Dr. Martin Huecker sees, on average, 10 methamphetamine addicts each month in his emergency room at the University of Louisville Health Sciences Center, sometimes three or four in an eight-hour shift. His experience signals a disturbing revival of a drug epidemic that plagued the country in the late 1990s and early 2000s.
“A lot of [increased use] probably has to do with availability, as the opioid pills have been harder and harder to find. So people will turn to methamphetamine,” Huecker told the Washington Examiner.“ A lot of dealers often take opioids that come from outside of the U.S. and add methamphetamine to them. And so that might be to make it more addictive and sell your product better.”
Meth has made a concerning comeback since its heyday in the 1990s, and it isn’t coming from Breaking Bad-type labs in rural America. It’s more accessible than ever in both urban and rural areas of the country thanks to an increased supply from across the southern border and thus a lower cost per dose.
In the past few years, the rate of meth abuse increased by about 60%, according to the 2017 National Survey on Drug Use and Health. About 684,000 people said they abused meth in 2016. That number swelled to 964,000 in 2017 and 1.1 million in 2018 — almost double the number of people who reported heroin abuse (526,000).
Dr. Wesley Zeger, an emergency medicine doctor at the University of Nebraska Medical Center, told the Washington Examiner the volume of meth users in the Omaha emergency room has doubled in the past two years and added that the figure has most likely quadrupled in the past five years.
More often than not, patients who use meth are less forthcoming about their addiction than those who use marijuana or cocaine, according to Zeger. If a meth user comes to the emergency room, it’s usually because of a health issue that’s a product of using the drug.
“We had a gal that came in, and she had an infection in the bones in her back,” Zeger said. “She uses IV methamphetamines. You go into your standard questions, one of them being if she has used IV drugs. And she says no.”
After he looked at her medical charts from four or five years ago, the last time she came into the ER, she admitted she was using intravenous drugs. Zeger asked if that was accurate and she told him it was, but it had been years since she had used.
“We end up doing a drug screen. And [the patient] probably used meth in the last two or three days,” he said.
According to Huecker, addicts often abuse more than one drug at a time, which is fueling the uptick in abuse. If they use opioids, they’re more likely to use stimulants such as meth. Some patients may go into an emergency room experiencing an overdose without exhibiting signs of an overdose because a combination of both makes patients “look about in the middle.”
“They might kind of even themselves out. And that’s been the whole point of like a speedball, you know, since the ‘70s or before,” Huecker said, referencing a dangerous mixture of a stimulant, such as meth or cocaine, with an opiate or benzodiazepine.
The rise of meth hasn’t yet led to corresponding attention in Washington, D.C., which has been preoccupied with opioids. Rather than address an imminent meth abuse crisis head-on, Congress aimed to tackle the opioid epidemic in 2018 by improving access to medication-assisted treatments including methadone and buprenorphine, which ease withdrawal symptoms and help treat opioid use disorder.
The law did establish a grant program to allocate funds for statewide efforts to keep meth off the streets, but lawmakers didn’t specify how the grant money should be used or aid law enforcement agencies in finding ways to address the problem. The secretary of Health and Human Services had to investigate the meth problem across the country as part of the bill as passed but didn’t have to offer any possible remedies.
Before that, in 2016, President Barack Obama signed legislation that also aimed to increase the availability of opioid overdose reversal drugs, allow nurse practitioners prescribing privileges to give patients medication-assisted treatment for the first time, and give states the ability to apply for grants to improve treatment for opioid and stimulant abuse. In 2019, though, grant money primarily went to agencies and organizations working to abate the opioid crisis. Not a single grant was allocated specifically to address a rise in meth abuse.
“The recent resurgence and uptick of meth abuse is really part and parcel with the fact that we don’t treat addiction comprehensively in this country,” said Courtney Hunter, director of advocacy and government affairs at the Center on Addiction. “We have knee-jerk responses to different epidemics instead of having a total public health approach to deal with addiction and not the single kind of drug, which we want to get away from.”
Most overdose deaths that include meth in toxicology reports also include heroin or fentanyl. Users often combine drugs because together, they induce an intensified high, because , unbeknownst to them, the dealer has cut the meth with deadly opiates.
The upward trend in meth abuse may continue largely because it goes hand in hand with the abuse of other drugs. Hunter said that by introducing policies that address only one substance at a time, they’re playing a never-ending game of “whack-a-mole.”
Huecker added that meth use may be a short-lived epidemic. Drug prevalence comes in generational waves, he said, and the increased rate of meth abuse is bound to dwindle, being replaced by some other drug, although the trend of high meth abuse will repeat itself.
“I think cocaine and crack cocaine were big in the ’80s. The ’90s, we saw meth. Then you go back to the ’70s, with the Vietnam vets, heroin was big back then,” Huecker said. “First, we have a big crack problem, we figured out some ways around it and get it to go away, and then meth pops up, and then we squash that, and then opioids come in.”
