Crystal meth abuse linked to underage sex, smoking and drinking

Teens who have never done drugs, but engage in other risky behaviours such as drinking, smoking and being sexually active, are more likely to use crystal meth, medical researchers at the University of Alberta have concluded.

Among teens already doing other drugs, those with unstable family environments are most likely to do crystal meth, found the research team led by Dr. Terry Klassen, a professor in the Department of Pediatrics in the Faculty of Medicine & Dentistry.

The researchers conducted an exhaustive search of the literature on methamphetamine use, and analyzed the results of a dozen studies to get a big-picture idea of factors at the individual, family and community level associated with crystal meth use among children and adolescents.

"If risk factors for MA use could be identified, physicians and other health-care professionals who work with youth may be better equipped to identify MA users, and develop education and prevention programs that could be targeted to youth at greater risk for using MA," Klassen said.

The U of A article was recently published in the medical journal BMC Pediatrics .

The researchers divided children and adolescents into two groups: "low-risk" (no previous drug use) and "high-risk" (history of drug use or time in a juvenile detention centre). There were some clear patterns of risk factors associated with crystal meth use, they said.

In the low-risk group, the U of A team also found that boys were more likely to try crystal meth than girls, and being homosexual or bisexual was also a risk factor.

But in the high-risk group, more girls than boys used crystal meth. In this group, drinking was not associated with methamphetamine use, but a family history of alcohol abuse was. Child abuse was not found to be significant factor.

Having certain psychiatric conditions was a risk factor for both groups. Because of the nature of the studies involved, the U of A researchers say they could not determine if these factors cause young people to use crystal meth, only that they are associated with abuse of this drug.

"This systematic review presents the best available evidence regarding factors for methamphetamine use among youth," Klassen said. "Engaging in high-risk behaviour may be a gateway for methamphetamine use or vice-versa." While many of the results might appear to be common sense, Klassen says there is always value in testing widely held beliefs or assumptions.

"You don't know beforehand whether a hypotheses will be proven or disproven," he noted. "If we didn't engage in these kinds of studies, we wouldn't know for sure."

The findings clearly indicate that health-care workers and counsellors "need to conduct a holistic assessment that includes psychiatric, lifestyle and family history," the U of A study concluded.

The research is intended for health-care professionals, but parents can learn from it as well. "When they start to see a cluster of (factors) that probably is a situation where they should be paying a lot more attention to their children. It may be more of a wake-up call," Klassen said.

The researchers scoured more than 40 databases for relevant academic articles and clinical trials, scientific journals, papers presented at scientific meetings, and so-called "grey literature" – harder-to-find sources such as government reports on the topic, PhD theses, and so on. The team restricted its search English-language studies.

The initial search results yielded 2,376 potentially relevant studies. The researchers eventually narrowed down the results to 13 separate studies that fit the criteria of their review. Seven were done in North America and the rest in Asia. The majority were carried out within the last few years. Sample sizes ranged from 60 to 78,715.

Some findings from individual studies, highlighted by Klassen and his team:

Low-risk youth:

• The fewer years of education that youth had, the more likely they were to use crystal meth.
• Being sexually active was "significantly associated" with using crystal meth.
• Youth who smoked, drank or used heroin and other opiates were more likely to try crystal meth.
• When it came to mental health, low-risk youth with adjustment disorder, conduct disorder and attention deficit hyperactivity were much more likely to use crystal meth. However, oppositional defiance disorder, anxiety, depression, bipolar disorder and eating disorder were not significantly associated with crystal meth use in the low-risk group.
• Being homosexual or bisexual, disruptive parenting, peers using meth and family history of drug use were other risk factors among young people who had never used drugs before.

High- risk youth:

• "Strict parental monitoring was found to be protective for MA use among high-risk youth."
• A family history of alcohol abuse, crime or drug abuse was associated with crystal meth use.
• Receiving psychiatric treatment, more than two stints in a juvenile detention centre and a history of violence were "significantly associated" with crystal meth use.