This first national estimate of the economic cost of methamphetamine (meth) use in the United States suggests that costs reached $23.4 billion in 2005. The analysis, with a lower-bound estimate of $16.2 billion and an upper-bound estimate of $48.3 billion, considers the burden of addiction, premature death, drug treatment, lost productivity, crime and criminal justice, health care, production and environmental hazards, and child endangerment.