From Oicanadian, August 22, 2022 | View original article
Study Finds Methamphetamine Use Common, Contributing to National Overdose Epidemic in Rural America
by Tammy Sewell
Methamphetamine remains a stubbornly prevalent illicit substance across large swaths of rural America, according to a new study by researchers from Oregon Health & Science University and other institutions.
The findings, published today in Open JAMA Network, show that methamphetamine remains a common drug and leads to overdoses in rural communities. About four in five people who use drugs in rural areas of 10 states said they had used methamphetamine in the past 30 days, according to the study.
It’s a huge problem that is often overlooked, said the lead author of the OHSU study.
“Among people who use drugs in rural communities, methamphetamine use is pervasive,” said Todd Korthuis, MD, MPH, professor of medicine (general internal medicine and geriatrics) at OHSU School of Medicine. and head of addiction medicine at OHSU. “It has long been a problem on the West Coast, but now we are seeing crystal meth use in rural communities across the United States. »
The national opioid epidemic continues to dominate the headlines and accounts for the majority of the more than 100,000 drug overdose deaths recorded in the United States last year, largely from fentanyl. However, Korthuis said it was a mistake to overlook the impact of methamphetamine which continues to grip rural communities across the country. Fentanyl now frequently contaminates methamphetamine, Korthuis said. People may think they’re only using meth, when in reality they’re unknowingly taking fentanyl, which is 50 to 100 times stronger than heroin.
The new study confirmed that the risk of non-fatal overdose was highest among people who used both methamphetamine and opioids; 22% of people using both drugs reported having overdosed in the past six months.
By comparison, 14% of rural people using opioids alone reported overdosing in the past six months. Of those who used methamphetamine only, 6% reported non-fatal overdoses.
“The co-use of methamphetamine and opioids is associated with an increased risk of overdose in rural communities,” Korthuis said. “Some people see rural areas as immune to issues like drug use and overdoses, but that’s not the case. »
The study found a consistent presence of economic distress, including the fact that 53% of respondents said they had been homeless in the previous six months. The situation increases the risk of so-called “deaths of despair” – drug overdose deaths, suicide and drug and alcohol-related illnesses.
“There are deaths of despair everywhere, but our rural communities have been hit hard,” Korthuis said.
Treatment for substance use disorders works, but remains rare in rural America: 40% of all survey respondents said they had tried to access treatment in the past six months, but couldn’t get it. Among those who used both methamphetamine and opioids, 44% did not have access to treatment.
Additionally, naloxone can reverse a fentanyl overdose, but it is rarely given to people who use methamphetamine. Naloxone distribution should be extended to people who use methamphetamine, Korthuis said.
A total of 3,048 people participated in the Rural Opioid Initiative study from January 2018 to March 2020. The survey recruited participants from rural areas with high overdose rates in 10 states, including Oregon, Illinois, Kentucky, North Carolina, Ohio, Wisconsin, West Virginia, Massachusetts, New Hampshire, and Vermont.
The research is based on data collected and/or methods developed through the Rural Opioid Initiative, a multisite study with a common protocol that was developed collaboratively by researchers from eight research institutes and the National Institute on Drug Abuse (NIDA), the Appalachian Regional Commission (ARC), the Centers for Disease Control and Prevention (CDC), and the Substance Abuse and Mental Health Services Administration (SAMHSA).