Related Experiment Video
Updated: Jul 28, 2025
High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry
Published on: April 23, 2019
Injection of Methamphetamine Has Increased in Boston, Massachusetts: 5 Waves of Centers for Disease Control and
Joanna M Streck1, R Monina Klevens, Conall O'Cleirigh
1From the Department of Psychiatry, Massachusetts General Hospital, Boston, MA (JMS, CO, AWB); Harvard Medical School, Boston, MA (JMS, CO, AWB); Massachusetts Department of Public Health, Boston, MA (RMK); and The Fenway Institute, Fenway Health, Boston, MA (CO, AWB).
Objectives:
In the United States, the number of overdose deaths related to opioids in combination with stimulants has increased; however, the Northeast has typically been less impacted by stimulant overdose. Injection drug use (IDU) results in high mortality from overdose and infectious disease and there are racial disparities observed in overdose death rates. We examined trends in stimulant and opioid IDU, including trends stratified by race, using 5 waves of cross-sectional state surveillance data.
Methods:
Data came from the Centers for Disease Control and Prevention's National HIV Behavioral Surveillance system Boston, Massachusetts site, which includes 5 waves of data (2005-2018) among adults in the Boston metropolitan area reporting IDU (N = 2550). Outcome measures were type of substance injected in the past 12 months (heroin, prescription opioids, "speedball," cocaine, crack, and/or methamphetamine).
Results:
Participants were 70% male, 58% non-Hispanic White, and injected a mean of 3 different drugs in the past 12 months. From 2015 to 2018, there was a more than 2-fold increase in injection of methamphetamine (15% vs 38%, P < 0.001), a pattern which held across racial groups. Combination heroin and methamphetamine injection increased from 2015 (15%) to 2018 (35%, P < 0.001). Multiple drug injection (injecting >1 drug) increased significantly across years compared with single drug injection ( P = 0.03).
Conclusions:
Findings suggest that increased use of methamphetamine and opioids extends to Boston. There is an urgent need for enhanced screening of methamphetamine use among those using opioids and increased access and payor coverage of efficacious treatments for stimulant and opioid use disorders (eg, contingency management and medication treatment for opioid use disorder).
Insights
Methamphetamine injection is rising among people who inject drugs in Boston, mirroring national trends. This increase in stimulant and opioid co-use necessitates enhanced screening and treatment for substance use disorders.
Area of Science:
- Public Health
- Epidemiology
- Substance Use Research
Background:
- Opioid and stimulant overdose deaths are increasing nationally.
- Historically, the Northeast US has seen lower rates of stimulant overdose.
- Injection drug use (IDU) is linked to high mortality and racial disparities.
Purpose of the Study:
- To examine trends in stimulant and opioid injection drug use in Boston.
- To analyze these trends stratified by race.
Main Methods:
- Utilized 5 waves of cross-sectional data from the National HIV Behavioral Surveillance system (2005-2018).
- Included 2550 adults reporting IDU in the Boston metropolitan area.
- Assessed past 12-month injection of heroin, prescription opioids, "speedball," cocaine, crack, and/or methamphetamine.
Main Results:
- Methamphetamine injection more than doubled from 2015 (15%) to 2018 (38%), consistent across racial groups.
- Combination heroin and methamphetamine injection rose from 15% (2015) to 35% (2018).
- Multiple drug injection increased significantly compared to single drug injection (P=0.03).
Conclusions:
- Findings indicate rising methamphetamine and opioid use in Boston.
- Urgent need for methamphetamine screening among opioid users.
- Increased access to evidence-based treatments for stimulant and opioid use disorders is crucial.
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