Is There Really A Meth Epidemic?By Doc
May 26, 2014
Well, it appears that Forbes is at it again. After posting articles online on November 4, 2013 and February 20, 2014, Forbes printed another online article on May 8, 2014 downplaying the dangers associated with methamphetamine and the extent of meth use; this time authored by Jacob Sullum and titled, “Three Bouts Of Meth Hysteria Illustrate The Politics Of Panics And The Need For Speed.” The article is in the format of a book review. The book in question is Meth Mania, written by Nicholas Parsons, a sociologist at Eastern Connecticut State University. The purported purpose for this book was to “explain why public alarm about methamphetamine bears little or no relationship to objective measures of use or abuse.” Sullum reports that Parsons claims that other news organizations, such as Newsweek, resort to “yellow journalism” and “scaremongering” in an attempt to create policies that promote “draconian prison sentences and precursor restrictions that bolstered murderous drug cartels while treating cold and allergy sufferers like criminal suspects.”
Blah blah blah!
I don’t know what the true agenda for Forbes is. It appears that Forbes is intent on downplaying the true dangers associated with methamphetamine. I’m sorry, but this attitude makes me madder than hell.
Sullum, Parsons and the like refer to government data to prove their point. Well, let’s take a look at how these data are collected. SAMHSA, which stands for the Substance Abuse and Mental Health Services Administration, is a division of the U.S. Department of Health & Human Services. You know them, the government entity responsible for implementing the Affordable Care Act. That’s your first clue.
So, how does SAMHSA collect data on methamphetamine? They conduct a survey! This “survey collects data through face-to-face interviews with a representative sample of the population at the respondent’s place of residence.” Seriously! In addition, the SAMHSA website reads, “For the 50-State design, 8 States were designated as large sample States (California, Florida, Illinois, Michigan, New York, Ohio, Pennsylvania, and Texas) with target sample sizes of 3,600.” “For the remaining 42 States and the District of Columbia, the target sample size was 900.”
Ok, are you beginning to see the flaws? First of all, which states have self-reported the greatest number of meth labs seized and people arrested for meth use? These states include Tennessee, Missouri, Iowa, Oklahoma and Indiana. Yet these states are lumped together with the other 37 states (and DC) in the smaller sample. Yet they claim that this is an adequate sample size with which to extrapolate the extent of meth use in the United States.
Secondly, SAMHSA has this disclaimer on their website, “Because of changes in the questionnaire, estimates for methamphetamine, stimulants, and psychotherapeutics in this report should not be compared with corresponding estimates presented in previous reports for data years prior to 2007.” The sampling data must first be manipulated using census data and other “corrections” before comparisons can be made. It’s interesting how these corrections have to be made on the methamphetamine data. There is no such disclaimer for marijuana, heroin or prescription drugs. Interesting! Thus, these data become curiouser and curiouser.
So Sullum, Parsons and other naysayers refer to the SAMHSA data as gospel when it comes to methamphetamine use. SAMHSA’s 2012 report states, “The number and percentage of persons aged 12 or older who were current users of methamphetamine in 2012 (440,000 or 0.2 percent) were similar to those in 2011 (439,000 or 0.2 percent) and in 2007 to 2010 (ranging from 314,000 to 530,000 and from 0.1 to 0.2 percent). However, the number and percentage in 2012 were lower than in 2006 (731,000 or 0.3 percent).” Thus, they claim that the reports found throughout the media are simply cases of “hysteria” and “yellow journalism” since SAMHSA reported that meth use actually decreased in 2012 compared to 2006. Someone just wants to unfairly punish meth users, according to Sullum and Parsons. They are just plain wrong! I wonder what their true agenda really is.
