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San Diego: Addicted To Meth

Long-term meth use alters brain chemistry, triggers violent behavior

Evening Edition

Aired 6/27/16 on KPBS Midday Edition.

San Diego: Addicted To Meth

GUEST:

Kenny Goldberg, health reporter, KPBS

Transcript

Methamphetamine is dangerous.

If you want proof, just go to the San Diego County morgue.

In 2014, county records show 262 deaths from meth-related causes. That’s more than the number of people who died from the flu and homicides combined that year.

Dr. Jonathan Lucas, the county's chief deputy medical examiner, said his office sees meth-related deaths almost every day.

“The last couple of years have actually been records for us," Lucas said. "We’ve seen more methamphetamine-related deaths in the last couple of years than we’ve ever seen in the last 20 years.”

Photo by Nicholas McVicker

Corpses in body bags lie on gurneys in the San Diego County morgue in this undated photo.

He said meth abuse isn't confined to young people. It's killing people of all ages.

“For example, in 2014, our youngest meth-related death was a 17-year-old girl that jumped out of a second-story window while intoxicated with methamphetamine," Lucas said. "Our oldest was a 70-year-old man who had heart disease, but he was intoxicated with methamphetamine.”

Lucas said meth can make underlying health conditions worse. People with heart problems who use the drug, for example, are at even higher risk of dying from a heart attack or a stroke.

But he said the high number of meth-related deaths don’t tell the whole story.

“The people that come to this office are really just the tip of the iceberg, a small proportion, a small piece of the pie of the methamphetamine problem," Lucas said.

Photo by Brooke Ruth

The overdose death numbers do not include drug-related suicides, homicides or other causes of death in which drugs were involved.

ER visits up dramatically

Kenny Goldberg

Dr. Danielle Douglas is shown in Sharp Grossmont Hospital's emergency department, Feb. 26, 2016.

Hospital emergency rooms are where the meth problem is even more visible.

In 2011, patients with meth-related problems accounted for 3,700 ER visits. That number jumped to more than 10,000 in 2014.

Dr. Danielle Douglas works in the county’s busiest ER, at Sharp Grossmont Hospital in La Mesa. She said the number of meth cases that come through there wears on doctors.

"I mean, yeah, at the end of a shift, and I’m just beat down, and it’s another meth addict?," Douglas said. "And you just kind of want to say, 'What the hell’s going on here?'”

What’s going on is the meth that’s being sold on the street is extremely potent and highly addictive. Long-term meth use also alters the brain, and can cause severe mood swings, violent behavior and delusions.

And overdoses and deaths.

How meth affects the brain

Video

The effect of meth on the brain

So what’s the attraction?

The high from methamphetamine is incredible, said Tom Freese, director of training for UCLA's Integrated Substance Abuse Programs.

“When it goes inside the brain, it stimulates a release of dopamine, the feel-good chemical inside the brain, that’s really unparalleled," Freese said. "There’s really no other way, from either natural or chemically induced kind of phenomenon to reach that peak of dopamine.”

Freese said methamphetamine also affects the serotonin system, another emotional regulator in the brain.

Meth also alters a person’s inhibitory control.

“That ability to say, 'I want to do that, but I’m not gonna do that,' and to put the brakes on a particular activity," Freese said. "That seems to be damaged, as well, as part of that overall prefrontal cortex, or the front part of the brain, that helps us make good decisions from bad decisions.”

Chasing the first high

Jose Escobedo is interviewed about his recovery from meth addiction, March 21, 2016.

Jose Escobedo of National City started smoking meth when he was 11.

Later on, he snorted it. But Escobedo said the best high was when he injected it.

“Shooting up drugs was like bouncing up and down, like it gave me like 10 times more than with smoking," Escobedo said. "So it was like a new experience, like a new thing that took over my life.”

Escobedo was addicted to meth for more than 20 years. At his peak, Escobedo shot up six times a day.

"'Cause it was like one after another after another. It wasn’t just to get high. It was just a habit," he said. "I just wanted to see it being drawn into the blood, I just wanted to see it going into my veins, I just wanted to feel it. I guess I was chasing my first high.”

He's now a recovering meth addict.

Where the meth comes from

Photo by Nicholas McVicker

Cars are shown lined up at the San Ysidro Port of Entry, April 27, 2016.

Aired 6/28/16 on KPBS News.

Part II: The methamphetamine that’s being sold on the street is extremely potent, highly addictive and cheaper than ever. That dangerous combination means meth is sending more people to our emergency rooms, jails and morgue.

When Escobedo first started using more than 20 years ago, most of the meth in San Diego County came from makeshift labs. Many of them were in East County.

These days, it’s different.

The methamphetamine on San Diego's streets today is largely produced in Mexican super labs controlled by the drug cartels.

A lot of it is smuggled through the nation’s busiest land border crossing in San Ysidro, where an estimated 60,000 cars and 30,000 pedestrians cross every day.

Sidney Aki, director of U.S. Customs and Border Protection at the San Ysidro Port of Entry, said his agents have found meth hidden in virtually every part of a vehicle, from the trunk to the battery. They’ve even discovered liquid meth in gas tanks.

And pedestrians?

"It was a female," Aki began. "She actually had a brassiere formed out of narcotics, and actually used as a brassiere, walking across our border.”

Meth seizures up at the border

In 2010, customs agents seized just over 2,500 kilos of meth at the San Ysidro border crossing.

In 2014, they confiscated more than 5,800 kilos.

Here’s another way to look at it:

One hit of meth is about a quarter of a gram — 5,800 kilos equals 5.8 million hits.

