The 2018 Annual Surveillance Report of Drug-Related Risks and Outcomes by the Centers for Disease Control and Prevention paints a grim picture of the continuing drug overdose crisis sweeping the United States.
“The current epidemic of drug overdoses began in the 1990s with overdose deaths involving prescription opioids, driven by dramatic increases in prescribing of opioids for chronic pain. In 2010, rapid increases in overdose deaths involving heroin marked the second wave of opioid overdose deaths. The third wave began in 2013, when overdose deaths involving synthetic opioids, particularly those involving illicitly manufactured fentanyl, began to increase significantly. In addition to deaths, nonfatal overdoses from both prescription and illicit drugs are responsible for increasing emergency department visits and hospital admissions.”
As in previous “wars on drugs,” the focus of the authorities has been on denying access to a particular addictive substance—in this case opioids—and on interdicting the trade of illicit drugs. The quote from the Annual Surveillance Report illustrates the limitations of that approach. After the crackdown on opioid pain relievers, users switched to heroin. When heroin failed to achieve the desired effect, users added the much more potent fentanyl.
We may currently be witnessing another transition, this time away from opioids. A substance that was the target of a previous crackdown is making a big comeback. At the dawn of the new millennium, methamphetamine—especially in the form of crystal meth—was “cooked” in homemade labs across the nation, particularly in economically deprived rural areas.
Measures against domestic meth production coincided with the rise of opioid painkillers and overdoses involving methamphetamines were significantly reduced. The opioid epidemic was afoot and meth was soon considered a thing of the past.
“The scourge of crystal meth, with its exploding labs and ruinous effect on teeth and skin, has been all but forgotten amid national concern over the opioid crisis,” reported the New York Times in 2018 from the West Coast. “But 12 years after Congress took aggressive action to curtail it, meth has returned with a vengeance. Here in Oregon, meth-related deaths vastly outnumber those from heroin. At the United States border, agents are seizing 10 to 20 times the amounts they did a decade ago. Methamphetamine, experts say, has never been purer, cheaper or more lethal.”
Domestic meth production relied on pseudoephedrine, previously found in many over-the-counter cold medicines. In 2005 Congress passed the Combat Methamphetamine Act. It put pseudoephedrine behind the counter, limited sales to 7.5 grams per customer in a 30-day period and required pharmacies to track sales. It was the same approach now pursued with prescriptions for opioid pain relievers, but reducing access only moved the production to Mexico where those restrictions don’t apply.
“Meth, it turns out, was only on hiatus. When the ingredients became difficult to come by in the United States, Mexican drug cartels stepped in,” reported the New York Times. “Now fighting meth often means seizing large quantities of ready-made product in highway stops.”
Fighting addiction needs to go beyond seizing contraband. As long as the demand is not diminished there will be people supplying the drugs. Addiction is a health crisis not a crime wave. People suffering from the disease of addiction can easily switch from one substance or behavior to another. In most cases, they do not crave the actual substance but rather the emotional relief provided by the substance or behavior.
Substance use disorders are complex biopsychosocial conditions frequently driven by co-occurring psychological and psychiatric problems such as depression, anxiety, and unprocessed trauma. This explains why efforts focusing almost entirely on restricting access to illicit drugs have done little to end the American addiction crisis.
Addiction to methamphetamines is a debilitating chronic disease requiring long-term comprehensive care that addresses body, mind, and spirit. There are no “anti-craving” medications for meth and detox is only the beginning of the healing process. In many cases, only a life-changing rehab experience can lay the foundation for long-term recovery from addiction.
If you or someone you know is struggling with substance use and could benefit from comprehensive addiction treatment, please contact The Farley Center at Williamsburg Place at 800.582.6066 or fill out our admissions request form.