

• Crack: Billings^L, Denver^L,E, El Paso^E, and Sioux Falls^L
• Powder cocaine: Denver^E, El Paso^E, Honolulu^L, New Orleans^L, and Washington, DC^L
• Heroin: Denver^E and Honolulu^L
• Marijuana: Baltimore^L, Denver^L,E, Honolulu^L,E, Memphis^E, Seattle^L, and Sioux Falls^L
• Ecstasy: Baltimore^L, El Paso^E, and Washington, DC^L

The El Paso epidemiologic source points out that methamphetamine dealers “would go broke if they didn’t sell other drugs.” No significant changes are reported during this reporting period in the other drugs sold.

The methamphetamine market has changed somewhat (fall 2001 vs spring 2002)...
Market disruptions have caused declines in availability:	Philadelphia, PAL: The market has continued its 5-year decline due to two disruptions: precursors were made less available; and numerous lab operators and chemists were arrested. Los Angeles, CAE: After pseudoephedrine prices rose, that precursor was mostly smuggled from Canada. But, with heightened border control since September 11, not as much is getting through. For example, a large bust at the Michigan border was directly related to the lower supply in Los Angeles.
Increases in both younger and older sellers are reported in some cities:	Baltimore, MDL: Adolescents are now involved in sales. Billings, MTL,E: Older adults are increasingly selling. Memphis, TNE: Sellers are getting younger. Seattle, WAE: Age range has broadened: while sellers are still predominantly young adults, adolescents and older adults are increasingly involved. Sioux Falls, SDE: Older adults (55–65 years) have been caught selling during the past year.
The market is shifting geographically:	Chicago, ILL: Labs have been seized inside the city for the first time. Memphis, TNE: Sellers are increasingly moving to more rural areas. Miami, FLE: Seven small labs were seized for the first time: in the past, such seizures occurred only in western and central Florida. New York, NYL: Local methamphetamine has spread from Upstate New York into the Long Island area. St. Louis, MOE: People are moving production from rural into city and suburban areas. Entrepreneurs see these areas as untapped markets and are establishing new connections. Seattle, WAL: Law enforcement pressure has pushed markets further out into previously unaffected areas. Almost all counties in Washington are reporting some activity: any leveling off in previous hot spots has been offset by increases in rural areas.
New market settings are noted in a few cities:	Chicago, ILL: Street sales are noted for the first time, mostly on the North Side. However, methamphetamine is not sold at the same locations as crack or heroin. Columbia, SCL: Methamphetamine sales are reported in nightclubs and bars for the first time. MemphisL: Methamphetamine is now being sold on the Internet. Seattle, WAL: Some people now openly sell methamphetamine as such, not disguised as ecstasy, at dances, raves, and other events.
Trafficking has been linked to terrorism:	New York, NYL: Several cases of pseudoephedrine diversion have involved terrorist groups who traffic drugs (including heroin) to fund their activities.

How is street-level methamphetamine sold? Disrupting methamphetamine sales is challenging because, as the vast majority of law enforcement and epidemiologic/ethnographic respondents report, it is primarily sold hand-to-hand, usually via acquaintance networks or personal introduction, and usually at a clandestine, predetermined meeting place. Sometimes beepers and cell phones are involved in these transactions (as in Honolulu, Los Angeles, Memphis, St. Louis, and Sioux Falls), and occasionally runners are involved (as in El Paso). Open methamphetamine markets in specific neighborhoods are mentioned in only a handful of cities (Chicago, Denver, Detroit, New Orleans, and Philadelphia).

Where are methamphetamine markets located? The geographic location of methamphetamine markets varies widely, according to law enforcement and epidemiologic/ethnographic respondents. Regional differences are less apparent than they were in the last Pulse Check.

