This is a B/START proposal from a new investigator seeking pilot study data on methamphetamine, a growing problem in several regions of the United States, and in particular, the Territory of Guam. The proposed pilot study will build on the existing relationship established over the past two years between the PI and the Government of Guam's Department of Mental Health and Substance Abuse. This B/START pilot study will provide the opportunity for the PI as a new investigator to pilot test methods for sampling community and clinically-ascertained methamphetamine users that will set the stage for larger epidemiologic investigations. In addition, two classes of risk factors will be studied that are hypothesized to be associated with methamphetamine use: 1) previous drug involvement; specifically it is hypothesized that a history of heavy alcohol and marijuana use will signal an increase in the risk for methamphetamine use; and 2) familial influences; it is hypothesized that methamphetamine and other drug use is clustered within families and associated with a number of family characteristics, including loss of cultural identity. Lastly, this study will study the suspected transition from ice smoking to injecting methamphetamine, gathering evidence from both the clinical sample of cases, and the epidemiologic sample. The ultimate goal of this line of research, starting with this small pilot study, will be to fill gaps in our understanding of the sequencing of drug involvement leading up to methamphetamine dependence, as well as point to potentially malleable risk factors. This information will be valuable not only to drug prevention program planners and treatment providers on Guam, but also possibly to individuals facing similar outbreaks of methamphetamine use on Hawaii and the U.S. mainland.
