Has the Opioid Epidemic Obsession Overshadowed Meth?

We've been focused on opioids for years, but meth is quickly coming back.

Posted Jan 22, 2019

When I was immersed deeply in the world of drugs in the early 2000s, heroin was rarely spoken of in the media. But according to local and national media, cocaine and methamphetamine (“meth”) were huge problems. Everywhere, you’d hear stories of police busting huge meth (also known as speed or crystal meth) operations and the terrible problem the drug was creating in our country. Because meth labs were seemingly blowing up everywhere, the fear that meth was taking over was perpetuated.

Though fewer and fewer people were making the stuff locally, more and more gangs from Central America (primarily Mexico) were stepping in to cover the gaps. But, as police and the DEA continued closing in, it seemed that meth gradually disappeared from our consciousness, if not necessarily from the streets. The next thing you knew, the opioid epidemic seemed to be the only thing anyone could talk about.

But has it overshadowed the growing meth problem in the United States? Lately, we've been hearing a lot of media coverage surrounding the opioid crisis. According to a new report on preventable deaths from the National Safety Council, Americans have a 1 in 96 chance of dying from an opioid overdose. To put it in perspective,  the probability of dying in a motor vehicle crash is 1 in 103.

But have we been too hyper-focused on this single drug?

The history of methamphetamines in the United States

There has been a long standing history of use of amphetamines in the U.S. since the 1930s and 40s. And methamphetamines (particularly the illicit drug methamphetamines hydrochloride) was popular in the 1990s and 2000s but began to decline in the mid-2000's when stricter laws were passed and enforced. One of the key ingredients in meth is ‘pseudoephedrine' which could be acquired from a common cold medicine—Sudafed—but the new law required pharmacies to retain records of all pseudoephedrine purchases. States such as Mississippi and Oregon required a prescription for purchase. I knew groups of meth “cooks” and dealers who would send out dozens of people (they literally called them smurfs) to go to hundreds of pharmacies around the state and obtain the large quantities of Sudafed that was needed. It took a lot of work and dedication (and a lot of meth to keep them going!). But the hard work got to everyone, and fewer and fewer labs could operate, so meth lab explosions became a thing of the past, and everyone seemingly forgot about meth.

Nowadays there may be fewer household meth labs, but there is actually more meth being smuggled in from Mexico. Sourcing the ingredients within the United States made it nearly impossible to produce on our home turf so Mexican cartels took this opportunity to produce purer, cheaper meth. And they became very good at it, creating Mexican superlabs that produced hundreds of pounds a day. The best meth I ever bought came from these “Breaking Bad” style labs…

If you don't use meth or know anyone that does, you may be thinking "it's not my problem." But, if you're a taxpayer (or a normal human being with emotions) it most certainly is your problem. According to a recent study in the Journal of the American Medical Association, the cost of amphetamine-related hospitalizations had increased from $436 million in 2003 to close to $2.2 billion by 2015. That’s a nearly 5-fold increased! Now, wouldn’t that money be better spent on mental health for anyone who needed it so people wouldn’t have to self-medicate?

What is the current state of meth use in the U.S?

"There is not a day that goes by that I don’t see someone acutely intoxicated on methamphetamine.”-  Dr. Tarak Trivedi

According to the JAMA study, Amphetamine-related hospitalizations increased by 245 percent from 2008 to 2015. The federal government estimates that more than 10,000 people died of meth-related drug overdoses last year. Deaths from meth overdose generally result from multiple organ failure or heart attacks and strokes, caused by increased heart rates and extremely high blood pressure. A few states, such as Texas and Colorado, have seen more overdoses from meth than opioid heroin.

What dangers does meth pose to users?

We’ve seen on television how meth users end up in the Emergency Departments in a ‘rage,’ high on the stimulant drug and behaving erratically. But meth is associated with a number of other short-term and long-term effects, many of which you may not have even heard of.

Short-term effects of meth use

Individuals who use methamphetamines will likely experience the following symptoms:

         •       Increased wakefulness and motor activity

         •       Decreased appetite

         •       Faster breathing

         •       Rapid and/or irregular heartbeat

         •       Increased blood pressure and body temperature

         •       Increased energy and motivation

         •       Increased repetitive/compulsive (stereotypic) behavior

Long-term effects of meth use-

When an individual uses methamphetamines over a longer period of time.

         •       Extreme weight loss

         •       Severe dental problems ("meth mouth")

         •       Intense itching, leading to skin sores from scratching

         •       Anxiety

         •       Confusion

         •       Insomnia

         •       Violent behavior

         •       Paranoia

         •       Hallucinations

How can people get treatment for methamphetamine addiction?

Amphetamine use is now the fourth most common reason to seek drug treatment in the United States, after alcohol, opioid, and marijuana use.

The most effective interventions are behavioral therapies, such as cognitive-behavioral therapy, which helps patients recognize, avoid, and cope with the situations in which they are most likely to use drugs. There is also contingency management using motivational incentives, vouchers or small cash rewards to encourage patients to remain drug-free and engage in treatment. Unfortunately, most programs still rely on outdated language that stigmatizes and disempowers those struggling.

Programs which aim to support, rather than punish, people with an addiction can help individuals make gains in recovery. The Women in Recovery program in Tulsa County offers an intensive program for women serving lengthy drug offense sentences. Most of these women have been battling addiction for up to fifteen years and this takes a huge toll on their health and their family. It may come as no surprise, that a majority of these women have also experienced traumatic events, from childhood abuse to sexual assaults and domestic violence and live in unhealthy environmental. It just goes to show that addiction can happen to anyone, and is usually connected to much deeper issue (obvious, I know, but too rarely addressed).

Using a range of treatments, training, and education, the program gives women who would be spending time behind bars a second chance at a productive and fulfilling life. But recovery is possible!

There are fewer tools to combat meth than to combat opioids: There is no medication like Naloxone, which can reverse opioid overdoses, or methadone, which can stem opioid cravings available for meth (although some studies with modafinil have provided some potential medication support). Not to mention the withdrawals from meth are troubling and include severe and long-lasting depression, incredible lack of energy and substantial weight gain! Many people struggle with quitting meth because they know that the withdrawal will leave them incapacitated for up to a week and they cannot afford to lose their jobs or are too ashamed to admit to their loved ones that they’re using.

An integrative approach to treating meth addictions

It’s clear that methamphetamine use is an emerging public health issue; pharmacologic and nonpharmacologic therapies that effectively treat amphetamine use disorder are desperately needed.

Unlike opioid addiction, meth addiction cannot be treated with medication. Rather, people addicted to the drug must attend counseling through outpatient and residential treatment centers. My IGNTD Hero recovery program is often sought after by meth addicts who feel misunderstood in other settings and are eager to get to the underlying issues of their struggle. It doesn't just address the addiction but the driving force that led you to start using in the first place.

References

Winkelman, T.N.A., Admon, L.K., Jennings, L., Shippee., N.D., Richardson, R., & Bart, G. (2018). Evaluation of Amphetamine-Related Hospitalizations and Associated Clinical Outcomes and Costs in the United States. Journal of the American Medical Association, 1(6). Retrieved from: doi:10.1001/jamanetworkopen.2018.3758