A top Trump administration health official is worried that meth-related deaths will counterbalance the progress the United States has made in reducing drug-overdose deaths.
Dr. Brett Giroir, assistant secretary for health, said in an interview Thursday that early data from 2019, which goes into June, indicates that meth-related deaths are increasing by about 25-30%. The trend is particularly concerning because meth is highly addictive, and people cannot be treated for meth with medicine in the same way they can for opioid addictions.
“We are seeing meth sweep across the country,” Giroir said, referring to the trend as the “fourth wave” of drug addiction seen in America after prescription painkillers, heroin, and fentanyl.
Giroir’s comments came just hours after the release of a trove federal data indicating that in 2018, the number of people who died from drug overdoses had fallen, a first in roughly two decades. That data showed that meth had increased fivefold since 2012, but it did not contain the information about 2019 that Giroir was referring to.
Meth is being manufactured in hundreds of thousands of pounds by Mexican drug cartels. The West first saw a jump in meth use that is now hitting the Midwest. Giroir said he was concerned the drug would become more prevalent in the East Coast next and could even overtake heroin and cocaine in the number of deaths.
“We anticipate in the next few months, it will overtake heroin and cocaine,” Giroir said. Drug deaths will be hard to parse out, however, because people use meth and fentanyl, a highly potent opioid, together. Often, Giroir said, people don’t know their drugs have been tainted. The same problem has been observed with cocaine. People who are addicted to drugs tend to use several different kinds at a time or take whatever they can get access to.
About half of the deaths from meth also involve fentanyl, Giroir said.
The 2019 data could signal that the good news from 2018 will be short-lived. Earlier in the day, the Centers for Disease Control and Prevention revealed that deaths from drug overdoses dropped from 70,237 in 2017 to 67,367 in 2018. Of those, 46,802 were caused by opioids, versus 12,676 by meth.
Giroir said that the administration and Congress could take credit for the reversal, though he cautioned there was no “silver bullet.” The drug overdose crisis, which began during the 1990s, came as a result of doctors overprescribing prescription painkillers such as OxyContin. When the prescriptions became more limited because news of their addictiveness surfaced, people who could no longer get the drugs from their doctors turned to heroin, an illegal substitute. Later, the drugs were increasingly tainted with fentanyl.
Giroir said new data indicated prescriptions of opiates were down nearly 35% from 2017 and said he has been holding webinars with doctors to make sure they carefully wean people off opioids rather than abruptly cut them off. There has also been a wider distribution of naloxone, an overdose-reversal drug that people can get over the counter in many states. An estimated 1.3 million people in America are on medication that helps fight the symptoms of withdrawal, an increase of just under 40% since 2017.
Acknowledging the complexity of the issue, Giroir said that economic factors had played a role as well, pointing to a recent study that showed the closure of a single manufacturing plant was associated with a surge in opioid deaths.
“That just makes the point that there are underlying social determinants or social influences that we can’t discount,” he said.
As next steps, the Centers for Medicare & Medicaid Services has asked for feedback about paying higher reimbursements to emergency departments that provide addiction medication to patients and also make sure that people get into long-term treatment.
Giroir declined to offer details of what might be in President Trump’s State of the Union address next week but said he was actively engaged on the issue and that it was personal to the president, who lost his brother to alcohol addiction.
“We are extremely pleased, but we are not taking our foot off the gas,” Giroir said.
