Regional disparities in prescription methamphetamine and amphetamine distribution across the United States in 2019

Introduction Methamphetamine is a highly addictive psychostimulant and controlled substance that has detrimental health consequences for chronic users. Amphetamine is a structurally-related stimulant commonly used to treat ADHD, however, it also has a high risk for substance misuse. The objectives of this report were to characterize the regional differences in prescription methamphetamine and amphetamine distribution in the US, and examine potential reasons for variations in distribution. Methods Data for prescription methamphetamine and amphetamine distribution was obtained from the US Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS) Retail Drug Summary Report for 2019. Quarterly, state, and regional differences in distributions of the two controlled substances were analyzed and. Results The preponderance (97%) of retail drug distribution for both drugs in 2019 were made through pharmacies. In the same year, prescription methamphetamine (+6.8%) and amphetamine (+5.8%) saw increases in drug distribution from Quarter 1 to Quarter 4.. Across the entire US, total per capita drug weight distribution of amphetamine was exactly 4,000 times higher than methamphetamine. Regionally, total per capita drug weight for methamphetamine was highest in the West (32.2% of total distribution) and lowest in the Northeast (17.4%). The total per capita drug weight for amphetamine was highest in the South (37.0% of total distribution) and lowest in the Northeast (19.4%). The ratio between the 90th and 10th percentiles of per capita drug weight by state was 4.39 for methamphetamine and 2.45 for amphetamine. Distribution of methamphetamine only measured 16.1% of its production quota, while distribution of amphetamine measured 54.0% of its production quota. Discussion Overall, prescription amphetamine distribution was common while prescription methamphetamine distribution was rare. Regional disparities were also present with lowest distribution of both substances in the Northeast region. The patterns observed in distribution are likely the result of stigmatization, differences in accessibility, and the efforts of initiatives such as the Montana Meth Project. This cycle will likely also change in response to physician recommendation and public opinions surrounding issues for pharmacotherapies for ADHD management.