{"id":3817,"date":"2019-05-08T05:26:42","date_gmt":"2019-05-08T10:26:42","guid":{"rendered":"https:\/\/wwwqa.cencalhealth.org\/?p=3817"},"modified":"2023-03-24T00:05:12","modified_gmt":"2023-03-24T05:05:12","slug":"opioid","status":"publish","type":"post","link":"https:\/\/wwwqa.cencalhealth.org\/news\/2019\/05\/opioid\/","title":{"rendered":"Meth Vs. Opioids: America Has Two Drug Epidemics, But Focuses On One"},"content":{"rendered":"

California Healthline
\nApril Dembosky, KQED<\/span><\/p>\n

Kim had been wine tasting with a friend in Sonoma, Calif. They got into an argument in the car that night and Kim thought someone was following them. She was utterly convinced. And she had to get away.<\/p>\n

\u201cI jumped out of the car and started running, and I literally ran a mile. I went through water, went up a tree,\u201d she said. \u201cI was literally running for my life.\u201d<\/p>\n

Kim was soaking wet when she walked into a woman\u2019s house, woke her from bed and asked for help. When the woman went to call the police, Kim left and found another woman\u2019s empty guesthouse to sleep in \u2014 Goldilocks-style.<\/p>\n

\u201cBut then I woke up and stole her car,\u201d said Kim, who is 47 and now in recovery. (KHN is using her first name only because she has used illicit drugs.) Kim had been high on Xanax and methamphetamine. \u201cI was crazy. Meth causes people to act completely insane.\u201d<\/p>\n

While public health officials have focused on the opioid epidemic in recent years, another epidemic has been brewing quietly, but vigorously, behind the scenes. Methamphetamine use is\u00a0surging in parts of the U.S.<\/a>, particularly the West, leaving first responders and addiction treatment providers struggling to handle a rising need.<\/p>\n

Across the country, overdose deaths involving meth\u00a0more than quadrupled from 2011 to 2017<\/a>. Admissions to treatment facilities for meth are up 17%.\u00a0Hospitalizations related to meth<\/a>\u00a0jumped by about 245% from 2008 to 2015. And throughout the West and Midwest, 70% of local law enforcement agencies say meth is their biggest drug threat.<\/p>\n

But policymakers in Washington, D.C., haven\u2019t kept up, continuing to direct the bulk of funding and attention to opioids, said Steve Shoptaw, an addiction psychologist at UCLA in Los Angeles, where he hears one story after another about meth destroying people\u2019s lives.<\/p>\n

\u201cBut when you\u2019re in D.C., where people are making decisions about how to deploy resources, those stories are very much muffled by the much louder story about the opioid epidemic,\u201d he said.<\/p>\n

Even within drug treatment circles, there\u2019s a divide. Opioid addiction advocates are afraid their efforts to gain acceptance for measures like needle-exchange programs and safe injection sites will be threatened if meth advocates demand too much.<\/p>\n

\u201cThe bottom line is, as Americans, we have just so much tolerance to deal with addiction,\u201d Shoptaw said. \u201cAnd if the opioid users have taken that tolerance, then there\u2019s no more.\u201d<\/p>\n

So, lawmakers in San Francisco are trying to get a grip on the toll meth is taking on their city\u2019s\u00a0public health system<\/a>\u00a0on their own. The mayor recently established a task force to combat the epidemic.<\/p>\n

\u201cIt\u2019s something we really have to interrupt,\u201d said Rafael Mandelman, a San Francisco district supervisor who will co-chair the task force. \u201cOver time, this does lasting damage to people\u2019s brains. If they do not have an underlying medical condition at the start, by the end, they will.\u201d<\/p>\n

Since 2011, emergency room visits related to meth in San Francisco have jumped 600% to 1,965 visits in 2016, the last year for which ER data is available. Admissions to the hospital are up 400% to 193, according to city public health data. And at San Francisco General Hospital, of 7,000 annual psychiatric emergency visits last year, 47% were people who were not necessarily mentally ill \u2014 they were high on meth.<\/p>\n

\u201cThey can look so similar to someone that\u2019s experiencing chronic schizophrenia,\u201d said Dr. Anton Nigusse Bland, medical director of psychiatric emergency services at San Francisco General. \u201cIt\u2019s almost indistinguishable in that moment.\u201d<\/p>\n

They have methamphetamine-induced psychosis.<\/p>\n

\u201cThey\u2019re often paranoid, they\u2019re thinking someone might be trying to harm them,\u201d he said. \u201cTheir perceptions are all off.\u201d<\/p>\n

If the person is extremely agitated, doctors might administer a sedative or even an antipsychotic medicine. Otherwise, the treatment is just waiting 12 to 16 hours for the meth to wear off. No more psychosis.<\/p>\n

\u201cTheir thoughts are more organized, they\u2019re able to maintain adequate clothing. They\u2019re eating, they\u2019re communicating,\u201d Nigusse Bland said. \u201cThe improvement in the person is rather dramatic because it happens so quickly.\u201d<\/p>\n

