Christine Vestal of The Pew Charitable Trusts’ “Stateline” is reporting that, while the nation still is trying to address the opioid epidemic, methamphetamine has been resurging in many parts of the country.
Federal officials say that, based on what they learned as opioids swept the U.S., methamphetamine is likely to spread even further.
“The beginning of the opioid epidemic was 2000 and we thought it was just localized,” said Kimberly Johnson, director of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration (SAMHSA). “Now we know that drug outbreaks aren’t likely to stay localized so we can start addressing them sooner and letting other states know of the potential for it spreading.”
Methamphetamine is also showing up in places that never experienced an earlier epidemic.
“What we’re seeing is that the use of methamphetamines has recently moved out of trailer parks and rural areas and into inner cities,” said Ken Roy, medical director of a major treatment facility, Addiction Recovery Resources, in New Orleans. “We’re seeing a lot of heroin addicts that also use methamphetamines. It used to be the only way we got meth patients was when they came to the hospital from rural areas,” Roy said.
Opioid users experience a dreamlike state and typically nod off. But methamphetamine produces an entirely different high. Users experience a sense of elation and hypervigilance, and often become paranoid and aggressive. “They may binge on meth for days without eating or sleeping, and they often start seeing things that aren’t there,” said Carol Falkowski, an addiction expert in Minnesota.
Death from a methamphetamine overdose is also very different from an opioid death. With opioids, which affect the part of the brain that controls breathing, high enough doses can shut down respiratory functions, quickly causing death.
With methamphetamine, death is typically caused by a stroke or heart attack, and is characterized by extreme sweating as the body overheats prior to death. Because methamphetamine represents a lower risk of overdose, many use it for decades, which often results in gradual organ failure and death. Those deaths are typically not counted in the overdose statistics.
Likewise, treatment for addiction to methamphetamine is different than for opioids. No FDA-approved medications exist to stop the cravings for methamphetamine, whereas three effective drugs are available to help people recover from opioid addiction.
As a result, methamphetamine treatment primarily consists of outpatient therapy, often after a brief stay in a residential facility. People who stop using methamphetamine do not suffer the severe withdrawal symptoms such as the vomiting, muscle pain and other flu-like symptoms suffered by opioid users. But they do tend to become immobilized, sleeping a lot and binge eating, as well as suffering from severe depression, anxiety and drug cravings.
Health officials in places like Minnesota and Oklahoma say the health care providers who helped legions of people overcome methamphetamine addiction during the last epidemic are prepared for a new onslaught. But Johnson, the SAMHSA director, cautioned that the addiction treatment workforce has not grown in proportion to the growth in overall drug use since then.
Tackling a new meth addiction wave on top of an opioid epidemic could strain the nation’s health care system, she said. “I don’t think what we’ve done to scale up access to treatment for opioid disorders is going to be that helpful for methamphetamines.”