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NIDA's Community Epidemiology Work Group (CEWG), an early warning network of researchers that provides information about the nature and patterns of drug use in major cities, reported in its June 2001 publication that methamphetamine continues to be a problem in Hawaii and in major Western cities, such as San Francisco, Denver, and Los Angeles. Methamphetamine availability and production are being reported in more diverse areas of the country, particularly rural areas, prompting concern about more widespread use. Drug abuse treatment admissions reported by the CEWG in June 2001 showed that methamphetamine remained the leading drug of abuse among treatment clients in the San Diego area and Hawaii. Stimulants, including methamphetamine, accounted for smaller percentages of treatment admissions in other states and metropolitan areas of the West (e.g., 9 percent in Los Angeles and Seattle and 8 percent in Texas). By comparison, stimulants were the primary drugs of abuse in a smaller percent of treatment admissions in most Eastern and Midwestern metropolitan areas, such as Minneapolis-St. Paul and St. Louis, where they accounted for approximately 3 percent of total admissions, or Baltimore, where no stimulant-related treatment admissions were reported in the first half of 2000. How is methamphetamine used?Methamphetamine comes in many forms and can be smoked, snorted, orally ingested, or injected. The drug alters moods in different ways, depending on how it is taken. Immediately after smoking the drug or injecting it intravenously, the user experiences an intense rush or "flash" that lasts only a few minutes and is described as extremely pleasurable. Snorting or oral ingestion produces euphoria - a high but not an intense rush. Snorting produces effects within 3 to 5 minutes, and oral ingestion produces effects within 15 to 20 minutes. As with similar stimulants, methamphetamine most often is used in a "binge and crash" pattern. Because tolerance for methamphetamine occurs within minutes - meaning that the pleasurable effects disappear even before the drug concentration in the blood falls significantly - users try to maintain the high by binging on the drug. In the 1980's, "ice," a smokable form of methamphetamine, came into use. Ice is a large, usually clear crystal of high purity that is smoked in a glass pipe like crack cocaine. The smoke is odorless, leaves a residue that can be resmoked, and produces effects that may continue for 12 hours or more.
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