Impact of Canadian federal methamphetamine precursor and essential chemical regulations on methamphetamine-related acute-care hospital admissions

Background: In response to its domestic methamphetamine problems and an emerging international consensus that methamphetamine precursor and essential chemicals should be controlled, Canada regulated its import/export of ephedrine and pseudoephedrine (precursor chemicals) in January 2003, its domestic distribution of those chemicals in July 2003, and its import/export and manufacturing of essential chemicals (e.g., toluene) in January 2004. This study examines the regulations' impact on the problem of methamphetamine-related hospital admissions in Canada. Methods: ARIMA-based intervention time-series analysis was used to assess impacts on monthly counts of Canada's methamphetamine-related acute-care hospital admissions (04/1996 to 03/2005). Cocaine-, heroin/opioid-, and alcohol-related hospital admissions were examined as quasi-control time-series. Results: No impact was found for the January 2003 regulation. The July 2003 and January 2004 regulations were associated with 20% and 21% increases, respectively, in methamphetamine-related admissions. No impacts on the quasi-control time-series were found. Conclusions: This study indicates that Canada's regulations were not associated with reductions in methamphetamine-related hospital admissions. The January 2003 regulation's focus on imports/exports rather than domestic distribution may help explain its lack of impact. In contrast, the two other regulations had salient domestic foci - domestic precursor sales (July 2003) and domestic essential chemical manufacturing (January 2004). Both regulations, however, were associated with increases in admissions, rather than declines. Government reports indicate that a shift in methamphetamine production, from smaller-scale operators to more sophisticated crime organizations (groups better able to circumvent the regulations), occurred around the times of the regulations. Such a shift could increase supply and possibly admissions.