A large-scale analysis of Ontario urine drug screens has quietly dismantled one of public health's most persistent assumptions: that methamphetamine use belongs primarily to young men on the margins. Researchers at Lawson Research Institute found women and adults over fifty present in numbers eight times greater than self-reported surveys had ever suggested, revealing how stigma and invisibility can distort a society's understanding of its own suffering. The findings arrive as stimulant-related deaths climb even as opioid deaths recede, suggesting the crisis has not diminished — it has simply
Ontario study reveals women, older adults comprise larger share of meth users than assumed
Stimulant users face elevated rates of HIV, viral hepatitis, and infectious endocarditis, with significantly higher emergency room and hospitalization rates.
somebody's wife or daughter or sister or grandparent
Mark
So the study looked at actual test results rather than asking people what they'd used. Why does that distinction matter so much?
Mimi
Because when you ask people directly, they often don't tell you the truth. Women especially seem reluctant to admit methamphetamine use—maybe shame, maybe fear of judgment. The urine screens don't lie the same way.
Luke
But we should be careful here. The study shows what tested positive in a specific health care setting in Ontario during those two years. We don't know if that population is representative of all methamphetamine users in the province.
Mark
The researcher mentioned that women's numbers were eight times higher than previous self-reported studies showed. That's a huge gap.
Mimi
It is. And it suggests that entire groups of people—women, older adults—have been invisible in the conversation about who uses stimulants. The stereotype was young men, and that shaped everything from treatment design to public messaging.
Luke
True, but we should note that the study still only captures people who came through the health care system and agreed to testing. People using stimulants who never seek medical care wouldn't show up in these numbers at all.
Mark
What about the health impacts? The study found higher rates of HIV and hepatitis among users.
Mimi
Yes, and they're also going to emergency rooms and getting hospitalized at much higher rates than the general population. That costs the system significantly more than if they had access to primary care or addiction treatment.
Luke
The study documents the correlation, but it doesn't tell us whether stimulant use causes the health problems or whether people with existing health vulnerabilities are more likely to use stimulants. That's an important distinction.
Mark
The researcher said stimulant use appears to be increasing. How confident is he about that?
Mimi
He's basing it on the shift in what's driving overdose deaths—opioids are down, stimulants are up. But he's also clear that the 2017-2018 data is a baseline. They'd need to repeat the study to actually measure change.
Luke
And the urine tests only detect use from the previous three days, so the study is definitely missing chronic users who weren't tested during that window.
Le Pouls
- A study of 215,000 Ontario drug screens has shattered the demographic profile of methamphetamine use, finding women at 41% and adults over 50 at 20% of positive tests — figures that dwarf anything self-reported data had shown.
- The gap between what people admit and what their bodies reveal points to a stigma so powerful it has been distorting public health policy for years, with women especially reluctant to disclose use they fear will define them.
- Some users may not even know they have consumed stimulants, as methamphetamine is increasingly mixed into other substances — a hidden exposure that makes the true scale of the problem even harder to measure.
- Those testing positive face dramatically higher rates of HIV, viral hepatitis, and infectious endocarditis, and are 63–65% more likely to end up in an emergency room, placing real and growing pressure on the health care system.
- With stimulant-related deaths rising even as opioid deaths fall, researchers warn the 2017–2018 data likely understates a problem that has only grown — and one that will remain invisible as long as the stereotypes persist.
A large-scale analysis of Ontario urine drug screens has quietly dismantled one of public health's most persistent assumptions: that methamphetamine use belongs primarily to young men on the margins. Researchers at Lawson Research Institute found women and adults over fifty present in numbers eight times greater than self-reported surveys had ever suggested, revealing how stigma and invisibility can distort a society's understanding of its own suffering. The findings arrive as stimulant-related deaths climb even as opioid deaths recede, suggesting the crisis has not diminished — it has simply shifted into populations we were not looking for.
A Lawson Research Institute study drawing on more than 215,000 urine drug screens collected across Ontario has overturned a long-standing assumption about methamphetamine use. Among the roughly 26,000 patients who tested positive, women accounted for 41 percent and adults over 50 for 20 percent — figures that represent not a modest revision but a wholesale challenge to the prevailing image of stimulant use as a young man's problem. Women's share of positive tests was approximately eight times higher than Canadian self-reported studies had previously indicated, and about 40 percent of those who tested positive were low-income.