The data collected on methamphetamine by SAMHSA has several other flaws. Let’s consider the data collection process. The interviewer sends a letter of inquiry to an address selected at random, and this is followed by a face-to-face meeting between the interviewer and resident at the randomly-selected address. So the interviewer sends a letter and arrives on the doorstep of a house where meth is used (and possibly even manufactured). What are the chances that the meth user will even open the door? I have talked to a lot of meth users, and every single one describes the intense paranoia that accompanies her meth use. Meth produces its intense euphoria, at least in part, by increasing the neurotransmitter dopamine in the brain. And it turns out that paranoia and psychoses are also mediated by an excess of brain dopamine. So a meth user, already paranoid that someone will find and steal/confiscate her meth will be extremely reluctant to discuss her meth use with a representative of the US government. No wonder the SAMHSA numbers are so artificially low!
Another difference that separates meth from other drugs such as cocaine, heroin and marijuana is that each of the later drugs must first be grown. That makes these drugs difficult to hide during the cultivation process, which is also dependent on geography as well as the season. With meth, all the user needs is a couple hundred dollars, a discount store and a couple of hours to make her own meth. No need to grow anything. And if the precursor pseudoephedrine is difficult to obtain, the Mexican Drug Cartels quickly fill the void.
Current and former users of the drug also claim that meth is “everywhere.” Meth users stay in the shadows due to the paranoia associated with their meth use. They only use with people that they know, and they keep the numbers of people that they use with relatively small. Meth is not a party drug like ecstasy (MDMA) is. When someone injects meth, she only has one thing on her mind – sex. And after the initial wave of euphoria passes, she wants to engage in sex for hours and hours and hours. Sex is personal, and people are often embarrassed/ashamed to openly discuss their sex lives with strangers (interviewers from the government!), and this reluctance plus the user’s paranoia makes it very unlikely that an interviewer will obtain an accurate representation of meth use.
Finally, is the world also involved in the meth hysteria? There are reports from Australia, New Zealand, Germany, England, North Korea, Iran, Indonesia, Brazil, Jakarta, and China, to name a few. In most of these countries, methamphetamine use is only second to marijuana, with meth surpassing the use of heroin in many countries where heroin has been the drug of choice for decades. And this is also occurring in countries where the penalties for possession of meth include the death penalty, which is a little more ‘draconian” than the punishment in the United States.
I do not know what the agenda for Forbes and authors like Sullum and Parsons really is. According to Sullum, “Parsons recommends harm reduction, which aims to minimize the damage done by drug policies as well as drugs.” Instead of putting people in jail or the hospital, they want us to acknowledge that people demand stimulation and it is up to us to provide that to them instead of instituting these hysterical and draconian “drug policies.” Hogwash (those who know me know I really toned that down!). When did it become my responsibility or the responsibility of the US Government to provide stimulation to the masses? Enough already!
If I am wrong, prove me wrong. I dare you!
A “report” recently came out online by the Open Society Foundation titled, “Methamphetamine: Fact vs. fiction and lessons from the crack hysteria.” The authors make this concluding claim, “The data show that many of the immediate and long-term harmful effects caused by methamphetamine use have been greatly exaggerated just as the dangers of crack cocaine were overstated nearly three decades ago.” Normally, I would have dismissed this report for a number of reasons. Then I saw that it had been picked up by Forbes in an article published online on February 20, 2014, by Jacob Sullum titled, “Hyperbole Hurts: The Surprising Truth About Methamphetamine.” I am unclear of the motivations behind these misleading reports, but I feel compelled to respond.
First of all, this was not a peer-reviewed scientific report even though it is promoted as such. “Peer review” simply means that the results from a scientific study are written in the form of a manuscript that is sent to several scientists in the same area of research (i.e., peers) to review to determine if the research was conducted using sound scientific principles and if the manuscript is an accurate representation of the data that the authors collected. This report was simply published online by the Open Society Foundation, and no date of publication can be found anywhere on the report. Therefore, this simply represents the opinion of the authors, and, I assume, the Open Society Foundation.
Secondly, only one of the authors is a scientist. The lead author, Carl Hart, Ph.D. is an Associate Professor of Psychology. Co-author Joanne Csete is actually the deputy director of the Open Society Global Drug Policy Program, while co-author Don Habibi, is a Professor of Philosophy and Religion.
