In recent years, the rising number of deaths attributed to heroin and other opioids has been deemed a crisis by local politicians and public officials. Note that heroin fatalities in Denver went up by 933 percent between 2002 and 2016, with casualties from the narcotic increasing by 756 percent statewide over that span. And during the same period, deaths from opioids other than heroin surged 372 percent and 128 percent in Denver and Colorado, respectively.
As a result, methamphetamine use has gotten less attention by comparison. But its lethality is equally alarming.
According to data provided by the Colorado Department of Public Health and Environment, methamphetamine deaths rose a staggering 1,450 percent in Denver from 1999, when just four people died of the drug, to 2018. Last year, more people perished in the Mile High from meth, 62, than from heroin, 47 — and the former figure falls just shy of the 68 individuals who died from the combination of all opiates other than heroin.
These figures come as no surprise to Lisa Raville, executive director of the Harm Reduction Action Center. "There's been more focus on heroin and opiate use lately, but meth never really went away," she says.
"We've been about 50/50 meth and heroin injectors for the past couple of years."
Raville adds that meth use really goes up among the homeless population when the temperatures drop. According to her, "Meth is a survival method for our unhoused neighbors in the wintertime."
For his part, Kirk Bol, manager of the CDPHE's registries and vital statistics branch, sees meth overdoses as experiencing a resurgence, as evidenced by a report about fatal meth overdoses in Pueblo County surpassing deaths from heroin or other opioids during 2018.
Why? Bol, corresponding via email, notes that "there are many suggested theories, but no single cause that we are aware of. The most recent statistics/presentation from the SAMHSA/National Survey on Drug Use and Health indicate that methamphetamine use has been increasing nationally, with some larger increases in western states, possibly suggesting that methamphetamine is more available from various sources. These are mirrored by CDC's published findings about drug-overdose deaths, as well as treatment-specific statistics from the Colorado Office of Behavioral Health at CDHS."
Additionally, Bol goes on, "much of the anecdotal information available suggests that in light of stricter polices on opioid prescribing and decreased availability of prescription opioids, there may be transition to both heroin and methamphetamine, which may also be lower-cost in addition to more readily available. This is evidenced in part by increasing numbers of drug-overdose deaths in Colorado involving both methamphetamine and heroin."
"There's a lot of poly-drug use," Raville agrees. "People will use stimulants for a few days, then use heroin, which puts them at a higher risk of overdosing. And they'll use meth when they don't have the medication they need, because it works for them. It can level them out and get them to feel like they're flourishing and pushing forward. Meth can make people feel great, and at a time when you're depressed and things aren't working out for you, it's great to feel like a rock star."
But the risks remain high, whether users realize it or not. There's plenty of misinformation surrounding the substance, Raville acknowledges, including that "people who use stimulants like meth, cocaine and crack think they can't overdose. And they can."
One reason for the confusion: Stimulant overdoses are very different from those triggered by heroin and other opiates. The latter are depressants that can cause a user's respiratory system to shut down. In contrast, meth and the like "present more like a heart attack, stroke or seizure," Raville explains. "That's why a lot of people don't know that can happen to them."
To better inform users of the dangers presented by stimulants, the Harm Reduction Action center has put together a publication dubbed Methamphetazine, with all of the illustrations and text contributed by participants at the facility. It's linked at the bottom of this post, too. But one section applies a different term — "overamping" — to stimulant overdoses.
Physical effects of overamping include overheating (hyperthermia), an increased heart rate, dehydration, sweating and rigid or flailing limbs. Among the psychological impacts are paranoia, anxiety and psychosis. A call to 911 should be made in the event of the following conditions:
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• Severe confusion/disorientation
• Trouble seeing/communicating
• Drooling/frothing at the mouth
• Uncontrollable muscle spasms (or stiffness/rigidity of muscles)
• Trouble walking/staying upright (falling)
• Difficulty breathing
• Seizure/heart attack/stroke
• Vibrating vision
• Tactile hallucinations (frequently bugs/mites in skin)
• Intense mood swings
• Extreme paranoia (sketching out)
• Stimulant psychosis
• Aggressive behavior
The prevalence of meth in Denver is another reason that Raville advocates for a safe-use site as envisioned in a pilot program favored by Denver City Council. Support for the concept crumbled earlier this year, with Senator Brittany Pettersen ultimately deciding not to propose it at the state legislature. But, Raville says, "it would definitely save the lives of stimulant users. If they have a heart attack, stroke or seizure at the site, they could get help. Otherwise, they're not alive — but when they're alive, there's hope."
The opioid crisis unleashed "a ton of funding through the feds and the state," Raville allows. "But we also have to talk about what stimulant use looks like for folks, and what a difference housing makes for them — because if you have housing, you don't need to inject meth in the winter to stay alive. Once they're housed, I rarely see them. That's another way we can help them."
Click to access a printable version of Methamphetazine , plus Colorado Department of Public Health and Environment data in regard to Colorado overdose deaths from 1999-2018, Colorado overdose deaths by county from 1999-2018 and Denver-metro overdose deaths from 1999-2018.