The War on Drugs: Methamphetamine, Public Health and Crime Carlos Dobkin, Nancy Nicosia.

The War on Drugs: Methamphetamine, Public Health and Crime

Carlos Dobkin, Nancy Nicosia

Why Is Methamphetamine a Problem?

• Methamphetamine is typically 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

• Surveyed users in Queensland reported that methamphetamine use had caused them to commit both property and violent crimes.

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– 24 states reported increases of 100% or more in

methamphetamine treatment admissions from 1993 to 1999 (SAMHSA 2001)

– 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)

• Recently, the news has focused on the growing meth problem and associated crime (e.g. NYTimes 2/10/2005)

Drug Treatment Admissions in the United States - Amphetamines, Cocaine and Heroin

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Year

Co

un

t

Amphetamines

Cocaine

Heroin

Drug Treatment Admissions for Amphetamines

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

100,000

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Year

Co

un

t

Midwest

Northeast

South

West

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

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

Evidence of the Effect of Reducing Methamphetamine Supply

• Cunningham and Liu (2003) find that regulation of precursors reduces methamphetamine hospitalizations.

• Abt Associates (2000) find a 1% price increase in methamphetamine 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 use data aggregated to the year level potentially masking

local or temporary changes.– They do not examine the direct effect of enforcement on

outcomes of interest such as crime and adverse health events.

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 them

• The DEA works to keep these precursors from getting diverted to illegal uses

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.

Significant Precursor Interventions Resulted from the DCDCA

• Two large interventions occurred in May 1995 – Clifton Pharmaceuticals: 25 metric tons of precursors– Xpressive Looks International: 500 cases and distribution

network of 830 million tablets (over 18 months)

• Scale of two interventions is enormous– Production potential was 29 metric tons of methamphetamine

• Scale dwarfs other seizure and consumption measures– DEA seized only 762 kilograms of methamphetamine in 1994

(DEA STRIDE)– ONDCP estimated total methamphetamine consumption was

34.1 metric tons in 1994

Our Analysis Relies on Detailed Data from Government 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

Figure 1: Methamphetamine Prices and Purity in California

0

20

40

60

80

100

120

Jan-94 Jun-94 Dec-94 Jun-95 Dec-95 Jun-96 Dec-96 Jun-97 Dec-97

Month

Pric

es a

nd P

urity

Price per Gram

Purity

Figure 2: Methamphetamine Purity by Size of Acquisition in California

0

20

40

60

80

100

120


Month

Pur

ity

0-1 Grams

1-10 Grams

10-100 Grams

Over 100 Grams

Figure 3: Methamphetamine Related Hospital and Drug Treatment Center Admissions

0

500

1000

1500

2000

2500

3000

3500

Jan-94 Jul-94 Jan-95 Jul-95 Jan-96 Jul-96 Jan-97 Jul-97

Month

Cou

nt o

f Adm

issi

ons

Per

Mon

th

Treatment Admissions

Hospital Admissions

Figure 4: Drug Treatment Center Admissions for Methamphetamine by Route of Drug Administration

0

500

1,000

1,500

2,000

2,500


Month of admission

Adm

issi

on p

er m

onth

Oral

Inhaled

Injected

Figure 5A: Cocaine and Heroin Prices in California

0

40

80

120

160

200


Month

Pric

e pe

r G

ram

Cocaine Price California

Heroin Price California

Figure 5B: Purity of Cocaine and Heroin in California

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10

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60

70

80

90

100


Month

Pur

ity

Cocaine Purity California

Heroin Purity California

Figure 6B: Regional Cocaine Purity

0

10

20

30

40

50

60

70

80

90

100


Month

Pur

ity

Cocaine Purity Northeast

Cocaine Purity Midwest

Cocaine Purity South

Cocaine Purity West

Figure 7: Hospital and Drug Treatment Admissions in California

0

500

1000

1500

2000

2500

3000

3500


Month

Ad

mis

sio

ns

Pe

r M

on

th

Hospital Heroin (Opioid)

Hospital Cocaine

Treatment Heroin (-5000)

Treatment Cocaine

Amphetamine Hospital

Admissions

Methamphetamine


Cocaine Hospital

Admissions

Cocaine and Crack


Opioid Hospital

Admissions

Heroin Treatment

Admissions1.1718 0.4254 0.1551 0.0506 -0.1392 -0.1928

[0.1050] [0.1259] [0.0619] [0.0651] [0.0383] [0.0662]-0.0429 0.0152 -0.0314 -0.0354 0.0056 0.0157[0.0327] [0.0368] [0.0195] [0.0181] [0.0126] [0.0175]

Constant 6.3613 7.343 7.3836 7.5422 7.223 9.0012[0.2931] [0.3900] [0.1749] [0.1944] [0.1131] [0.1718]

Observations 47 47 47 47 47 47R-squared 0.86 0.59 0.82 0.68 0.8 0.82

Table 2A: Hospital and Drug Treatment Center Admissions in California

Notes: Regressions are on statewide outcomes by month for 1994 to 1997. The outcomes are in logs. All the regressions include time trends, month dummies, and cocaine and heroin prices and purity.

