Methamphetamine Use and Psychiatric Morbidity in Sri Lanka: Sociodemographic Insights from a Tertiary Care Clinic

Abstract Background and Objectives Methamphetamine (METH) use is rising across South and Southeast Asia, yet evidence on user characteristics and psychiatric morbidity remains limited. This study examines the sociodemographic features, psychiatric symptoms, and their associations among METH users in Sri Lanka. Methods A cross-sectional study recruited 245 consecutive patients attending a substance use disorder clinic at the National Hospital of Sri Lanka. Data were collected using a structured questionnaire, DSM-5 diagnostic criteria, and the Brief Psychiatric Rating Scale (BPRS). Results Most participants were male (97.6%), with a mean age of 31.3 years (SD = 9.7). Mean age of initiation was 29.2 years (SD = 10.0), with friends being the most common introducers (86.9%). Dependence was identified in 60.8%. Polysubstance use was frequent, with nicotine (93.1%) and heroin (73.9%) most common. Substance-induced psychosis (10.6%) and depressive disorder (4.9%) were the main psychiatric diagnoses. The mean BPRS score was 24.2 (SD = 8.0); suspiciousness (86%), hostility (82.5%), and depressive mood (61.6%) were the most prevalent symptoms. Higher BPRS scores were significantly associated with younger age, family history of mental illness, unemployment, recent METH use, and dependence. Logistic regression confirmed dependence as an independent predictor (OR = 6.8, 95% CI = 1.7–26.9) for higher BPRS values. Conclusion METH users in Sri Lanka are predominantly young males with high rates of dependence, polysubstance use, and significant psychiatric morbidity. These findings highlight the urgent need for integrated mental health and substance use interventions and provide data relevant for regional and global public health strategies.