Academic journal article Human Organization

Trajectories of Methamphetamine Use in the Rural South: A Longitudinal Qualitative Study

Academic journal article Human Organization

Trajectories of Methamphetamine Use in the Rural South: A Longitudinal Qualitative Study

Article excerpt

This paper describes trajectories of methamphetamine (MA) use among participants in a longitudinal study in rural Arkansas and Kentucky. Thirty-nine baseline qualitative interviews were conducted with active MA users. Twenty-four participants were interviewed again from 12 to 24 months later. At follow-up, 13 participants reported quitting MA use, six had reduced MA use, and five were using the drug at approximately baseline levels. Two participants had changed modes of administering MA. Health, legal, and family issues, or a combination of these factors, were linked to quitting or reducing MA use. Sixteen participants had made positive changes without drug abuse treatment, one used professional inpatient treatment, and two utilized faith-based programs. Willpower, self-isolation, staying busy, family support, and using substitute drugs were cited as strategies for avoiding MA use. The study findings have important implications for understanding rural MA use careers, guiding future research, and informing intervention strategies.

Key words: methamphetamine, ethnography, southern United States, use patterns

Introduction

Illicit methamphetamine (MA) production and use emerged as problems in California in the 196Os (Morgan and Beck 1997). By the 1980s, the drug was being mass produced on the West Coast and in Mexico for interstate distribution in the United States (Miller 1997; National Drug Intelligence Center 2002, 2003). MA production and use have recently spread to the West, South, and Midwest (Barnes, Boeger, and Huffman 1998; McMaster, Tripp, and Argo n.d.; Sexton et al. 2006a, 2006b; Sexton et al. 2005; Weisheit and Fuller 2004). There are also reports of potential emerging MA use in New England (Singer et al. 2006).

Regional MA economies differ. For example, Southern urban MA supply is generally dependent on wholesale "imported" MA that is distributed through retail street sales (National Drug Intelligence Center 2003). In the rural South, however, small-scale local MA production for personal use, gifts, barter, or sales is common (Sexton et al. 2006a, 2006b).

MA is an addictive CNS stimulant that causes short-term and long-term adverse consequences (see, e.g., Anderson and Flynn 1997; Clatts, Welle, and Goldsam 2001 ; Gawin and Ellenwood 1988; Rawson, Anglin, and Ling 2002; Richards et al. 1999; Sexton et al. 2006b; Thompson et al. 2004; Wolkoff 1997; ZuIe and Desmond 1999). Therefore, understanding patterns of MA use and planning appropriate interventions is important.

MA use trajectories are often described as rising and spiraling out of control in relation to variables like modes of administering MA and lack of problem recognition. For example, shifting to injecting MA can occur because it is viewed as producing quicker more intense "highs" (Sexton et al. 2006b). Escalating local MA production, its availability in many settings, and peer pressure may lead to increased use (Sexton et al. 2006a, 2006b; Sexton et al. 2005). "Functional" MA use to enhance work or sexual performance can escalate as tolerance for the drug increases along with the inability to deal with cravings for MA (Bruehl et al. 2006; Morgan and Beck 1997; Reback 1997; Sexton et al. 2006b). Perceived functional use may persist for long periods since one study reported an average of nine years between first MA use and drug abuse treatment entry (Brecht et al. 2004).

A variety of factors related to decreases in trajectories of MA use have been identified. External forces like courtordered drug abuse treatment can sometimes contribute to abstinence from MA use (Brecht et al. 2004, Brecht, Greenwell, and Anglin 2005; Hser et al. 2003). Legislation may also influence MA availability and use trends. Recent research in California, Nevada, and Utah, for example, has assessed the impact of legislation implemented between 1989 and 1997 to regulate ephedrine and pseudoephedrine which are key MA-making ingredients. …

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