Purity MethamphetamineLog Price Methamphetamine

The Intervention is Associated with Temporary Changes in Prices, Purity, and

Adverse Health Outcomes• There was a large though temporary increase in prices

– Price increased from $40 to $100 – Prices returned to pre-intervention levels within four months

• There was an enormous and somewhat longer-term 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

Drug Testing Revealed All Arrests Property Crime Violent Crime Drug Arrests Marijuana 0.34 0.36 0.32 0.36 Cocaine 0.26 0.29 0.17 0.41 Opiates 0.07 0.08 0.03 0.10 Methamphetamine 0.17 0.14 0.12 0.32Survey Reported Methamphetamine Use Last 72 Hours 0.09 0.07 0.05 0.20 Last 30 Days 0.15 0.12 0.10 0.28 Have used ever 0.30 0.26 0.23 0.44 Times in Last Month if > 0 11.03 11.31 9.04 12.54Spent Some Money on Drugs in Last Month 0.32 0.35 0.21 0.49At Time of Arrest Under Influence of Drugs or Alcohol 0.28 0.23 0.27 0.36 Need Drugs or Alcohol 0.08 0.09 0.04 0.12Monthly Income and Spending Percent Reporting Legal Income 0.73 0.71 0.81 0.79 Percent Reporting Illegal Income 0.15 0.19 0.07 0.22 Legal Income 771 647 1,073 696 Illegal Income 275 343 123 416 Money Spent on Drugs 124 167 53 152Observations 16,584 6,231 3,838 2,998

Table 1A: Drug Use and Sources of Income by Type of Crime in San Diego, Los Angeles and San Jose 1994-1997

Note: The drug test used is EMIT screening which is known to be sensitive to false positives. Positive methamphetamine tests are confirmed using gas chromatography. Tests will pick up cocaine, heroin and methamphetamine use in the 3-5 days prior to the test. Arrestees are tested within 48 hours of arrest.

Figure 8A: Methamphetamine Use Among Arrestees in San Diego, Los Angeles and San Jose (Regression Adjusted and Smoothed)

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4


Month

Per

cent

of A

rres

tees

Usi

ng

Positive Urine TestReported Use in Last 72 HoursReported Use in Last 30 DaysEver Used

Figure 8B: Positive Methamphetamine Test Among Arrestees in San Diego, Los Angeles and San Jose by Crime Type (Regression Adjusted and Smoothed)

0

0.1

0.2

0.3

0.4

0.5

0.6

Feb-94 Aug-94 Feb-95 Aug-95 Feb-96 Aug-96 Feb-97 Aug-97

Month

Pro

port

ion

with

Pos

itive

Urin

e T

est f

or M

etha

mph

etam

ines

Drug Arrests

Violent Crime

Property Crime

Other Crimes

Figure 8C: Proportion of Arrestees Reporting Ever Having Used Methamphetamine in San Diego, Los Angeles and San Jose by Crime Type (Regression Adjusted and Smoothed)

0

0.1

0.2

0.3

0.4

0.5

0.6


Month

Pro

port

ion

with

Pos

itive

Urin

e T

est f

or M

etha

mph

etam

ines

Drug Arrests

Violent Crime

Property Crime

Other Crimes

All Arrestees

Reported Ever Using

Methamphetamine

Reported Using Methamphetamine in the Last Month

Positive Urine Test for

MethamphetaminePositive Urine Test Marijuana 0.34 0.36 0.36 0.34 Methamphetamine 0.17 0.42 0.68 1.00 Cocaine 0.26 0.21 0.14 0.13 Opiates 0.07 0.09 0.06 0.06Reported Use in Last Month Marijuana 0.41 0.57 0.67 0.56 Methamphetamine 0.15 0.50 1.00 0.59 Cocaine 0.10 0.14 0.15 0.09 Opiates 0.04 0.08 0.07 0.04Reported Ever Using Marijuana 0.77 0.97 0.96 0.93 Methamphetamine 0.30 1.00 1.00 0.75 Cocaine 0.40 0.72 0.71 0.62 Opiates 0.12 0.26 0.24 0.18Arrestees 16,584 4,971 2,462 2,799

Table 3: Poly Drug Use Among Methamphetamine Users

Notes: These are computed from a sample of arrestees in San Diego, Los Angeles and San Jose for the 1994 to 1997 period

