MOUNT VERNON – Community leaders from across the state gathered in Mount Vernon last Wednesday to hear about the drug that some fear could spur America’s next addiction epidemic: meth.
According to Dr. James Sturmi, the medical director for Pinnacle Treatment Centers in Ohio, overdose deaths involving meth have increased 750 percent in the U.S. since 2007. The number of people with stimulant use disorder increased nearly 50 percent from 2016 to 2017, he added. Meth is now involved in 15 percent of all overdose deaths, and people are picking it up young; the average age of a new meth user is 23 years old.
“I have both professionally and personally seen and learned a lot about the rapid explosion of methamphetamine use, overdose death and all of its consequences, over the past 6-8 months,” said Sturmi, who spoke on the second day of KSAAT’s Knox Addiction Conference at Mount Vernon Nazarene University.
“We’re clearly on the edge of another epidemic.”
Meth has already established a stronghold in Knox County, local officials say. Knox County Common Pleas Court Judge Richard Wetzel, who attended KSAAT’s annual conference, said “we’ve seen a decline in heroin cases and an increase in methamphetamine cases.”
State Rep. Rick Carfagna, who represents all of Knox County in Ohio’s 68th house district, said 89 percent of the criminal drug cases currently being prosecuted in Knox County are meth-related.
According to Sturmi, Knox County isn’t alone. The midwest, and particularly Appalachia, have been hit hardest by the recent meth surge. That’s because it’s related to the opioid epidemic, he said, which has flatlined or leveled off in many areas in recent years.
Meth, Sturmi said, presents itself as a reasonable spinoff for opioid addicts. The introduction of fentanyl to heroin has caused opioid addicts to fear the drug, due to the increased possibility of a fatal overdose. Meth is seen as a safer alternative, Sturmi said, which “is a huge, huge problem.”
Meth is also cheaper than heroin, and it’s easier to manufacture. Although home labs have declined substantially since Congress passed the Combat Methamphetamine Act of 2005, Sturmi said the bulk of today’s meth supply is made in Mexico.
Mexican cartels, Sturmi said, “are one step ahead of us.” When the U.S. clamped down on home-cookers, the cartels saw a market opportunity and seized it. This is similar to what happened in the early and mid-2000s, he said, “when they realized Americans had a voracious and insatiable appetite for opioids.”
“This law that was passed certainly helped avoid a lot of these horrific accidents, and it cut by 80 percent the amount of methamphetamine that was produced domestically, but it also gave Mexicans an opportunity to create and process these very efficient products,” Sturmi said.
“They’re producing much more pure and much more potent methamphetamine. And as the number of people in the U.S., particularly those who have previously been using opioids or may still be using opioids, as those OD deaths have gone down and there’s been less use of that, they see this as a strong second product, if you will, that’s easy to make, that’s very inexpensive, and they’re just creating it as fast as they can.”
In a presentation to physicians, educators, community members and law enforcement officials, Sturmi spoke mostly about the physiological effects of meth. It’s a highly addictive stimulant that can be swallowed, snorted, smoked or injected. The ‘highs’ are long-lasting – typically eight hours – and addicts will often go on multi-day benders while taking the drug.
Due to the intense euphoria caused by the drug, addicts will often not sleep or eat during these ‘runs.’ They will often feel “agitated and invincible,” Sturmi said, and the drug sometimes inspires aggression or violence towards others.
Chemically, few stimulants are more dangerous than methamphetamine. Taking meth causes 13 times more dopamine to be released into the brain than normal, and the drug does not leave one’s system quickly. It takes 12 hours for 50 percent of the drug to be removed from a user’s body; in contrast, it takes one hour for cocaine (another aggressive stimulant) to make the same progress.
Both opioids and meth silence the prefrontal cortex, the area of the brain that controls judgement and decision-making. This is why people continue to abuse drugs, even after multiple overdoses.
“It causes people, really good people in many cases, to make horrible decisions,” Sturmi said.
In the long run, meth use causes brain damage and heart problems, among myriad other health-related side effects. Six months of meth use can cause permanent brain damage, similar to that inflicted by the use of bath salts. Addicts expose themselves to a long list of serious heart conditions, including malignant hypertension (extremely high blood pressure that can develop rapidly, causing organ damage) and sudden cardiac arrest.
A deficit in thinking and motor skills, memory loss, severe dental problems and weight loss are all common side effects as well. The brain injury incurred by using the drug can lead to strokes, Parkinson’s Disease, dementia and suicide. Babies born by meth-addicted mothers will sometimes exhibit serious neurobehavioral deficits.
Despite this alarming reality, however, Sturmi said there is hope. He talks face-to-face to meth addicts on a daily basis, in order to help guide them through recovery. He said that if addicts are able to recover quick enough, the brain damage will be minimal.
The next step in fighting America’s meth boom must be medical innovation, Sturmi said.
“Unfortunately, there is not a single medication that has been approved by the FDA, or any of the thought leaders in addiction medicine, that is known to be effective in lessening cravings and the effects of methamphetamine use,” he said.
The National Institute on Drug Abuse is currently “looking hard at several different types (of medications) now that we understand more about how methamphetamine affects the brain, and where things go wrong,” Sturmi added.
“This is a high priority for NIDA. There’s a lot more grant money out there than there has been, probably forever, [to look into meth-related addiction medication].”
Sturmi believes that the U.S., as a whole, was largely unprepared for the opioid epidemic. There was a lack of education when it came to how opioids work and what could be done to curb the trend, he said, and eventually it became too late.
Given the million-plus years of life that were lost in Ohio from 2008-2018 due to opioids, Sturmi believes the effort to fight meth addiction will be far more proactive.
“I mean, this is pretty much all-hands-on-deck at this point,” Sturmi said. “I think we learned enough from the opioid epidemic not to under-respond.”
Wetzel said attending last week’s discussion helped him better understand the medical dynamic of meth, which will help him in his role on the bench. Given the criminal behavior associated with meth – which Wetzel said has manifested locally in burglaries and home invasions – understanding the psychological side of the drug can help the court make decisions that will make the user and community safer.
“It’s very helpful for somebody like me to understand the science underlying the behavior that I see, and then also the connection between not only the physiological effects of methamphetamine use on the brain and the heart and the body and so forth, but the mental health effects of that kind of a drug on the people who use it,” Wetzel said.
“The earlier that I’m able to identify what these effects are and what we’re seeing, as a connection to methamphetamine use, the easier it is for our supervision staff and me to address those issues.”
Those in court on meth charges might need treatment, a mental health evaluation, behavioral health assistance or all of the above, Wetzel explained. Understanding the medical and psychological effects of the drug will give the court perspective on what’s best for all involved.
“It adds to the depth of the evaluation of the case, beyond just a criminal aspect of the case,” Wetzel said.
The State of Ohio has increased funds for mental health and substance abuse treatment through the biennial budget, Carfagna added, as $7.7 million will be allocated in fiscal year 2020 to increase naloxone access, create a loan repayment program and expand public health education. The state has targeted funding to help all affected by the current drug crisis, including parents, children and the elderly population.
Most of the funding is meant to bolster current services, Carfagna said, not create new ones.
“We want to put money towards the things that are already working in our communities,” he said.
Both Carfagna and Sturmi advocated for the treatment of addiction as a disease, not a choice. They stressed the importance of empathizing and working with the victims of addiction, not shunning them and furthering long-held stigmas.
“My only ask is that we all collectively continue to drive home the message that those who are suffering need to be handled with compassion,” Carfagna said. “Not with fear, not with judgement.”