Methamphetamine is an illicit psychoactive stimulant with well recognized effects on the cardiovascular, pulmonary, and central nervous systems. The impacts of methamphetamine on these systems is well-researched. There is however limited understanding as to the effects of methamphetamine use on bone mineral density (BMD). This study found a reduction in BMD in methamphetamine users when compared to an age matched control group of patients with similar fractures and no history of methamphetamine use. Methamphetamine use may be a causative factor of, or may be correlated with, the development of osteopenia and osteoporosis. Due to its impact on BMD, methamphetamine use may increase rates of fracture and portend lower implant success rates following fracture repair. Further studies on the effectiveness of orthopaedic implants and complication rates following fracture repair are vital for improving care for this population.