Substance use is a significant concern in Guam, led by crystal methamphetamine, known locally as “ice” or “shabu,” which has been the island’s dominant drug since the 1990s. Key figures from the territory’s own epidemiological data:

• 10.2% of Guam adults reported illicit drug use other than marijuana in 2021, according to the Guam Epidemiological Profile.
• Smoking and vaping run high. Guam’s smoking prevalence is higher than the median across all U.S. states and territories, and youth vaping is notably high.
• Youth drug use is rising. Use of illicit drugs other than marijuana has increased among Guam high school students compared to the U.S., and youth marijuana use outpaces adult use.
• Alcohol use is comparatively lower. Binge drinking and heavy drinking among Guam adults and youth sit below U.S. averages.
• About 38% of Guam’s population is under age 25, which shapes prevention priorities.
• 8.1% of arrests cleared in Guam in 2020 were alcohol-related.

Meth’s hold deepened over decades. According to the U.S. Department of Justice’s National Drug Intelligence Center, methamphetamine-related arrests rose from 47 in 1994 to 333 in 1999, and by 1999 meth was tied to nearly three of every four adult drug arrests. Meth also accounted for more than 90 percent of drug-related federal sentences in the territory in the late 1990s, with most of the supply coming from the Philippines and other parts of East Asia.

Guam expanded Medicaid to the Adult Group effective January 1, 2014, so many residents can access covered care through the territory’s Medicaid program. The Guam Behavioral Health and Wellness Center (GBHWC) is the public agency that runs the island’s mental health and substance-use programs, with residential treatment supported by federal block grant funding. Notably, both of the facilities listed below are marked as free or no-payment in the directory, which helps residents who are uninsured or underinsured.