Importance Mortality associated with methamphetamine use has increased markedly in the US. Understanding patterns of methamphetamine use may help inform related prevention and treatment. Objective To assess the national trends in and correlates of past-year methamphetamine use, methamphetamine use disorder (MUD), injection, frequent use, and associated overdose mortality from 2015 to 2019. Design, Setting, and Participants This cross-sectional study analyzed methamphetamine use, MUD, injection, and frequent use data from participants in the 2015 to 2019 National Surveys on Drug Use and Health (NSDUH). Mortality data were obtained from the 2015 to 2019 National Vital Statistics System Multiple Cause of Death files. Exposures Methamphetamine use. Main Outcomes and Measures Methamphetamine use, MUD, injection, frequent use, and overdose deaths. Results Of 195 711 NSDUH respondents aged 18 to 64 years, 104 408 were women (weighted percentage, 50.9%), 35 686 were Hispanic individuals (weighted percentage, 18.0%), 25 389 were non-Hispanic Black (hereafter, Black) individuals (weighted percentage, 12.6%), and 114 248 were non-Hispanic White (hereafter, White) individuals (weighted percentage, 60.6%). From 2015 to 2019, overdose deaths involving psychostimulants other than cocaine (largely methamphetamine) increased 180% (from 5526 to 15 489; P for trend <.001); methamphetamine use increased 43% (from 1.4 million [95% CI, 1.2-1.6 million] to 2.0 million [95% CI, 1.7-2.3 million]; P for trend = .002); frequent methamphetamine use increased 66% (from 615 000 [95% CI, 512 000-717 000] to 1 021 000 [95% CI, 860 000-1 183 000]; P for trend = .002); methamphetamine and cocaine use increased 60% (from 402 000 [95% CI, 306 000-499 000] to 645 000 [95% CI, 477 000-813 000]; P for trend = .001); and MUD without injection increased 105% (from 397 000 [95% CI, 299 000-496 000] to 815 000 [95% CI, 598 000-1 033 000]; P for trend = .006). The prevalence of MUD or injection surpassed the prevalence of methamphetamine use without MUD or injection in each year from 2017 to 2019 (60% to 67% vs 37% to 40%; P for trend ≤.001). Adults with MUD or using injection were more likely to use methamphetamine frequently (52.68%-53.84% vs 32.59%; adjusted risk ratio, 1.62-1.65; 95% CI, 1.35-1.94). From 2015 to 2019, the adjusted prevalence of MUD without injection more than tripled among heterosexual women (from 0.24% to 0.74%; P < .001) and lesbian or bisexual women (from 0.21% to 0.71%; P < .001) and more than doubled among heterosexual men (from 0.29% to 0.79%; P < .001) and homosexual or bisexual men (from 0.29% to 0.80%; P = .007). It increased over 10-fold among Black individuals (from 0.06% to 0.64%; P < .001), nearly tripled among White individuals (from 0.28% to 0.78%; P < .001), and more than doubled among Hispanic individuals (from 0.39% to 0.82%; P < .001). Risk factors for methamphetamine use, MUD, injection, and frequent use included lower educational attainment, lower annual household income, lack of insurance, housing instability, criminal justice involvement, comorbidities (eg, HIV/AIDS, hepatitis B or C virus, depression), suicidal ideation, and polysubstance use. Conclusions and Relevance This cross-sectional study found consistent upward trends in overdose mortality, greater risk patterns of methamphetamine use, and populations at higher risk for MUD diversifying rapidly, particularly those with socioeconomic risk factors and comorbidities. Evidence-based prevention and treatment interventions are needed to address surges in methamphetamine use and MUD.

中文翻译：

---

美国成年人的甲基苯丙胺使用、甲基苯丙胺使用障碍和相关的过量死亡。

重要性 在美国，与甲基苯丙胺使用相关的死亡率显着增加。了解甲基苯丙胺的使用模式可能有助于为相关的预防和治疗提供信息。目的 评估 2015 年至 2019 年过去一年甲基苯丙胺使用、甲基苯丙胺使用障碍 (MUD)、注射、频繁使用和相关过量死亡率的全国趋势和相关性。设计、设置和参与者 本横断面研究分析了甲基苯丙胺2015 年至 2019 年全国药物使用与健康调查 (NSDUH) 参与者的使用、MUD、注射和频繁使用数据。死亡率数据来自 2015 年至 2019 年国家生命统计系统多死因文件。暴露甲基苯丙胺的使用。主要结果和措施 甲基苯丙胺使用、MUD、注射、频繁使用和过量死亡。结果 在 195 711 名 18 至 64 岁的 NSDUH 受访者中，104 408 名女性（加权百分比，50.9%），35 686 名西班牙裔（加权百分比，18.0%），25 389 名非西班牙裔黑人（以下简称黑人） （加权百分比，12.6%）和 114 248 名非西班牙裔白人（以下称白人）个体（加权百分比，60.6%）。从 2015 年到 2019 年，涉及可卡因以外的精神兴奋剂（主要是甲基苯丙胺）的过量死亡人数增加了 180%（从 5526 人增加到 15489 人；趋势 P <.001）；甲基苯丙胺的使用增加了 43%（从 140 万 [95% CI，1.2-160 万] 增加到 200 万 [95% CI，1.7-230 万]；趋势 P = .002）；频繁使用甲基苯丙胺增加了 66%（从 615 000 [95% CI，512 000-717 000] 到 1 021 000 [95% CI，860 000-1 183 000]；趋势 P = .002）；甲基苯丙胺和可卡因的使用增加了 60%（从 402 000 [95% CI，306 000-499 000] 到 645 000 [95% CI，477 000-813 000]；趋势 P = .001）；和未注射的 MUD 增加了 105%（从 397 000 [95% CI，299 000-496 000] 到 815 000 [95% CI，598 000-1 033 000]；趋势 P = .006）。从 2017 年到 2019 年，每年 MUD 或注射的流行率超过了不使用 MUD 或注射的甲基苯丙胺的流行率（60% 至 67% 对 37% 至 40%；P 表示趋势 ≤.001）。患有 MUD 或使用注射剂的成年人更有可能经常使用甲基苯丙胺（52.68%-53.84% 对 32.59%；调整后的风险比，1.62-1.65；95% CI，1.35-1.94）。从 2015 年到 2019 年，在异性恋女性（从 0.24% 到 0.74%；P < .001）和女同性恋或双性恋女性（从 0.21% 到 0.71%；P < . 001），在异性恋男性（从 0.29% 到 0.79%；P < .001）和同性恋或双性恋男性（从 0.29% 到 0.80%；P = .007）中增加了一倍以上。它在黑人个体中增加了 10 倍以上（从 0.06% 到 0.64%；P < .001），在白人个体中增加了近三倍（从 0.28% 到 0.78%；P < .001），在西班牙裔个体中增加了一倍以上（从 0.39% 到 0.82%；P < .001)。甲基苯丙胺使用、MUD、注射和频繁使用的风险因素包括教育程度较低、家庭年收入较低、缺乏保险、住房不稳定、刑事司法介入、合并症（例如，艾滋病毒/艾滋病、乙型或丙型肝炎病毒、抑郁症） 、自杀意念和多物质使用。结论和相关性 这项横断面研究发现服药过量死亡率呈持续上升趋势，甲基苯丙胺使用的风险模式更大，MUD 风险较高的人群迅速多样化，特别是那些有社会经济风险因素和合并症的人群。需要基于证据的预防和治疗干预措施来解决甲基苯丙胺使用和 MUD 激增的问题。