This first national estimate suggests that the economic cost of methamphetamine (meth) use in the United States reached $23.4 billion in 2005. Given the uncertainty in estimating the costs of meth use, this book provides a lower-bound estimate of $16.2 billion and an upper-bound estimate of $48.3 billion. The analysis considers a wide range of consequences due to meth use, including the burden of addiction, premature death, drug treatment, and aspects of lost productivity, crime and criminal justice, health care, production and environmental hazards, and child endangerment. Other potential harms of meth, however, could not be included due to a lack of scientific evidence or to data issues. Although meth causes some unique harms, many of the primary cost drivers are similar to those identified in economic assessments of other illicit drugs. Among the most costly elements are the intangible burden of addiction and premature death, which account for nearly two-thirds of the economic costs. The intangible burden of addiction measures the lower quality of life experienced by those addicted to the drug. Crime and criminal-justice costs also account for a significant share of economic costs, as do lost productivity, removing a child from the parents' home, and drug treatment. One unusual cost captured in the analysis is that associated with the production of meth, which requires toxic chemicals that can result in fire, explosions, and other negative events. This report contains eight sections: (1) Introduction; (2) The Cost of Methamphetamine Treatment; (3) The Cost of Methamphetamine-Related Health Care Among Methamphetamine Users; (4) Premature Death and the Intangible Health Burden of Addiction; (5) Productivity Losses Due to Methamphetamine Use; (6) The Cost of Methamphetamine-Related Crime; (7) The Methamphetamine-Related Cost of Child Maltreatment and Foster Care; (8) The Societal Cost of Methamphetamine Production; (9) Consideration of Costs Not Included; and (10) Conclusion. [A bibliography is included. Four appendixes include: (1) Supporting Information for Estimating the Cost of Methamphetamine-Related Health Care: Inpatient Days; (2) Additional Calculations to Support Productivity-Loss Estimates; (3) Additional Information to Support the Cost of Methamphetamine-Related Crime; and (4) Deriving Methamphetamine Attribution Factors from the Inmate Surveys. Contains 68 footnotes and 65 tables. Additional funding was provided by the Meth Project Foundation.]