Statement of purpose To investigate characteristics and trends of methamphetamine exposures reported to United States (US) poison control centers.

Methods/Approach Data from the National Poison Data System were analyzed to investigate exposures to methamphetamine.

Results From January 1, 2000 through December 31, 2019, US poison control centers managed 54,199 cases involving methamphetamine as the first-ranked substance. Adults 20–39 years old accounted for more than half (56.3%) of all cases. There were 1,291 deaths, of which 43.0% involved multiple-substance exposures. Among multiple-substance exposures in which methamphetamine was the first-ranked substance, stimulants and street drugs (excluding methamphetamine) were most commonly present (22.7%), followed by opioids (19.0%). The substance class associated with the most fatalities was opioids (n=243, 26.6%). The rate of methamphetamine exposures per 100,000 US population increased by 79.5% from 2000–2005, then decreased by 68.0% from 2005–2007, followed by an increase of 614.6% from 2007–2019. From 2007–2019, the rate significantly increased among all age groups, except among 6–12-year-olds, and in all US regions. The rates of single- substance and multiple-substance exposures increased significantly from 2007–2019 by 456.7% (p<0.0001) and 843.6% (p<0.0001), respectively. From 2007–2019, the proportions of cases resulting in admission to a health care facility and serious medical outcome increased by 38.6% and 55.2%, respectively, and the fatality rate increased by 492.3%.

Conclusions The rate of exposure to methamphetamine in the US declined initially following passage of the Combat Methamphetamine Epidemic Act of 2005. However, since 2007, the rate and severity of methamphetamine exposures in the US have increased.

Significance This is the first study to analyze methamphetamine exposures among all age groups over an extensive time period in the US. The findings from this study can help inform future prevention, monitoring, and research efforts.