Lead author Michael Silverman, medical director of infectious diseases care at St. Joseph's Health Care London, pointed to stigma as a likely driver of the gap. Women may be unwilling to disclose use they fear will define them socially; others may not know they have consumed stimulants at all, if the drug was mixed into other substances without their knowledge. Silverman called the findings a prompt for broader empathy — a reminder that addiction reaches into every corner of society, touching someone's wife, daughter, sister, or grandparent.
The health consequences documented in the study are serious. People who tested positive were significantly more likely to have HIV, viral hepatitis, and infectious endocarditis, and were 63 to 65 percent more likely to visit an emergency room or be hospitalized — a pattern with real financial weight for the health care system. Silverman also cautioned that the data likely understates the problem, since urine screens detect only recent use. Perhaps most urgently, stimulant-related deaths have been rising even as opioid deaths decline, suggesting that use has grown since the 2017–2018 period the study covers — and that the populations most affected remain hidden behind assumptions the evidence can no longer support.
A study of more than 215,000 urine drug screens conducted across Ontario between 2017 and 2018 has upended long-held assumptions about who uses methamphetamine and amphetamine. Researchers at Lawson Research Institute, part of St. Joseph's Health Care London, found that women and older adults represent far larger shares of stimulant users than previous research suggested—a finding that challenges the prevailing image of methamphetamine use as primarily a young man's problem.
The numbers tell a striking story. Of the roughly 26,000 patients who tested positive for methamphetamine or amphetamine, women accounted for 41 percent of those positive tests. People older than 50 made up 20 percent. These figures are not marginal adjustments to existing knowledge; they represent a dramatic departure from what Canadian studies relying on self-reported drug use had previously documented. Women's representation in the positive tests was approximately eight times higher than earlier research had indicated. About 40 percent of those who tested positive fell into the low-income bracket.
Michael Silverman, the medical director of infectious diseases care at St. Joseph's and lead author of the study published in the Canadian Journal of Addiction, offered an explanation for the gap between what the urine screens revealed and what people had been willing to report about themselves. Women may be reluctant to disclose methamphetamine use because of the stigma attached to it, he suggested. Others may not even realize they have taken the drug if it was mixed into other substances without their knowledge. Stimulant drugs like methamphetamine and amphetamine are relatively inexpensive, which may contribute to their circulation and use across different populations.
Silverman framed the findings as a call for broader empathy and a recalibration of public understanding. "We have to be more open to the possibility that women and people over 50 may be using," he said. The study, he emphasized, should prompt recognition that addiction cuts across all segments of society—that the people struggling with stimulant use are "somebody's wife or daughter or sister or grandparent." The implication was clear: the stereotypes that had shaped policy and perception were not just inaccurate; they were obscuring the true scope of the problem.
The health consequences of stimulant use revealed by the study are substantial. People who tested positive for methamphetamine or amphetamine were significantly more likely to have HIV, viral hepatitis, and infectious endocarditis compared to those who tested negative. They were also 63 to 65 percent more likely to visit an emergency room or be hospitalized. Because emergency room visits cost substantially more than primary care encounters, this pattern has real financial implications for the health care system. Silverman noted that the stigma surrounding addiction—the assumption that people have simply chosen this path—obscures the fact that stimulant use is affecting people from all walks of life who have become dependent.
The study likely understates the actual extent of stimulant use, Silverman cautioned, because urine tests detect only recent consumption, generally within the previous three days. He also noted that stimulant use appears to be rising. While opioid-related deaths have declined, the proportion of deaths associated with stimulants has increased, suggesting that usage has grown since the 2017-2018 period covered by this analysis. Repeating similar analyses in the future could help researchers track how stimulant use evolves over time and provide a clearer picture of a problem that, the evidence now suggests, is far more widespread and demographically diverse than previously understood.
Citations marquantes
We have to be more open to the possibility that women and people over 50 may be using. Hopefully it breeds some empathy for people who are suffering with addiction, to realize that it's across our society.— Michael Silverman, lead author of the study and medical director of infectious diseases care at St. Joseph's Health Care London
These are people from across all walks of life that are being affected and who have become addicted, so it's affecting all of us.— Michael Silverman
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