The War on Drugs: Methamphetamine, Public Health and Crime

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The War on Drugs Methamphetamine, Public Health
and Crime

• Carlos Dobkin, Nancy Nicosia

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Background on Methamphetamine

• Methamphetamine is typically sold in powdered
  form. It is usually inhaled, but may also be
  ingested orally or injected.
• Slows dopamine uptake and creates a euphoric
  state
• Some users experience violent and psychotic
  episodes
• Hallucinations, paranoia, depression
• Some users experience adverse physical symptoms
• Chest pains, headaches
• Users surveyed in Queensland reported committing
  both property and violent crimes.

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Methamphetamine Abuse Is a Growing Problem in the
U.S.

• In the 1980s methamphetamine was used primarily
  by adult white males in western states
• Use is increasing among minorities, women and
  high school students
• Nearly one-third of state and local enforcement
  agencies surveyed in 2003 rated methamphetamine
  as one of the greatest drug threats in their area
  (NDIC 2003)
• There has been lots of attention to the
  methamphetamine problem in the press. (e.g.
  NYTimes 2/10/2005)

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The Government Has Three Strategies to Curb
Illegal Drug Use

• Prevention Education and community action
• Discourage people from starting to use drugs
• 2B budget in 2005
• Demand side intervention
• Treatment Programs for drug users
• Get people who use drugs to stop
• 4B budget in 2005
• Demand side intervention
• Enforcement Reduce Availability
• 6B budget in 2005
• Supply side intervention
• Unlike treatment and prevention experimental
  evaluation is not feasible

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Goals of this Study

• Examine the impact of an extremely successful DEA
  enforcement effort in the methamphetamine
  precursor market on
• Price and purity of methamphetamine
• Hospitalizations and drug treatment admissions
  for methamphetamine
• Property crime, violent crime and drug crime

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Evidence of the Effect of Reducing
Methamphetamine Supply

• Cunningham and Liu (2003) find that regulation of
  precursors reduces methamphetamine
  hospitalizations.
• Abt Associates (2000) find that a 1 increase in
  methamphetamine prices reduces consumption by
  1.48
• Numerous studies of price elasticity of cocaine
  and heroin in U.S. (DiNardo 1993, Yuan and
  Caulkins 1998, Caulkins 2000 )
• These studies have some limitations
• They are identified of changes in price with
  unknown sources.
• They typically use data aggregated to the year
  and state level potentially masking temporary or
  local changes.
• They do not examine the direct effect of
  enforcement on outcomes of interest such as crime
  and adverse health events.

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Methamphetamine Production Is Dependent on
Precursor Availability

• Methamphetamine is cooked in illegal drug labs
  using either ephedrine or pseudoephedrine as a
  precursor
• Ephedrine or pseudoephedrine have many legal
  uses.
• Over the counter medicine such as Sudafed and
  Tylenol Cold contain pseudophedrine
• The DEA works to keep these chemicals from
  getting diverted to illegal uses

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Significant Precursor Legislation (1989-2000)

• October 1989 Chemical Diversion and Trafficking
  Act
• Regulated bulk ephedrine and pseudoephedrine
• August 1995 Domestic Chemical Diversion Control
  Act (DCDCA)
• Removes the record keeping and reporting
  exemption for single entity ephedrine products.
• October 1996 Methamphetamine Control Act
• Regulates access to over the counter medicines
  containing ephedrine.
• October 1997 Methamphetamine Control Act
• Regulates products containing pseudoephedrine or
  phenylpropanolamine
• July 2000 The Methamphetamine Anti-Proliferation
  Act
• Establishes thresholds for pseudoephedrine drug
  products.

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Significant Precursor Interventions Resulted from
the DCDCA

• Two large interventions occurred in May 1995
• Clifton Pharmaceuticals 25 metric tons of
  ephedrine and pseudoephedrine
• Xpressive Looks International Distributed about
  830 million ephedrine tablets (over 18 months)
• Scale of two interventions is enormous
• Production potential was 29 metric tons of
  methamphetamine
• DEA seized only 762 kilograms of methamphetamine
  in 1994 (DEA STRIDE)
• ONDCP estimated total methamphetamine consumption
  was 34.1 metric tons in 1994

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Our Analysis Relies on Detailed Data from a
Variety of Sources

• Census of DEA seizures purchases
• Census of California hospitalizations
• Census of drug treatment admissions in California
• Survey and drug test of a non random sample of
  arrestees for three California cities
• Monthly reported crimes and arrests in California
  by jurisdiction

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The Interventions Resulted in Temporary Changes
in Prices, Purity, and Adverse Health Outcomes

• There was a large though temporary increase in
  prices
• Price increased from 30 to 100
• Prices returned to pre-intervention levels within
  four months
• There was an enormous and longer-lasting impact
  on purity
• Purity declined from 90 to 20
• Purity required 18 months to recover to near
  pre-intervention levels
• There was a substantial decline in adverse health
  outcomes associated with methamphetamine
• Amphetamine-related hospitalizations declined by
  50
• Methamphetamine-related treatment admissions
  declined by 35
• Changes in health outcomes track the purity
  rather than prices

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Some Evidence of Substitution to Other Drugs

• Poly drug use is high among arrestees
• Methamphetamine users also use cocaine, heroin
  and marijuana
• There is some evidence that some methamphetamine
  users are switching to cocaine and heroin
• Decline in cocaine purity
• Increase in positive cocaine and heroin tests
  among arrestees who reported ever using
  methamphetamine
• Still a very large overall reduction in drug use

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There is Evidence of an Association Between
Methamphetamine Use and Crime

• Drug use is common among people arrested for
  property crimes, violent crimes and drug crimes
• Proportion of arrestees testing positive for
  methamphetamine for all three crime categories
  drops as a result of the intervention.
• How a reduction in methamphetamine supply might
  impact crime rates is not clear
• Property crime may rise or fall depending on the
  price elasticity of consumption
• Violent crime due to the pharmacological effects
  of methamphetamine may fall
• Violent crime due to the enforcement of property
  rights may fall
• Drug crime arrests for possession and sale are
  likely to fall as there are fewer transactions to
  conduct

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The 1995 DEA Intervention Had a Large, Temporary
Impact on Adverse Outcomes

• Price jumped from 30 per gram to 100 per gram
  and Purity declined from 90 to 20
• Hospital admissions for methamphetamine declined
  by 50
• Treatment admissions for methamphetamine declined
  by 35
• Methamphetamine use declined by 55 among
  arrestees and some arrestees switched to cocaine
  and heroin.
• Felony arrests for Dangerous Drugs declined by
  50
• Misdemeanor arrests for Other Drug Laws
  declined by 25
• The decrease in methamphetamine availability may
  have slightly reduced larcenies and motor vehicle
  thefts
• No discernable reduction in violent crime

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Conclusions

• Supply interdictions can reduce the rates of
  adverse health outcomes
• A reduction in drug supply will result in a
  reduction in the number of drug arrests
• Supply interdictions may reduce some property
  crimes specifically larceny and motor vehicle
  thefts.
• Lack of a large impact on violent crime or
  property crime suggests either
• Methamphetamine consumption does not cause large
  amounts of these crimes or
• Interdiction may not be an effective way of
  reducing the crime caused by methamphetamine use
• Despite this enormous success on the part of DEA
  the supply of methamphetamine recovered fairly
  rapidly.