• All areas (central city, suburban, and rural) are the scene of methamphetamine sales in cities spanning all regions: Baltimore^L, Billings^L, Denver^L,E, Detroit^E, Memphis^L, Philadelphia^L, Seattle^L, and Sioux Falls^L.
• Central city selling locations are more prominent in Honolulu^L, New Orleans^L, and Washington, DC^L.
• Both central city and suburban selling locations are reported in Chicago^L, Honolulu^E, and Los Angeles^L.
• Both central city and rural selling areas are reported in Memphis^E.
• Nearby rural areas are the primary sales locations reported in Boston^L, Portland^L, and St. Louis^L,E.
• Suburban areas are the most common selling sites in Columbia (SC)^L and El Paso^L,E.

More than half of responding law enforcement and epidemiologic/ ethnographic sources report that methamphetamine is sold both indoors and outdoors. However, sales take place primarily indoors in eight cities: Boston^L, Chicago^L, Columbia^L, El Paso^L, New Orleans^L, Portland (ME)^L, St. Louis^L,E, and Washington, DC^L.

Similar to reports in previous Pulse Checks, private residences are the most frequently mentioned specific settings for methamphetamine sales across Pulse Check cities. The next most common settings are nightclubs or bars, private parties, raves and concerts, and hotels or motels. Respondents also frequently mention cars, parks, public housing developments, schools, and college campuses. Less frequently mentioned sales locations (six or fewer respondents) include in or around malls (in Baltimore, Billings, Denver, Honolulu, Memphis, and Philadelphia), supermarkets (in Baltimore, Billings, Denver, Memphis, and Philadelphia), crack houses (in Billings, Denver, Honolulu, Philadelphia, and Sioux Falls), and around treatment clinics (in Baltimore, Denver, Memphis, and Philadelphia). Crack houses in Sioux Falls are known as “meth houses.”

Methamphetamine is often associated with the gay scene... Boston, MAE: Methamphetamine use is limited to gay clubs. Los Angeles, CAE: Methamphetamine is often used in the gay party scene. Miami, FLE: Methamphetamine has generally been available only in the gay community in the techno dance scene on Miami Beach, where users sell the drug to one another. However, it may be spreading through that venue to other populations, in the same way that ecstasy grew out of the club scene, as evidenced by increased activity in emergency departments: DAWN mentions of amphetamine/methamphetamine outnumber those involving ecstasy. New York, NYE: Methamphetamine use has increased in gay communities. One gay men’s organization is now holding three to eight methamphetamine-related meetings per week, primarily because of the increase in methamphetamine-related HIV.

METHAMPHETAMINE: THE USERS

How many methamphetamine users are in treatment? (Exhibit 5) Among programs represented by Pulse Check treatment sources, only a handful have substantial percentages of people who report methamphetamine use. In addition to the increases noted in the table, some increases are reported in treatment programs where the numbers are still relatively low, as in Columbia (SC)^N and Denver^N.

Who uses methamphetamine? Methamphetamine users across Pulse Check cities are likely to be either young adults (18–30 years) or adults older than 30. Average mean age, based on information provided by treatment and epidemiologic/ethnographic sources across the sites, is 29.2 (n=13). Adolescents, however, are named as the predominant users by four non-methadone treatment sources: in Billings, Columbia (SC), Los Angeles, and Sioux Falls. Males are the predominant users according to sources in 12 cities, but sources in 8 cities indicate that men and women are equally likely to use methamphetamine. More women than men use the drug according to sources in three cities: Columbia (SC)^E,N, El Paso^E, and Memphis^M. In El Paso, many of the female users are dancers, many are unemployed, and many use it either for weight loss or for increased energy.

Methamphetamine users continue to come from predominantly low or low-to-middle socioeconomic groups. Those in treatment tend to be unemployed, and the majority are court referred. Users also continue to be primarily Whites, according to all but two of the reporting Pulse Check sources: Asian/Pacific Islanders predominate in the Honolulu nonmethadone treatment program, and Hispanics predominate in the Los Angeles non-methadone program. The Los Angeles epidemiologic source notes a gradual increase in Asian/Pacific Islanders in treatment, though their numbers remain low. American Indians are mentioned as users in Billings and Sioux Falls; Hispanics are mentioned in Denver and Sioux Falls; and Blacks are mentioned in Columbia, Miami, Memphis, and Sioux Falls.