Trends In Drug Use Come In Waves<\/p>\n

The trend in rising stimulant use is nationwide: cocaine on the East Coast, meth on the West Coast, said\u00a0Dr. Daniel Ciccarone,<\/a>\u00a0a professor of medicine and substance use researcher at the University of California-San Francisco.<\/p>\n

\u201cIt is an epidemic wave that\u2019s coming, that\u2019s already here,\u201d he said. \u201cBut it hasn\u2019t fully reached our public consciousness.\u201d<\/p>\n

Drug preferences are generational, Ciccarone said. They change with the hairstyles and clothing choices, like bell-bottoms or leg warmers. It was heroin in the 1970s, cocaine and crack in the \u201980s. Then opiate pills. Then methamphetamine. Then heroin. And now meth again.<\/p>\n

\u201cThe culture creates this notion of let\u2019s go up, let\u2019s not go down,\u201d Ciccarone said. \u201cNew people coming into drug use are saying, \u2018Whoa, I don\u2019t really want to do that. I hear it\u2019s deadly.’\u201d<\/p>\n

Kim has been with meth through two waves. When she got into speed in the 1990s, she was hanging out with bikers, going to clubs in San Francisco.<\/p>\n

\u201cNow what I see, in any neighborhood, you can find it. It\u2019s not the same as it used to be where it was kind of taboo,\u201d Kim said. \u201cIt\u2019s more socially accepted now.\u201d<\/p>\n

Dying From Meth<\/p>\n

A hint about who uses meth now comes from the data on deaths.<\/p>\n

Meth is not as lethal as opioids: 47,600 people died of opioid-related\u00a0overdoses in 2017<\/a>\u00a0compared with 10,333 deaths involving meth. But the death rate for meth has been rising. Meth-related deaths in San Francisco doubled since 2011, another indication that more people are using meth and that today\u2019s supply is very potent, said the UCSF\u2019s Ciccarone.<\/p>\n

Another hypothesis to explain the growth in meth-related overdoses is that meth users are aging. Most meth deaths are from a brain hemorrhage or a heart attack, which would be unusual for a 20-year-old.<\/p>\n

\u201cBecause your tissue is so healthy at that age,\u201d said Dr.\u00a0Phillip Coffin,<\/a>\u00a0a physician and the director of substance use research at the San Francisco Department of Public Health. \u201cWhereas when you\u2019re 55 years old and using methamphetamine, you might be at higher risk for bursting a vessel and bleeding and dying from that.\u201d<\/p>\n

Another explanation for the rising death rate is that meth has become contaminated. And that affects everyone, old and young. Last year, three young people in San Francisco died after smoking meth together. It turns out the meth had fentanyl in it. The synthetic opioid has been causing waves of heroin overdoses across the country, but now it\u2019s showing up mixed into cocaine and meth.<\/p>\n

Most researchers believe the contamination happens accidentally, when a dealer uses the same equipment to bag fentanyl and later meth, Ciccarone said.<\/p>\n

Relapses Are Common<\/p>\n

Over her two decades of meth use, Kim has been through drug treatment more than a dozen times. Relapse is part of recovery, and among meth users,\u00a060% will start using again within a year<\/a>\u00a0of finishing treatment. Unlike opioids,\u00a0there are no medication treatments for meth addiction<\/a>, which makes it particularly hard to treat.<\/p>\n

In April, Kim completed a six-month residential treatment program for women in San Francisco called the Epiphany Center. She came directly from jail, after serving time for her housewarming-and-car-theft spree in Sonoma. She said that in the first 30 days all she could do was try to clear the chaos from her mind.<\/p>\n

\u201cYou have to get used to sitting with yourself, which is essential for life, is to get along with your own self,\u201d she said.<\/p>\n

Kim, who has four children, is hopeful that this round of treatment will stick. She is living in transitional housing now, has a job and has been accepted to a program at the University of California-Berkeley to finish her college degree.<\/p>\n

\u201cI\u2019ve gone through 12 different programs and it\u2019s been for my children, for my mom, for the courts. I\u2019ve never come to be there for myself,\u201d Kim said. \u201cSo it\u2019s like I\u2019ve come to a place where it has to be for me.\u201d<\/p>\n

This story is part of a partnership that includes\u00a0KQED<\/a>,\u00a0NPR<\/a>\u00a0and Kaiser Health News, an editorially independent program of the\u00a0Kaiser Family Foundation<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

California Healthline April Dembosky, KQED Kim had been wine tasting with a friend in Sonoma, Calif. They got into an argument in the car that night and Kim thought someone was following them. She was utterly convinced. And she had to get away. \u201cI jumped out of the car and started running, and I literally […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","inline_featured_image":false,"footnotes":""},"categories":[5,7],"tags":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/posts\/3817"}],"collection":[{"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/comments?post=3817"}],"version-history":[{"count":1,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/posts\/3817\/revisions"}],"predecessor-version":[{"id":3823,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/posts\/3817\/revisions\/3823"}],"wp:attachment":[{"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/media?parent=3817"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/categories?post=3817"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wwwqa.cencalhealth.org\/wp-json\/wp\/v2\/tags?post=3817"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}