The objective of this study was to estimate the prevalence of methamphetamine use and its correlates among people who use drugs in rural US communities participating in the national Rural Opioid Initiative (ROI). We hypothesized that co-use of methamphetamine and opioids would be associated with increased nonfatal overdose.
In this cross-sectional, multistate study of rural communities, 79% of people using drugs reported past-30-day methamphetamine use; nonfatal overdose was greatest in people using both methamphetamine and opioids (22%) vs opioids alone (14%), or methamphetamine alone (6%). People using both substances reported the least access to treatment; only 17% of those using methamphetamine alone had naloxone.
These findings suggest that harm reduction and substance use disorder treatment interventions must address methamphetamine use as well as opioids to decrease overdose in rural communities.
