Overshadowed by opioids, meth is back

Surge in hospitalizations and death is 'totally off the radar'

Published Dec 5, 2018 at 1:45 pm (Updated Dec 5, 2018)

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“You see people as young as their 30s with congestive heart failure as if they were in their 70s."

Dr. Tarak Trivedi

By Anna Gorman, Kaiser Health News

The number of people hospitalized because of amphetamine use is skyrocketing in the United States, but the resurgence of the drug largely has been overshadowed by the nation’s intense focus on opioids.

Amphetamine-related hospitalizations jumped by about 245 percent from 2008 to 2015, according to a recent in the Journal of the American Medical Association. That dwarfs the rise in hospitalizations from other drugs, such as opioids, which were up by about 46 percent. The most significant increases were in Western states.

The surge in hospitalizations and deaths due to amphetamines “is just totally off the radar,” said Jane Maxwell, an addiction researcher. “Nobody is paying attention.”

Doctors see evidence of the drug’s comeback in emergency departments, where patients arrive agitated, paranoid and aggressive. Paramedics and police officers see it on the streets, where suspects’ heart rates are so high that they need to be taken to the hospital for medical clearance before being booked into jail. And medical examiners see it in the morgue, where in a few states, such as Texas and Colorado, overdoses from meth have surpassed those from heroin.

Amphetamines are stimulant drugs, which are both legally prescribed to treat attention deficit hyperactivity disorder and produced illegally into methamphetamine.

Opioids become harder to getCommonly known as crystal meth, methamphetamine was popular in the 1990s before laws made it more difficult to access the pseudoephedrine, a common cold medicine, needed to produce it.

As opioids become harder to get, police said, more people have turned to meth, which is inexpensive and readily available.

Lupita Ruiz, 25, started using methamphetamine in her late teens but said she has been clean for about two years. When she was using, she said, her heart beat fast, she would stay up all night and she would forget to eat.

Ruiz, who lives in Spokane, Wash., said she was taken to the hospital twice after having mental breakdowns related to methamphetamine use, including a monthlong stay in the psychiatric ward in 2016.

“It just made me go crazy,” she said. “I was all messed up in my head.”

The federal government estimates that more than 10,000 people died of meth-related drug overdoses last year. Deaths from meth overdose generally result from multiple organ failure or heart attacks and strokes, caused by extraordinary pulse rates and skyrocketing blood pressure.

In the short term, the drug can cause a rapid heart rate and dangerously high blood pressure. Many long-term users are emaciated and have missing teeth, dilated pupils and a tendency to pick at their skin because of a sensation of something beneath it.

“You see people as young as their 30s with congestive heart failure as if they were in their 70s,” said Dr. Tarak Trivedi, an emergency room physician in Los Angeles and Santa Clara counties.

Nationwide, amphetamine-related hospitalizations were primarily due to mental health or cardiovascular complications of the drug use, the JAMA study found. Sometimes doctors have trouble distinguishing symptoms of methamphetamine intoxication and underlying mental health conditions.

Unlike opioid addiction, meth addiction cannot be treated with medication. Rather, people addicted to the drug rely on counseling through outpatient and residential treatment centers.

There simply aren’t enough resources devoted to amphetamine addiction. The number of residential treatment facilities, for example, has continued to decline.

“We have really undercut treatment for methamphetamine,” said Maxwell, the addiction researcher. “Meth has been completely overshadowed by opioids.”