How, where, and with what other drugs do users take methamphetamine? Methamphetamine can be smoked, injected, snorted, or taken orally, and these routes of administration continue to vary widely across the Pulse Check cities. Often, several routes are equally likely in a given city. A few changes are noted since the last Pulse Check:

Exhibit 4.
How is methamphetamine referred to in the four regions of the country?*

d

Users on the move ... Methamphetamine users’ residence locales continue to vary across different Pulse Check cities. Two contrasting trends continue to be noted: Toward rural areas: Users have been spreading into rural areas of Denver and Memphis, and into the reservation areas of Sioux Falls. In Memphis, this spread is related two trends: increased gang activities in rural areas and increased access to the rurally produced drug. Away from rural areas: In Los Angeles, use has been shifting from rural to central city and suburban areas because manufacture has spread. The St. Louis problem is also starting to creep into the city.

• Billings, MT^N: Smoking is increasing, but injecting remains common.
• Honolulu, HI^E: A small group of injectors is emerging, but nearly all users still smoke.
• Los Angeles, CA^M: While injecting still predominates, newer users tend to smoke.
• Memphis, TN^E: Users are generally shifting from smoking and oral use to snorting.
• Sioux Falls, SD^E: New younger (15–16 years) methamphetamine users tend to move fairly quickly from snorting and smoking to injecting.

Methamphetamine tends to be used in private settings, often in small groups among friends. Private residences remain the most commonly mentioned use settings, followed by private parties. Other common settings include nightclubs, cars, public housing developments, college campuses, and hotels or motels.

Exhibit 5.
Which treatment programs in Pulse Check sites have substantial percentages^a of clients reporting methamphetamine use? How have those percentages changed (fall 2001 vs spring 2002)?

City/Program	Primary use	Any useb	Fall 2001 vs Spring 2002
Billings, MTN	17%	32%	Stable
Honolulu, HIN	68%	NR	Some increase
Honolulu, HIM	0	10%	Some increase
Los Angeles, CAM	0	8%	Stable
St. Louis, MON	Approximately 12%c	NR	Stable
St. Louis, MOM	0	10%	Some increase
Seattle, WAN	7%	7%	Some increase
Sioux Falls, SDN	>80%d	100%	Large increase
a7 percent or more bPrimary + secondary + tertiary use c35 percent among rural residents, 1.5 percent among central city residents dA small program for adolescents only Sources: Non-methadone and methadone treatment providers

Marijuana remains the most commonly reported drug taken by methamphetamine users. The two drugs are usually used sequentially, but sometimes they are combined, as reported in Detroit, Memphis, Portland (ME), and Sioux Falls (where “lacing” is increasing). Several other drugs are mentioned:

• Benzodiazepines, such as alprazolam (Xanax®) or diazepam: Honolulu, Los Angeles, Memphis, Philadelphia, and Portland
• Club drugs, such as ecstasy, GHB, and amylnitrate (“poppers”): Los Angeles
• Crack: Memphis
• Depressants, such as phenobarbital: El Paso
• Heroin: Boston and Seattle
• Powder cocaine: Portland
• Prescription opiates: Billings, Columbia (SC), Los Angeles (particularly hyrocodone, or Vicodin®), and Memphis (particularly hydromorphone, or Dilaudid®).
• Sildenafil (Viagra®): Miami

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⁺ The following symbols appear throughout these Highlights to indicate type of respondent: ^LLaw enforcement respondent, ^EEpidemiologic/ethnographic respondent, ^NNon-methadone treatment respondent, and ^MMethadone treatment respondent.

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