Meth’s Resurgence Spotlights Lack of Meds to Combat the Addiction

Corporal Jason Garcia of the Santa Ana, Calif. Police Department holds a rock of crystal meth. (Leonard Ortiz/Digital First Media/Orange County Register via Getty Images).

In 2016, news reports warned the public of an opioid epidemic gripping the nation.

But Madeline Vaughn, then a lead clinical intake coordinator at the Houston-based addiction treatment organization Council on Recovery, sensed something different was going on with the patients she checked in from the street.

Their behavior, marked by twitchy suspicion, a poor memory and the feeling that someone was following them, signaled that the people coming through the center’s doors were increasingly hooked on a differ­ent drug: methamphetamine.

“When you’re in the boots on the ground,” Vaughn said, “what you see may surprise you, because it’s not in the headlines.”

In the time since, it’s become increasingly clear that, even as the opioid epidemic continues, the toll of methamphetamine use, also known as meth or crys­tal meth, is on the rise, too.

The rate of overdose deaths involving the stimulant more than tripled from 2011 to 2016, the Centers for Disease Control and Prevention reported.

But unlike the opioid epi­demic — for which medica­tions exist to help combat ad­diction — medical providers have few such tools to help methamphetamine users sur­vive and recover. A drug such as naloxone, which can reverse an opioid overdose, does not exist for meth. And there are no drugs approved by the Food and Drug Administration that can treat a meth addiction.

“We’re realizing that we don’t have everything we might wish we had to address these different kinds of drugs,” said Dr. Margaret Jarvis, a psychia­trist and distinguished fellow for the American Society of Ad­diction Medicine.

Meth revs up the human body, causing euphoria, elevat­ed blood pressure and energy that enables users to go for days without sleeping or eating. In some cases, long-term use alters the user’s brain and causes psy­chotic symptoms that can take up to one year after the person has stopped using it to dissipate.

Overdosing can trigger heart attacks, strokes and seizures, which can make pinpointing the drug’s involvement difficult.

Meth users also tend to abuse other substances, which com­plicates first responders’ efforts to treat a patient in the event of an overdose, said Dr. David Persse, EMS physician direc­tor for Houston. With multiple drugs in a patient’s system, overdose symptoms may not neatly fit under the description for one substance.

“If we had five or six miracle drugs,” Persse said, to use im­mediately on the scene of the overdose, “it’s still gonna be difficult to know which one that patient needs.”

Research is underway to de­velop a medication that helps those with methamphetamine addiction overcome their con­dition. The National Institute on Drug Abuse Clinical Trials Network is testing a combina­tion of naltrexone, a medica­tion typically used to treat opi­oid and alcohol use disorders, and an antidepressant called bupropion.

And a team from the univer­sities of Kentucky and Arkan­sas created a molecule called lobeline that shows promise in blocking meth’s effects in the brain.

For now, though, existing treatments, such as the Ma­trix Model, a drug counseling technique, and contingency management, which offers pa­tients incentives to stay away from drugs, are key options for what appears to be a meth resur­gence, said Jarvis.

Illegal drugs never disappear from the street, she said. Their popularity waxes and wanes with demand. And as the de­mand for methamphetamine use increases, the gaps in treat­ment become more apparent.

Persse said he hasn’t seen a rise in the number of calls relat­ed to methamphetamine over­doses in his area. However, the death toll in Texas from meth now exceeds that of heroin.

Provisional death counts for 2017 showed methamphet­amine claimed 813 lives in the Lone Star State. By compari­son, 591 people died due to her­oin.

The Drug Enforcement Ad­ministration reported that the price of meth is the lowest the agency has seen in years. It is increasingly available in the eastern region of the United States. Primary suppliers are Mexican drug cartels. And the meth on the streets is now more than 90 percent pure.

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