Figure 8D: Positive Drug Test Among Arrestees in San Diego, Los Angeles and San Jose Who Report Ever Having Used Methamphetamine

(Regression Adjusted and Smoothed)

0

0.1

0.2

0.3

0.4

0.5

0.6


Pro

po

rtio

n T

es

tin

g P

os

itiv

e

Methamphetamine Positive

Cocaine Positive

Opiates Positive

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

There is Evidence of an Association Between Methamphetamine Use and Crime

• Drug use is common among people arrested for property crime, violent crime 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 rise

or fall– Drug crimes such as possession are likely to fall as there are

fewer transactions to conduct

Figure 9: Reported Property Crime in California

0

10000

20000

30000

40000

50000

60000

70000

80000

90000


Months

Larc

eny

0

5000

10000

15000

20000

25000

30000

MV

The

ft, R

obbe

ry a

nd B

urg

lary

Burglary

Larceny

MV Theft

Robbery

Figure 10: Reported Violent Crimes in California

0

200

400

600

800

1,000

1,200


Month

Mon

thly

Rep

orte

d H

omic

ides

and

Rap

es

0

5,000

10,000

15,000

20,000

25,000

30,000

Mon

thly

rep

orte

d A

ssau

lts

Homicide

Rape

Assault

Burglary Larceny MV Theft Rape Robbery Homicide Assault0.0829 0.0015 0.1364 -0.1119 -0.2022 -0.2201 -0.0399

[0.0384] [0.0343] [0.0381] [0.0483] [0.0361] [0.1098] [0.0585]-0.0079 0.0005 -0.0061 -0.0002 0.0171 0.0217 -0.0028[0.0082] [0.0088] [0.0120] [0.0149] [0.0090] [0.0233] [0.0132]

Constant 10.2572 11.2437 10.0183 6.6448 9.1776 5.7663 9.5432[0.0935] [0.1144] [0.1291] [0.1898] [0.0937] [0.2277] [0.1505]

Observations 47 47 47 47 47 47 47R-squared 0.96 0.91 0.95 0.82 0.97 0.85 0.89

Table 2B: Reported Property and Violent Crime in California

Notes: Regressions are on statewide outcomes by month for 1994 to 1997. The outcomes are in logs. All the regressions include time trends, month dummies, and cocaine and heroin prices and purity.

Log Price Methamphetamine

Purity Methamphetamine

Figure 11A: Felony Drug Arrests in California

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

15-Jan-94 15-Jul-94 15-Jan-95 15-Jul-95 15-Jan-96 15-Jul-96 15-Jan-97 15-Jul-97

Da

ng

ero

us

Dru

gs,

Na

rco

tics

an

d M

arij

ua

na

0

50

100

150

200

250

300

350

400

450

500

Oth

er

Dru

g L

aw

s

Felony Dangerous Drugs

Felony Marijuana

Felony Narcotics

Felony Other Drug Laws

Figure 11B: Misdemeanor Drug Arrests in California

0

50

100

150

200

250

300

15-Jan-94 15-Jul-94 15-Jan-95 15-Jul-95 15-Jan-96 15-Jul-96 15-Jan-97 15-Jul-97

Glu

e S

niff

ing

an

d D

an

ge

rou

s D

rug

s

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

Ma

riju

an

a a

nd

Oth

er

Dru

g L

aw

s

Misdemeanor Dangerous Drugs

Glue Sniffing

Misdemeanor Marijuana

Misdemeanor Other Drug Laws

Felony Narcotics

Felony Dangerous

DrugsFelony

MarijuanaFelony Other Drug Laws

Misdemeanor Dangerous

DrugsMisdemeanor Glue Sniffing


Misdemeanor Other Drug

Laws0.0672 1.1263 -0.2207 -0.3034 -0.4787 -0.3716 -0.3134 0.4806

[0.0672] [0.1117] [0.0746] [0.1660] [0.1898] [0.1421] [0.0532] [0.0563]-0.0648 -0.0706 -0.0179 -0.0167 -0.0205 -0.0699 0.0214 -0.0207[0.0383] [0.0316] [0.0229] [0.0360] [0.0508] [0.0386] [0.0163] [0.0174]

Constant 8.8729 7.8748 7.3756 6.0031 5.7065 5.1805 8.0762 8.3122[0.2787] [0.2748] [0.1968] [0.3251] [0.4669] [0.3926] [0.1835] [0.1330]

Observations 47 47 47 47 47 47 47 47R-squared 0.69 0.85 0.73 0.88 0.46 0.7 0.95 0.85Notes: Regressions are on statewide outcomes by month for 1994 to 1997. The outcomes are in logs. All the regressions include time trends, month dummies, and cocaine and heroin prices and purity.