That’s how much was confiscated. Nobody knows how much is getting in.

What's worse is the methamphetamine that’s coming across from Mexico is stronger than ever, and the price on the street is lower than ever. That leads to more meth use and more meth-related problems.

Meth users filling jail cells

Meth users also are taking up a lot of space in the county's jails.

According to the San Diego Association of Governments, in 2014, of the people arrested and jailed in county, 53 percent of the women and 40 percent of the men tested positive for meth.

San Diego County 2014 Arrestee Drug Use

Drug Male Female
Methamphetamine 40% 53%
Marijuana 45% 31%
Cocaine 5% 6%
Opiates* 13% 15%

*A positive opiate drug test could indicate use of opiates other than heroin, including morphine, hydrocodone, hydromorphone and Codeine. Source: 2014 Adult Arrestee Drug Use in the San Diego Region from SANDAG

These people aren't casual users when it comes to methamphetamine, said Cynthia Burke, SANDAG’s director of research.

“We find that on average, arrestees report that they’ve been using meth for about 16 years," Burke said. "We know that they use it for an average of five days at a time, that they’re using a gram. Many of them smoke it. About one in four report that they’ve injected it.”

Lenny Ignelzi/Associated Press

U.S. Attorney Laura Duffy speaks at a news conference, Feb. 6, 2014.

Besides U.S. Customs and Border Protection, other law enforcement agencies involved in the fight against meth include the San Diego County Sheriff’s Department, the county District Attorney's Office and the U.S. Justice Department.

But Laura Duffy, San Diego's U.S. attorney, said others also need to step up.

“We are not going to be able to tackle this problem through law enforcement efforts alone," Duffy said. "This is a community problem. This is a health epidemic problem that we all need to come together and put resources towards.”

Drug court

Photo by Nicholas McVicker

Members of the Drug Court program participate in a 12-step meeting, March 21, 2016.

Aired 6/29/16 on KPBS News.

Part III: The methamphetamine that’s being sold on the street is extremely potent, highly addictive and cheaper than ever. That dangerous combination means meth is sending more people to our emergency rooms, jails and morgue.

Escobedo, the recovering meth addict, has one thing to show for his more than 20 years of using the drug: a rap sheet — assault with a deadly weapon, DUI, hit and run, burglary.

His latest arrest came in January 2014 when he was on parole.

The prosecutor on his case gave him a choice: go back to prison for 12 years or try to kick his habit through the county's Drug Court.

So Escobedo gave Drug Court a shot.

In March, Escobedo attended the court's 12-step meeting with other hard-core meth addicts. All of the men had criminal records. As part of the recovery process, they’re encouraged to be brutally honest about their addiction.

“My addiction is to heroin and methamphetamine," one man with heavily tattooed arms said.

“My focus was getting high, my focus was being around people who are getting high," another addict said.

After the men shared their stories, Arturo Molina, the lead substance abuse counselor in the Chula Vista Drug Court, weighed in.

“In Drug Court you want to learn how to live life without using drugs," he told the men. "But not only that, OK? Drug Court is like a new way of life.”

Arturo Molina discusses his job as lead substance abuse counselor for the Drug Court in Chula Vista, March 21, 2016.

Daniel Stone, the program manager at the Chula Vista court, said it's a different approach to getting people off of drugs.

“The concept of the Drug Court programs is a collaborative, team approach that involves a San Diego Superior Court judge, district attorney, public defender, and case management and treatment team, and law enforcement," Stone said.

People convicted of non-violent drug offenses are eligible for Drug Court. There are four of the courts in San Diego County, and more than 1,600 nationwide.

These are not Hollywood celebrity country-club rehab programs. In Drug Court, addicts go through 18 months of hard work and constant supervision.

They’re required to go to 12-step meetings five days a week, get individual counseling and get a job. They’re frequently drug tested.

And if they test dirty? They go to jail.

The length of their jail stay “depends on how many times it’s happened," Stone said. "Sometimes it’s a weekend. Sometimes it’s three weeks.”

If they screw up enough times, addicts have to serve their original sentence.

County officials say 90 percent of Drug Court graduates remain arrest-free two years after completing the program.

Escobedo said Drug Court has given him the tools and support to clean up his act. He said there were "a lot of things I needed to do."

"You can’t be in denial about things," Escobedo said. "You can’t fight the program. You can’t cheat the program. 'Cause you’re not actually cheating the program. You’re cheating yourself.”

Drug Court graduation

Jose Escobedo speaks at his Drug Court graduation ceremony at the Chula Vista Library auditorium, March 24, 2016.

The Chula Vista Library auditorium is packed for graduation night for nine Drug Court participants. The court's judge welcomes each graduate to the stage.

The crowd of family members cheered loudly.

Some of the graduates cried, incredulous that they actually made it through the program.

Then Escobedo took the stage and talked about success. For the first time since he was a little kid, he’s gone 18 months completely clean and sober.

“I have my family here as a witness. I hurt them a lot," Escobedo said. "I plan on staying clean and doing what I gotta do to stay clean, and just keep making them happy. They’re all here: my wife, my kids, ma, my sister Erica, Israel."

In his closing remarks, Escobedo talked about a new way of life.

“I’m happy with everybody who’s in the program. I was able to interact with a lot of people, you know what I mean, and make clean friends," he said. "And it’s something different than going back to the old people, neighborhood, old ways, old ways of thinking. It’s a new way of life, and I plan on staying, and I will be staying clean. And I thank you guys all.”

Amid thundering applause, Escobedo walked off the the stage with a big smile on his face.

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