Methamphetamine is now the leading cause of drug-related deaths in Oregon, according to health authorities. This is because meth overdose deaths in the US have more than quadrupled over a six-year period.
Dr. Andy Mendenhall, chief medical officer for Central City Concern in Portland, Oregon, says that meth-related deaths have outpaced opioid-related deaths for the last three years, despite the current opioid epidemic. He said that there is an uptick in the number of meth users in the state, and it has contributed to the sudden increase in overdose deaths.
Local and regional law enforcement says that meth being sold in Oregon is coming up through California from many Latin American countries. Mendenhall also said that many meth users in Oregon are struggling with polysubstance use disorder. This means they abuse more than one drug at once—putting themselves at an even greater risk of an overdose for a much stronger high.
“There's a deeper supply chain for methamphetamines that are purer and more potent,” he said. “So, therefore, patients are using more substance and suffering fatal consequences.”
Mendenhall said that the typical person who uses methamphetamines is difficult to characterize, but acknowledges the trends associated with poverty. “We know that methamphetamines affect many people of lower socioeconomic class and disenfranchised communities with high unemployment. In the Portland metropolitan area and the population we're serving, we're seeing methamphetamine use concurrent with opioid use in many of our homeless patients that have a polysubstance-use disorder.”
He said that the age range includes young adults all the way to people in their 60s. The chief medical officer explained that people abuse substances in the first place because “many human beings will seek reward to pathological levels.”
Some people start with gateway drugs, while others begin with prescription drugs. In either case, they begin abusing the substance of their choice until they need a much more potent substance—and that is how some people find meth.
“When we're talking about substances like opioids, heroin, methamphetamines, in particular…we see that most patients have started with the use of alcohol or nicotine or cannabis, and there's good evidence not to say that those are gateway substances that lead directly to the use of more potent substances, but rather that individuals that have a propensity or a proclivity to experiment with substances, to use substances, also are frequently at risk of using other substances.
So when we consider the social demographics of who uses, if you will, methamphetamines, this is a community-based disease state where people are exposed to individuals using substances. They are exposed to people using stronger and stronger substances, and at some point, people will pick up methamphetamines," Mendenhall explained.
Patients in Oregon seek help by approaching large medical detox facilities all over the state. Mendenhall said that they are currently serving 6,000 patients under their treatment programs.
As for the treatment: “There are no FDA-indicated medications for the treatment of methamphetamine use at this time,” he said.
And because there are no medications for meth addiction, the primary treatment is an evidence-based practice of outpatient treatment, with one-on-one psychotherapy. Mendenhall said that a behavioral intervention called contingency management can be used to reward patients for having negative urine drug screens. The patients are given little incentives for compliance with treatment.
“This is really the basis of best practice for the treatment of stimulant use disorder, methamphetamines in particular. And concurrent with that, it's important to note that the recovery community of mutual help groups, the recovery community of people in sober living housing, in supportive recovery housing type facilities, creates an environment of recovery for people where they can have and develop new relationships with people that are on the same pathway.
That's a literature-based and also very important part of the work that we're doing at Central City Concern to help patients who are using methamphetamines.” Click the link to see Albuquerque's top rehab placement programs.
As for its connection with the present opioid crisis, Mendenhall believes that the epidemic is not taking away from funding to address the meth crisis. He refers to the slow but successful evolution towards the treatment of addictive disease. The real problem, he said, is the accessibility of treatment.
“I think the challenge right now is that in the face of the epidemic, both with respect to opioids and with respect to methamphetamines, there's still a gap—meaning there's a gap in access. We need more funding for these services in order to provide access and capacity to the population that's currently suffering right now."
If someone in the family is struggling with opioid or alcohol addiction, it is important to seek help. A combination of medical detox and behavioral therapy can go a long way in the fight against drug abuse. But because every individual is affected by addiction differently, a comprehensive program tailored to their specific needs is necessary. Look for a nearby addiction treatment facility today and find out how drug treatment programs work.
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