Addictions, Drug & Alcohol Institute

Perspectives of People Who Use Methamphetamine on Reducing or Stopping Their Use

Report by Sierra Teadt, MPH(c) and Alison Newman, MPH

Key points

  • Most participants saw both benefit and harm from their methamphetamine use. Almost 2/3rds had interest in stopping their methamphetamine use, while others were interested in reducing their use or changing how they used methamphetamine.
  • Many participants lacked stable housing, employment, or other practical needs like transportation, childcare, and primary health care.
  • Interest in stopping or reducing methamphetamine use was not always static throughout the interviews. Participants revealed ambivalence about their methamphetamine use.
  • Regardless of their level of interest in reducing or stopping their methamphetamine use, participants wanted social and health care services beyond substance use disorder treatment to help them reduce or stop their methamphetamine use.

Overview

In June 2021, ADAI conducted qualitative interviews with syringe service program (SSP) participants who use methamphetamine to explore interest in “reducing or stopping stimulant use” and barriers and supports related to improving health and reducing methamphetamine use.

The interviews explored five main topics: 1) patterns and drivers of methamphetamine use, 2) interest in reducing or stopping that use, 3) factors that would facilitate changes in methamphetamine use, 4) barriers to changing methamphetamine use, and 5) interest in specific support services and resources. 

Table showing following: Age: 18-29, 7 people, 26%. 30-39, 8 people, 30%, 40-49, 10 people, 37%, 50-59, 2 people, 7%. Race/Ethnicity: White, 20 people, 74%, American Indian, 3 people, 11%, Latino, 1 person, 3%, Multi-racial, 3 people, 12%. Gender: Male, 17 people, 63%, Female, 10 people, 37%. Housing status (self-disclosed): Unhoused, 16 people, 59%, House, 8 people, 30%, Unknown, 3 people, 11%
Table 1. Demographics of participants, n=27

Individuals visiting participating SSPs were asked if they would like to volunteer to participate. If they agreed, brief (10-30 minute) interviews were conducted via Zoom. Recordings were transcribed securely and then analyzed using qualitative software.

Twenty-seven people participated in the interviews across the three sites: 19 in Spokane, 5 in Clarkston, and 3 in Kennewick. The majority were below the age of 40, male, and white, mirroring the general participant demographics of the WA State SSP Health Survey (Table 1). Although interviewers did not ask about housing status, nearly all participants self-disclosed their housing status during the interview, with the majority living unhoused.

Survey themes & recommendations

Themes
  • Patterns and drivers of methamphetamine use
  • Interest in reducing or stopping use
  • Factors that would facilitate change
  • Barriers to changing methamphetamine use
  • What services would help?

Cross-cutting themes:

  • Family and relationships
  • Housing and stability…“A lifestyle of loss”
  • Stigma and acceptance
  • A continuum of needs
  • Ambivalence and readiness for change

Explore the recurring interview themes and associated quotes in this interactive presentation:

Recommendations

The results of these interviews add to current data showing that many people who use methamphetamine are interested in reducing or stopping their use and accessing a variety of support services if they are designed and delivered appropriately. People who use methamphetamine have clear preferences and innovative ideas for service models and are eager to share their perspectives when given genuine opportunities for input and involvement.

Programs and services may be more successful in engaging and supporting people who use methamphetamine if they:

  • Meaningfully involve these individuals in the planning and implementation of services. People who use drugs have clear preferences and useful insights and ideas.
  • Include resources to help meet basic needs such as food, housing, health care, and employment, and co-locate these services where possible. Given the instability faced by many individuals, navigation support and direct linkage rather than simple referrals will increase access. Meeting basic needs can also build trust and encourage further engagement in healthcare, social services or substance use treatment.
  • Allow time, as people could not see stopping or reducing their use immediately, but might in several or many months in the future.
  • Provide flexible, walk-in access for individuals to engage in the moment when motivation, readiness, and life circumstances make that possible. 
  • Emphasize acceptance, self-efficacy, and meaningful personal connections.  
  • Support incremental behavior change and view continued methamphetamine use as an opportunity for further engagement rather than as criteria for exclusion or dismissal from services.
  • Train staff on harm reduction and effective engagement strategies for methamphetamine. ADAI has several videos and materials here: Methamphetamine in Washington: Informing Policy & Research Summit (2019) and Methamphetamine: Practical Strategies.
Additional resources

Check out our one-page summary for syringe services program participants, which provides a short overview of reasons people wanted to cut back on their meth use, what they felt would help, and their thoughts on judgment vs. acceptance.

ADAI’s LearnAboutTreatment.org website has a page on Treatment for Stimulant Use Disorder that provides information about:

  • What are stimulants?
  • What is stimulant use disorder?
  • What are the treatments for stimulant use disorder?
  • Resources

“Treat us like individual human beings”: 2018 qualitative interviews with Washington State syringe exchange participants Alison Newman, MPH, Connor Henry, MPH, Caleb Banta-Green, PhD, MPH, MSW

WA State Syringe Services Program Survey 2019

Methamphetamine Overdose/Overamping on StopOverdose.org

Interest in reducing methamphetamine and opioid use among syringe services program participants in Washington State, journal article by Dr. Vanessa McMahan et al. (Drug Alcohol Depend 2020; 216:108243.)

Methamphetamine trends across Washington State, WA Data page from ADAI

Acknowledgments

Thank you to Blue Mountain Heart to Heart and the Spokane Regional Health District, and to the syringe exchange participants who shared their time and experiences.

Sierra Teadt was involved in this project as part of her practicum with the University of Washington School of Public Health. Sierra was supervised by Alison Newman, with Caleb Banta-Green as the practicum faculty advisor.

This work was supported by the WA Health Care Authority, Division of Behavioral Health and Recovery.