With “marked” increases in statistics related to crystal meth use, is London “breaking bad”?
That’s three times the provincial average, and the increase happened while admissions for fellow stimulants crack and cocaine went down.
According to the report on drug use in London (item 3 on the May 15 board of health agenda), crack was the stimulant most likely to present at addictions services from 2009-12 until meth overtook it last year.
There was also a 40-percent hike in inpatient hospitalizations related to methamphetamines (14.4 per 100,000 residents in 2012 from 10.9 in 2008).
In 2009, the London Police Service seized three grams of methamphetamines. In 2012, they pulled more than a kilogram off the streets, 1,121 grams in all. The number of prescription pills seized increased 27.4 percent over the same period.
In May, the Ontario Provincial Police called reporters to their regional base to announce a bust that included 12 kilos of cocaine and 3.5 kilos of “100 percent pure” meth.
Dr. Andrea Sereda’s four years in family medicine have focused on the homeless. She has a “heavy” caseload of about 400 patients at the London Intercommunity Health Centre (LIHC) clinic within the Salvation Army’s Centre of Hope and has seen a rise in meth use.
She said many patients present with “poly-addictions” with meth showing up that way as a second or third substance being abused at once, adding that she would tend to see more opiate cases because there are more strictly medical treatment options – there’s no methadone equivalent for meth.
“Overwhelmingly it was opiates as a presenting problem but stimulants are now either co-ingested or they’re a presenting problem (on their own),” she said. “I’ve only worked in London but I can say subjectively that yes, we’ve seen an increase. Many of those patients often have a poly-substance presentation that now contains meth whereas it didn’t necessarily when I started four years ago.”
According to Pam Hill, the director of clinical services at Addiction Services Thames Valley (ADSTV), at six percent meth is among the top five problem drugs for people 24 and younger who seek their help but that’s just half as many as seek help for cocaine, and a fraction of the 27 percent who ask for help with cannabinoid (marijuana) abuse.
But she admits ADSTV only sees the fraction of users who seek help. She said there are probably a lot more people who consider themselves recreational users because the consequences haven’t affected their life enough to appear to be a problem.
Like Sereda, she said meth is appearing as one of a number of drugs being abused at once.
She said a person who takes meth goes one of two ways: angry and violent or extremely happy and energetic. The drug has a dangerous potential to create long-term psychosis because it is so intense and takes a longer time to wear off than other stimulants like cocaine.
“It’s interesting because it really blends mental health and addiction together,” she said. “It’s often hard to tease out whether it’s a mental health or substance abuse issue.”
The high is followed by a very deep crash: Hill pointed to the case of a man whose arm was amputated because he literally fell asleep on it for three days, cutting off the circulation.
With obvious physical signs like weigh loss, tooth decay and sores, long-term meth users are more vulnerable to predators on the street.
“We’re trying to create safety for people,” she said. “We don’t have a strategy for meth specifically, but we’re observing trends. The biggest thing is getting to the underlying issues that will cause people to move to substance abuse.”
The Middlesex-London Health Unit’s CEO and medical officer of health Dr. Chris Mackie said Wednesday (June 25) meth is a concern but with an opiate use rate well above the provincial and national averages, that’s where the focus has to be.
“It’s a really interesting problem (but) although it’s higher the provincial average it’s still down on the list and we’re trying to focus on the big ones.”
The biggest one saw a threefold spike in 2013: 41 people died from overdoses of prescription opiates, compared to 12 the year before. That was more than half of all fatal drug overdoses that year, putting opiates on par with alcohol-related deaths (55) and ahead of motor vehicle collisions (17) for deaths among two- to-40-year-olds.
Mackie hopes it’s an anomaly.
“It challenges the idea that illegal drugs aren’t as big a problem as many people think,” he said. “At 41 deaths it’s really catching up to other causes, which is totally new and puts a different perspective on things. I sincerely hope that’s an aberration.”