So, what are the major claims in this report? The authors first discuss how the “crack baby” epidemic was overstated, and suggest that this was a plot to artificially increase the penalties for “crack” compared to powder cocaine possession and distribution. I agree that the penalties should be the same for any form of cocaine, but that is NOT the motivation underlying the warnings associated with methamphetamine use.
The authors then lump in methamphetamine with all other forms of amphetamine (Adderall), and they even include Ritalin in the mix. But then, surprisingly, they cite statistics collected by the United Nations Office on Drugs and Crime (UNODC) in 2011, “UNODC’s most recent report concluded that markets for methamphetamine are growing faster than for other ATS [amphetamine-type stimulants], fueled in part by significant increases in East and Southeast Asia, the United States and Mexico in the last five or six years.” In addition, “While production was highest in the Middle East, Southeast Asia and North America (including Mexico), production in Africa, especially South Africa, was increasing.” Yes, there is a global methamphetamine epidemic as I and others have stated. Yet Sullum talks of “hyperbole.” What’s going on here?
The authors then claim that the advertisements and websites presented by groups such as the Montana Meth Project have caused the organization to lose credibility because they exaggerate the harmful effects of meth and are just using scare tactics reminiscent of the cult film “Reefer Madness.” I have also told the readers that not everyone who uses meth looks like the people represented in some of the mug shots of meth users. The authors claim that people with prescriptions for Adderall don’t look like that way either. Obviously not! As a pharmacologist, I realize that the effects of any drug are dose related. At low, prescription doses of Adderall, people are not likely to experience many adverse side effects. But on the other end of the spectrum is the IV meth user who is increasing the dose of meth in an attempt to get that desired effect that she felt the first time that she injected the drug. She may even inject the drug repeatedly every two or three hours, even though the drug is still active in her body for another 6-12 hours. This use is not pharmacological and not logical, but it happens over and over again as people chase that high. Comparing prescription Adderall (or Ritalin) use to a chronic IV meth user is misleading and disingenuous at best.
As far as the effects of methamphetamine on the brain, the authors provide an example from a peer-reviewed manuscript published in a highly reputable neuroscience journal in 2004. They point out some perceived limitations in this study from 10 years ago and then paint all subsequent brain imaging studies with the same wide brush, stating, “This example is not unique. The brain imaging literature is replete with a general tendency to characterize any brain differences as dysfunction caused by methamphetamine.” Yet the scientific literature is full of studies from the laboratories of respected scientists demonstrating that methamphetamine does indeed lead to the loss of brain cells. The mechanism of action for this is known. What the authors still fail to make clear is that these effects are related to the amount of the drug that is used and how long the individual has been using it. Furthermore, the authors do not discuss the differences between smoking and injecting meth IV. While the effects of cocaine and nicotine are similar by either route, the effects of IV meth are much more pronounced compared to smoked meth. If you don’t believe me, then ask someone who has tried both routes of administration.
Finally, the authors question the addictive potential of meth. They cite studies in which meth users are brought into a laboratory as paid research subjects. When asked if they would choose a 50 mg hit of meth or $20, the meth users would usually choose the money. The authors claim that this is proof that meth is not all that addictive – at least not addictive the way the media “hypes” it. But the research subjects are not high at the time and likely did not decide to join the research study to get high. They do it for the money. People who are actively using meth are not likely to enter these research studies. With high-dose meth use, people often experience paranoia and are distrustful of everyone. Let’s see the data when the study is repeated with someone who is coming off a 3-day meth binge and is actively looking for her next hit of meth. Then let’s see what she chooses!
I could go on, but you get the idea. A paper recently appeared in the peer-reviewed journal Drug and Alcohol Dependence titled, “The global epidemiology and burden of psychostimulant dependence: Findings from the Global Burden of Disease Study 2010.” The authors of this manuscript conclude, “Dependence upon psychostimulants is a substantial contributor to global disease burden.” The global methamphetamine epidemic is real, regardless of what George Soros and the Open Society Foundation want us to believe.