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San Diego: Addicted To Meth

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

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

San Diego: Addicted To Meth
San Diego: Addicted To Meth
San Diego: Addicted To Meth GUEST:Kenny Goldberg, health reporter, KPBS

This is KPBS Midday Edition. Maureen Cavanaugh. San Diego cannot shake it addition to methamphetamine. In 19 San Diego cannot shake it addition to methamphetamine. In 1980s Vidino was known as the meth capital of the world. The problem has actually gotten worse. The drug kills more San Diegans than ever and its impacts in hospital emergency rooms and crimes are at all-time highs. In the first episode of our three-part series on meth, KPBS Kenny Goldberg takes a look at how it is sending more residents to the hospital and the more.  Methamphetamine is dangerous. If you want proof, go to the county more. 262 San Diego and start from meth related causes in 2014. That is more than the people who died from the flu and homicides combined that year.  The last couple years have actually been records. We have seen more methamphetamine related deaths in the last couple years that we have ever seen in the last 20 years. Dr. Jonathan Lucas is San Diego counties deputy medical examiner. He says meth is killing people of all ages.  In 2015 our youngest meth related death was a 17-year-old girl the jumped out of a second story window while intoxicated with methamphetamine. Eldest was a 70-year-old man that heart disease. He was intoxicated with methamphetamine.  Lucas explains meth can make underlying health conditions even worse. People with heart problems who use meth are at higher risk of dying from heart attack or stroke. He points out the high number of meth related deaths do not tell the whole story.  The people come to this office a really just the tip of the iceberg, a small piece of the pie of the methamphetamine problem.  And bigger piece of the pie is found in local hospital emergency rooms. In 2011 there were 3000  And bigger piece of the pie is found in local hospital emergency rooms. In 2011 there were 3700 ER visits for meth related problems. That number jumped to more than 10,000 in 2014. Dr. Donyell Douglas works in the busiest ER in La Mesa. She says the situation is getting out of hand.  Any Dr. that says they haven't been frustrated probably would not be telling the truth. At the end of the shift when IMB down and it is another meth addict and you want to say what the hell is going on here.  What's going on is the method is being sold on the Street is extremely potent and highly addictive. Combine that with the fact that long-term meth use alters the brain and can cause severe mood swings, violent behavior, and solutions, not to mention overdose and death. What is the attraction? The high is incredible says Tom Freese.  When it goes inside the brain it stimulates the release of dopamine, the feel-good chemical inside the brain that is unparalleled. There is no other way from either natural or chemically induced phenomenon to reach that peak of dopamine.  Tom Freese is the director of training for the integrated substance abuse program. He has helped governments all over the world set up drug treatment systems. He says methamphetamine also affects the serotonin system, and other emotional regulator in the brain. He says meth alters inhibitory control.  The ability to say I want to do that but I'm not going to do that in to put the brakes on a particular activity. That seems to be damaged as well as part of the overall prefrontal cortex or the from part of the brain that helps us make good decisions from bad decisions.  José Escobedo started smoking meth when he was 11. Later on he snorted it. He says the best height was when he injected it.  Shooting of drugs was like bouncing up and down. It gave me 10 times more than what smoking day. It was a new experience. It was the new thing that took over my life.  He was addicted to meth for more than 20 years. At his peak he shot up six times a day.  It was like one after another after another. It wasn't to get high, it was just the habit. I wanted to see it going into my veins. I felt like I was chasing the first high.  Welcome, Kenny Goldberg. What prompted you to do the series on meth?  Every year or so the county hold a press conference where they talk about the latest methamphetamine report card. It is put together by the methamphetamine strikeforce. I was noticing that there were hundreds of deaths. There was widespread affects on crime. It was like ho-hum. The next day forget about it and methamphetamine is not the news very much. I came to find out that it is an absolutely devastating drug. It is permissions and has wide spread affects at San Diego. Affects the methamphetamine continue to mount.  What makes meth such a dangerous drug?  It is very powerful. It is very potent. It is highly addictive. In the first episode of our series we talked to a guy at UCLA who talks about producing such high levels of dopamine, the pleasure seeking chemical in the brain, that surpass any other form of human activity that they know of or any other drug. It is better than sex and better than whatever strikes your fancy. Methamphetamine sense the dopamine level II the moon and people get hit into that feeling.  Another person that we heard from in your report talked about doing math over and over in the course of a day. Is it cheap? Can people afford to do this?  Yes, it is cheap. It is cheaper than ever now. It is more powerful than ever. It is an absolute perfect recipe.  As you pointed out in the introduction to the series, San Diego has had a long history with methamphetamine. Remind us about the days when San Diego was called meth capital of the world.  San Diego got that moniker in the mid-80s when a lot of the methamphetamine was made in makeshift labs in backyard labs and labs in trailers and many of them in each County and all over the county. That is when the precursor chemicals to make methamphetamine were more widely available. People could go into a drugstore and by dozens of packs of Sudafed and melted down and make methamphetamine out of it. That is no longer available since we have had loss the make precursor chemicals illegal. Back then that is when San Diego got the named the meth capital of the world. He came to discover that things are even worse now. It doesn't have that title anymore at the methamphetamine situation is even worse than it is in the 80s and 90s.  How and where is methamphetamine produced now?  It is largely produced in Mexican super labs controlled by the drug cartels. It is highly potent. They are selling it for dirt cheap. It is very powerful. It is like making bad. If you have seen that show, they have it down to a science. They make it in the factories that look like a Costco with Fort Bliss and big giant containers of it. It is mass-produce. It is no longer a makeshift backyard thing. It is a factory artifact now.  It is an industry. Who are some of the people we will hear from as your series progresses?  In the episode tomorrow we talked to Laura Duffy he was the U. S. attorney here in San Diego. We will talk to a person at sandbag who spells out the percentage of arrestees in San Diego County jails. I think it is 40% of men and 53% of women. Be the people arrested in jail and test positive for methamphetamine. We will also take listeners and viewers down to the border where we see the meth is coming in across the border. Even though meth seizures our way up at the border crossings, somehow the meth is still getting and.  Are we making any progress in the fight against meth in San Diego?  Seizures have doubled at the border over the last year. In that respect, we are. A lot of law enforcement agencies is involved in the fight against meth. We really making progress? You'd have to ask them about that. It is like the war on drugs. If it ever over? Did we ever really make progress? I'd have to say with that many addicts and such a pernicious effect on crime and death and emergency room visits, I'd have to say no.  I have been speaking with KPBS reporter Kenny Goldberg. We will be talking about the subjects raised in his reports here on KPBS midday in addition. Thank you.  Thank you. 

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.”

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.

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

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

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.
Nicholas McVicker
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

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

San Diego: Addicted to Meth II
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.”

Former U.S. Attorney Laura Duffy speaks at a news conference, Feb. 6, 2014.
Lenny Ignelzi/Associated Press
Former 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

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

San Diego: Addicted To Meth (Pt 3)
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.
Nicholas McVicker
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.
Matthew Bowler
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.