title: Impact of Canadian federal methamphetamine precursor and essential chemical regulations on methamphetamine-related acute-care hospital admissions.
abstract: BACKGROUND
  In response to its domestic methamphetamine problems and an emerging international consensus that methamphetamine precursor and essential chemicals should be controlled, Canada regulated its import/export of ephedrine and pseudoephedrine (precursor chemicals) in January 2003, its domestic distribution of those chemicals in July 2003, and its import/export and manufacturing of essential chemicals (e.g., toluene) in January 2004. This study examines the regulations' impact on the problem of methamphetamine-related hospital admissions in Canada.
  
  
  METHODS
  ARIMA-based intervention time-series analysis was used to assess impacts on monthly counts of Canada's methamphetamine-related acute-care hospital admissions (04/1996 to 03/2005). Cocaine-, heroin/opioid-, and alcohol-related hospital admissions were examined as quasi-control time-series.
  
  
  RESULTS
  No impact was found for the January 2003 regulation. The July 2003 and January 2004 regulations were associated with 20% and 21% increases, respectively, in methamphetamine-related admissions. No impacts on the quasi-control time-series were found.
  
  
  CONCLUSIONS
  This study indicates that Canada's regulations were not associated with reductions in methamphetamine-related hospital admissions. The January 2003 regulation's focus on imports/exports rather than domestic distribution may help explain its lack of impact. In contrast, the two other regulations had salient domestic foci--domestic precursor sales (July 2003) and domestic essential chemical manufacturing (January 2004). Both regulations, however, were associated with increases in admissions, rather than declines. Government reports indicate that a shift in methamphetamine production, from smaller-scale operators to more sophisticated crime organizations (groups better able to circumvent the regulations), occurred around the times of the regulations. Such a shift could increase supply and possibly admissions.
authors.affiliation: Centre for Addiction and Mental Health, Toronto, ON, Canada. Russell Callaghan@camh.net
authors.forename: Russell C
authors.initials: RC
authors.lastname: Callaghan
authors.forename: James K
authors.initials: JK
authors.lastname: Cunningham
authors.forename: J Charles
authors.initials: JC
authors.lastname: Victor
authors.forename: Lon-Mu
authors.initials: LM
authors.lastname: Liu
mesh_terms: D000701:Analgesics, Opioid / Q000633:toxicity; D002170:Canada; D003042:Cocaine / Q000633:toxicity; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D000431:Ethanol / Q000633:toxicity; D006801:Humans; D008694:Methamphetamine / Q000737:chemistry / Q000633:toxicity*; D010343:Patient Admission / Q000706:statistics & numerical data*; D054199:Pseudoephedrine; D019966:Substance-Related Disorders / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D000431:Ethanol; D008694:Methamphetamine; D054199:Pseudoephedrine; D003042:Cocaine