Health outcomes associated with methamphetamine use among young people: a systematic review.
OBJECTIVE
Methamphetamine (MA) use among young people is of significant social, economic and public health concern to affected communities and policy makers. While responses have focused upon various perceived severe harms of MA use, effective public health interventions require a strong scientific evidence base.


METHODS
We conducted a systematic review to identify scientific studies investigating health outcomes associated with MA use among young people aged 10-24 years. The International Classification of Diseases (ICD-10) was used to categorize outcomes and determine the level of evidence for each series of harms.


RESULTS
We identified 47 eligible studies for review. Consistent associations were observed between MA use and several mental health outcomes, including depression, suicidal ideation and psychosis. Suicide and overdose appear to be significant sources of morbidity and mortality among young MA users. Evidence for a strong association between MA use and increased risk of human immunodeficiency virus (HIV) and other sexually transmitted infections is equivocal. Finally, we identified only weak evidence of an association between MA use and dental diseases among young people.


CONCLUSIONS
Available evidence indicates a consistent relationship between MA use and mental health outcomes (e.g. depression, psychosis) and an increased risk of mortality due to suicide and overdose. We found insufficient evidence of an association between MA use and other previously cited harms, including infectious diseases and dental outcomes. As such, future research of higher methodological quality is required to further investigate possible associations. Current interventions should focus attention upon MA-related health outcomes for which sound scientific evidence is available.
Marshall
Brandon D L
BD
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada. bmarshall@cfenet.ubc.ca
Werb
Daniel
D
D000293:Adolescent; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000453:epidemiology*; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D002648:Child; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology; D062787:Drug Overdose / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008694:Methamphetamine / Q000009:adverse effects*; D011247:Pregnancy; D011605:Psychoses, Substance-Induced / Q000453:epidemiology; D012196:Review Literature as Topic; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D009057:Stomatognathic Diseases / Q000453:epidemiology*; D013405:Suicide / Q000706:statistics & numerical data; D055815:Young Adult
D000697:Central Nervous System Stimulants; D008694:Methamphetamine