San Diego is struggling to curtail its meth problem. Recently released data show meth-related deaths and use are at record highs despite an increase in border seizures and arrests.
The government reports highlight methamphetamine’s continued grip on the region at a time when the opioid crisis is the nationwide focus.
An annual report card that was released last week by a county task force on meth found 483 people died with the drug in their system in 2018. A September study by SANDAG showed meth was the top drug of choice for surveyed men and women who were arrested in the county last year.
Dr. Joe Sepulveda, an assistant medical director and psychiatrist at Family Health Centers of San Diego, which offers county-backed substance abuse treatment, said part of the problem is the drug is easy to access and cheap to buy. It's also due to limited treatment options, he said, and unlike opioid addiction, there is no medication approved by the U.S. Food and Drug Administration to successfully treat meth addiction.
“Meth hits different parts of the brain. Opioids hit what we call the mu receptors in the brain — it’s one specific receptor and we can target that with the medication that we’re currently using … but we don’t have that specific target for methamphetamine,” Sepulveda said.
Sepulveda said funding is also a challenge. While intensive therapy is standard treatment, he said there are other successful strategies that aren't covered by publicly funded programs. He specifically pointed to contingency management, which involves participants earning prizes, such as a store gift card or movie pass, for a drug-free urine test.
“No one’s willing to pay for that and it’s very difficult to secure funding for it, so implementing these strategies that we know are evidence-based and work in the real world is difficult,” Sepulveda said.
However, Family Health Centers of San Diego received grant dollars from the Center for Care Innovations and will soon offer contingency management and therapy program for dual-users of methamphetamine and opioids.
A county Health and Human Services Agency spokeswoman said the department boosted funding for substance use disorder treatment last year and is continuing to expand services, but addressing methamphetamine addiction is complicated by a lack of medication-assisted treatment.
“Methamphetamine addiction presents particular challenges for impacted individuals as it is a complex condition requiring sustained outreach and often multiple opportunities for individuals to engage in care,” spokeswoman Sarah Sweeney wrote in an email.
Sweeney said the department will look into possible options to support contingency management in the region, but currently, the evidenced-based practice is not one of the strategies approved by the state under Drug Medi-Cal.
On the enforcement side, the volume of meth busts at ports of entry have grown more than three-fold since 2014 while misdemeanor and felony arrests for using or selling the drug have grown 50%, according to the San Diego County Meth Strike Force 2019 report card.
Still, more than half of arrestees in the county last year told SANDAG researchers the drug was “very easy” to get — only second to marijuana, which is legal in California but not under federal law. The cost of meth has also significantly decreased.
San Diego County District Attorney Summer Stephan said methamphetamine is not only responsible for more deaths than any other illicit drug but often linked to violent crimes.
"It is not only a threat to the person using it but also to public safety," Stephan said in a statement to KPBS.
She said opioids are also a problem in the region largely because the substance is an instant killer, especially since the rise of counterfeit pills laced with highly deadly fentanyl. Fatalities from meth, on the other hand, are often associated with long-term use.
At the Dec. 9 release of the meth report card, Stephan said her office will continue to be aggressive in its enforcement against the drug and urged the public to help steer friends and family members who may be addicted to meth toward recovery programs.
“We will continue to fight on the prosecution, the prevention and the protection angle but we need the community to wake up and realize that this is a true epidemic,” she said
Meth has been the top drug used by adults seeking substance abuse treatment since 2014, according to county admissions data. However, that changed last year when heroin became the top substance used by those seeking treatment. The county said this jump is due to moving opioid treatment programs under the county's behavioral health care system in July 2018.