Table 2C: Drug Arrests in California

Purity MethamphetamineLog Price Methamphetamine

Figure 12: Amphetamine Hospitalizations Rate by Amphetamine Hospitalization Rate of County

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1.8

2


Month

Adm

issi

ons

Per

Mon

th P

er 1

0K R

esid

ents

0 - 0.33 Admissions Per Month Per 10K Residents

0.33 - 0.51 Admissions Per Month Per 10K Residents


More than 1.15 Admissions Per Month Per 10K Residents

Figure 13A: Homicide Rate by Amphetamine Related Hospitalization Rate of County

0

0.05

0.1

0.15

0.2

0.25


Month

Crim

es P

er M

onth

Per

10K

Res

iden

ts





Figure 13B: Larceny Rate by Amphetamine Related Hospitalization Rate of County

20

25

30

35

40

45

50

55


Month

Crim

es P

er M

onth

Per

10K

Res

iden

ts





Burglary Larceny MV Theft Rape Robbery Homicide Assaults0.379 1.095 0.402 -0.008 -0.032 0.008 -0.071[0.244] [0.518] [0.212] [0.016] [0.077] [0.005] [0.179]-0.291 -1.391 0.113 0.006 -0.064 -0.002 0.059[0.311] [0.996] [0.401] [0.031] [0.191] [0.011] [0.183]0.057 -0.752 -0.245 0.008 -0.001 -0.011 -0.022[0.376] [0.457] [0.391] [0.021] [0.076] [0.007] [0.144]

Observations 2,784 2,784 2,784 2,784 2,784 2,784 2,784R-squared 0.91 0.93 0.90 0.44 0.96 0.57 0.84

Notes: All regressions are at the county level by month. The regressions include county fixed effects, year effects, month dummies, proportion black and Hispanic in county and the proportion in various age categories. The regressions are weighted by county population age 15 to 44. The regressions include all California counties between 1994 and 1997.

Rate Amphetamine AdmissionsRate Cocaine AdmissionsRate Opioid Admissions

Table 3A: County Level Crime Rates Regressed on County Level Hospital Admissions Rates

Felony Narcotics

Felony Dangerous

DrugsFelony Other

Drugs Felony MJ

Misdemeanor Dangerous

Drugs

Misdemeanor Other Drug

LawsMisdemeanor Glue Sniffing


0.019 0.740 -0.010 -0.020 -0.007 0.554 -0.023 -0.102[0.051] [0.102] [0.020] [0.028] [0.012] [0.131] [0.015] [0.042]0.339 -0.055 0.081 -0.061 -0.043 0.133 0.007 -0.046[0.184] [0.136] [0.038] [0.037] [0.048] [0.210] [0.017] [0.059]0.023 -0.146 0.018 0.096 -0.005 -0.140 -0.022 0.073[0.107] [0.125] [0.025] [0.036] [0.014] [0.126] [0.020] [0.067]

Observations 2,784 2,784 2,784 2,784 2,784 2,784 2,784 2,784R-squared 0.91 0.84 0.71 0.68 0.65 0.80 0.45 0.58

Table 3B: County Level Arrest Rates Regressed on County Level Hospital Admissions Rates

Notes: All regressions are at the county level by month. The regressions include county fixed effects, year effects, month dummies, proportion black and Hispanic in county and the proportion in various age categories. The regressions are weighted by county population age 15 to 44. The regressions include all California counties between 1994 and 1997.

Rate Amphetamine AdmissionsRate Cocaine AdmissionsRate Opioid Admissions

Figure 14: Purity and Health and Crime Outcomes

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000


Month

Arr

ests

, Hos

pita

l Adm

issi

ons

and

Tre

atm

ent A

dmis

sion

s pe

r M

onth

0

10

20

30

40

50

60

70

80

90

100

Per

cent

Pur

ity, P

erce

nt o

f Arr

este

es T

estin

g P

ositi

ve F

or

Met

ham

phet

amin

e


Hospital Admissions

Felony Dangerous Drugs

Misdemeanor Other Drug Laws

Arrestee Positive Test

Purity

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

• Price jumped from $40 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

reduced larcenies and motor vehicle thefts• No discernable reduction in violent crime

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 significant change in violent crime suggests either: methamphetamine consumption does not cause large amounts of violent crime or that interdiction is not an effective way of reducing violent crime associated with methamphetamine use.

• Despite this enormous success on the part of DEA the supply of methamphetamine recovered fairly rapidly.

The War on Drugs: Methamphetamine, Public Health and Crime Carlos Dobkin, Nancy Nicosia.

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