As opioid overdose deaths have begun to fall, a quieter crisis has grown alongside them: stimulant-related deaths — driven largely by methamphetamine — rose sharply over the past decade and now account for a significant share of all drug overdose fatalities in the United States. Understanding what methamphetamine is, how it affects the brain, and what treatment looks like is essential for families, caregivers, and communities working to address this challenge.
According to the Substance Abuse and Mental Health Services Administration's (SAMHSA) 2023 National Survey on Drug Use and Health (NSDUH), an estimated 2.6 million people aged 12 or older — about 0.9 percent of Americans in that age group — used methamphetamine in the past year. The 2024 NSDUH showed the rate edging down slightly to 0.8 percent. Methamphetamine use is not confined to any one region: it is present in rural, suburban, and urban communities alike, and across all income levels.
Methamphetamine is a powerful stimulant that can be smoked, snorted, injected, or swallowed. The illicit drug supply today is largely dominated by highly potent, inexpensive product manufactured by transnational criminal organizations — a supply shift that has driven both increased availability and increased potency compared with earlier decades.
The toll from methamphetamine has grown dramatically. Data from the Centers for Disease Control and Prevention (CDC) show that overdose death rates involving psychostimulants with abuse potential — a category largely reflecting methamphetamine — rose from 3.9 per 100,000 people in 2018 to 10.4 per 100,000 in 2023, nearly tripling in five years. In 2023, nearly 35,000 overdose deaths involved psychostimulants, representing roughly 1 in 3 of all drug overdose deaths that year.
Encouragingly, 2024 saw a broad decline in overdose deaths overall — the largest single-year drop on record — and stimulant-involved deaths declined along with opioid deaths. But the absolute numbers remain far above where they stood just a decade ago.
One of the most critical developments in understanding meth-related overdose deaths is the role of polysubstance use. According to a CDC analysis published in the Morbidity and Mortality Weekly Report (MMWR), the vast majority of stimulant-involved overdose deaths in recent years also involved opioids — and most of those involved illicitly manufactured fentanyl (IMF).
This means many people who use methamphetamine and die of an overdose have fentanyl in their system, sometimes without knowing it. Street drugs today are frequently contaminated with fentanyl, which can be invisible, odorless, and lethal in tiny amounts. Keeping naloxone (Narcan) on hand remains life-saving even for people who use stimulants, because an unintentional opioid exposure can happen at any time. Fentanyl test strips — where legal — are another harm-reduction tool that can help people check their supply before use.
Disparities in stimulant-involved deaths are also striking. CDC data show the largest per-capita increases have occurred among non-Hispanic American Indian or Alaska Native communities, underscoring the need for culturally tailored prevention and treatment efforts.
The National Institute on Drug Abuse (NIDA) explains that methamphetamine works by triggering a massive release of dopamine in the brain's reward circuits — far more than natural rewards like food or social connection. This flood of dopamine creates an intense rush of pleasure and reinforces continued use in a powerful way. With repeated use, the brain begins to adapt: the dopamine system is disrupted, and the person may find it harder to feel pleasure from everyday activities.
Long-term methamphetamine use is associated with:
Research also offers real hope: NIDA notes that some brain changes may partially reverse after a person stops using methamphetamine, particularly with a year or more of sustained abstinence. Recovery is possible, and treatment works.
As of 2026, there are no FDA-approved medications specifically for methamphetamine use disorder — a significant gap compared with opioid use disorder, which has three well-established medication options. The FDA has taken steps to accelerate development of stimulant use disorder treatments, and several clinical trials (including studies of naltrexone/bupropion combinations) are underway. But behavioral treatments are effective right now.
The best-evidenced approach is contingency management (CM). In CM, people receive small, tangible rewards — prize draws, vouchers, or gift cards — for meeting treatment goals such as providing drug-negative urine samples or attending sessions. A 2024 SAMHSA advisory specifically endorsed CM for stimulant use disorder and authorized SAMHSA grant funds to be used for it. CM has been shown to work across a range of settings and populations, including people with co-occurring opioid and stimulant use disorders.
Other evidence-based behavioral treatments include:
Residential and intensive outpatient treatment programs can combine these approaches and address underlying mental health conditions — which co-occur with substance use disorders at high rates.
If you or someone you love is struggling with methamphetamine use, help is available. SAMHSA's National Helpline connects callers with free, confidential information and treatment referrals 24 hours a day, 7 days a week. The Behavioral Health Treatment Services Locator at FindTreatment.gov can help identify local programs, including sliding-scale and publicly funded options.
At Empower Next Project, our Empower Next Steps program connects individuals and families with pathways to care and community support. And because fentanyl contamination of the drug supply is now widespread, our Empower Next Breath program ensures that naloxone is available to the people who need it — regardless of what substances are involved.
Get help now: Call or text 988 (Suicide & Crisis Lifeline) for mental health and substance use crisis support. For treatment referrals, call SAMHSA's free, confidential National Helpline at 1-800-662-4357 (1-800-662-HELP), available 24/7 in English and Spanish.
This article is educational and is not a substitute for professional medical or clinical advice. If you are experiencing a medical emergency, call 911. For substance use support and treatment referrals, call SAMHSA's National Helpline at 1-800-662-4357.