Meth use is driving overdose epidemic in rural America — not opioids

PORTLAND — Hit shows like “Breaking Bad” put a spotlight on the dangerous nature of making and using methamphetamine. Now, a new study finds the common drug in pop culture is also a common problem in rural America. Researchers from Oregon Health & Science University say that meth use is actually driving the nation’s overdose crisis, rather than the commonly suspected cause — opioids.

In a study of more than 3,000 people living in rural communities, the team found that roughly four in five people who use drugs used methamphetamines within the last month.

“Among people who use drugs in rural communities, methamphetamine use is pervasive,” says Todd Korthuis, M.D., M.P.H., professor of medicine in the OHSU School of Medicine, in a university release. “This has been a West Coast problem for a long time, but now we see methamphetamine use in rural communities across the United States.”

The team focused on residents in 10 states between January 2018 and March 2020. These individuals lived in rural areas with the highest overdose rates in Oregon, Illinois, Kentucky, North Carolina, Ohio, Wisconsin, West Virginia, Massachusetts, New Hampshire, and Vermont.

What’s the difference between meth and opioids?

Methamphetamine, commonly referred to as meth or crystal meth, is a stimulant that induces a “high” that can sometimes last for over 12 hours. Opioids, like heroin, fentanyl, or prescription painkillers, are depressants that slow the activity of the central nervous system — including breathing. A high due to opioids is typically shorter than a meth high.

Much of the country’s attention has focused on opioids, since they account for the majority of over 100,000 overdose deaths in the U.S. last year, according to the researchers. Most of these deaths were the result of taking fentanyl — a synthetic opioid 50 to 100 times stronger than morphine.

However, Korthuis says this is causing many to overlook the problem of widespread methamphetamine use outside of the urban cities. Moreover, the study authors note that fentanyl is now frequently contaminating batches of methamphetamine. While people may think they’re only taking a stimulant, they’re actually receiving a potentially fatal dose of opioids.

Results of the Rural Opioid Initiative study show that people taking both methamphetamine and opioids had the highest risk of suffering a non-fatal overdose. More than one in five (22%) taking both substances reported suffering an overdose within the previous six months.

Among rural Americans saying they only use opioids, 14 percent experienced a recent overdose. Meanwhile, just six percent of those only using meth suffered a non-lethal overdose.

“Co-use of methamphetamine and opioids is associated with a big increased risk of overdose in rural communities,” Korthuis says. “Some people view rural areas as immune to problems like drug use and overdose, but they’re not.”

Economic distress in rural America bringing on more ‘deaths of despair’

The study also found that economic distress is a widespread problem among these communities where drugs are prevalent. In fact, 53 percent reported being homeless at some point over the previous six months. Researchers say these issues among low-income communities increase the number of “deaths of despair” — those involving overdoses, suicide, and diseases linked to drugs and alcohol.

“There are deaths of despair everywhere, but our rural communities have been hard hit,” Korthuis explains.

The study authors add that treatment problems are least likely to reach Americans living in these communities. Four in 10 respondents said they tried to get treatment for substance abuse but were unable to find help in their area. Among those using both meth and opioids, 44 percent could not access treatment.

The team also warns that people taking meth rarely receive naloxone, an overdose treatment that often revives people taking fentanyl. They urge health officials to expand the distribution of this overdose drug so people who take methamphetamine have it as well.

The study is published in JAMA Network Open.

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  1. bad news folks – naloxone does zero for anyone using meth. it specifically blocks opiate receptors – since meth is a stimulant, not an opiate, it doesnt work.

    advocating its availability for meth users is like advocating for a spare tire when you’re out of gas – it also underscores that those recommending it know little about the methamphetamine pharmacology and physiology.

    1. Perhaps you didn’t take note that, “Moreover, the study authors note that fentanyl is now frequently contaminating batches of methamphetamine.”. I hope that youse do not feel too, too embarrassed and thus fall to addiction in hopes of hiding your shame.
      I have been hearing for many many months that fent/other opiates are in all sorts of illicit drugs. Where have you been?

      1. i was commenting specifically on the physiology and pharmacology of naloxone and methamphetamine. i made no claims as to how illicit drugs may be combined. and where have i been?

        practicing medicine. for the last 25 years.

      2. Thank you for your service.
        Do you know then whether there is any harm in giving naloxone to an OD who has “only” done meth? In the order of “safe than sorry”. I’ve had a wacky heart reaction from a normal dose of psuedophed and wouldn’t enjoy a meth OD and sure that it is that I am.

    2. WellmInfind it very interesting on how poor people find $200 a day or more from their drug use. Maybe they are poor because of their behavior and attitude in life.

      1. How do you know how much such drug users pay? I thought meth was popular because it was cheap, and I expect fentanyl is much cheaper than heroin or opium.

        Expense aside, do you remember reading that 4 in 10 users in rural communities cannot find available treatment for drug addiction? Our rural communities are vastly underserved. They lack adequate health facilities, and there are few jobs available. Also with the shortage of teachers, I expect they also get the short end of that stick as well. Imagine what your attitude might be, growing up in such an environment.

  2. The blood is on the hands of the pharma companies who continue to make psuedo-ephedrine. The DEA attempted to ban the chemical and make meth disappear, but people’s colds are importantly more important than all of these lives lost.

    1. The Mexican cartels have found a way around needing any form of Ephedrine. We are way beyond cold medicines now. Look up P2P. Of course this new form is even worse.

  3. The problem is Trumphumpers have this thing for cheap, illegal substances to deaden the reality of their pathetic lives. No wonder this is happening in mostly red states with a highly uneducated populace. So MAGA!

    1. Trumphumpers. Lol. And to think I thought methheads and druggies came from the liberal population in America.

  4. I don’t feel sorry for idiots. If it’s genetics or forced onto someone, that would be an exceorion. Otherwise, I’m sicxk of the pity party for idiots. Or should we start a fund for the care of those who jump off cliffs?

    1. Introduce drugs to my children or grandchildren, and I will see to it that your life will be extremely shortened. I too am sicxk of the pity party for drug addicts.

  5. The meth overdoes are being caused by the addition of black market Fentanyl, a potent opioid. Read the article before ripping everyone else.

  6. I’m confused. The headline says “Meth use is driving overdose epidemic in rural America — not opioids” but the Article says that Opioids are a majority of the 100,000 Overdose deaths last year, A lot of Meth is contaminated with Fentanyl (an opioid), 22% of those using both, 6% of only meth, and 14% of only opioid users have reported a non-fatal overdose. All of this seems to be pointing to Opioids as the driver of overdoses in rural America. I am in a very small rural town in a blue state and the fentanyl overdoses are way too high for our population. I think people are seeing the opioid crisis with their own eyes and I am curious how you got the article title from the information you presented.

  7. The title of the article is misleading at best and almost feels like there was a purpose to it. As one reads through the article you quickly find out that meth use alone is not driving overdoses. It is the combination of both materials being used. It is like the author does not want any stigma of being opioids for overdoses and push it back on the meth community.

    1. Yes I find it very hard to find a study in America that only deals with meth and not “meth and ____” as overdose in Americans rise! I can’t find one death that was caused by and only by meth. There was either in pre-existing injury or something wrong with the person but never the cause and only cause of death is methamphetamine.

  8. What about sex addiction? Food addiction? Every single person on this planet is addicted to something proven fact addiction runs in every single person so why would you write off drug addiction but not right off every other addiction if you got a solution for one you should have solution for all

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