Los Angeles has recently seen a series of knife attacks and other crimes where the suspects not only display violent but strange behavior that is often attributed by the public to mental illness, but which professionals say have other characteristics:
Meth.
Methamphetamine use is no secret. Addictive stimulants are a fixture in popular culture, on the big (“Winter’s Bone”) and small (“Breaking Bad”) screens. But when officials talk about the harmful effects of controlled substance abuse, most focus on fentanyl, a powerful opioid.
It’s fentanyl that grandstanding politicians falsely claim in Halloween candy or that can kill in contact with the skin (it is not, and cannot be). It’s the fentanyl they say is coming through our porous southern border and flooding our streets (true, but mostly hidden among travelers and cargo entering legally, not among illegals crossing into the US). It is fentanyl that is the target of many bills in the state Legislature intended to crack down on drug crimes by increasing penalties.
In contrast, lawmakers rarely focus on illegal methamphetamine and we in LA rarely talk about its effects on public safety and health, including psychosis that mimics serious mental illness. There is a widespread but mistaken belief among users that the drug is as legal to possess and use as marijuana, and not more dangerous. Even some law enforcement officials and doctors mistakenly believe that the law allows such use.
Although historically it has been the drug of choice for white motorcycle gangs and the underemployed desert or Central Valley residents, it exploded between LA and Inland Empire high school students who used to concentrate while studying for exams, residents of housing projects who appreciate it very rarely. low cost and ease of access, and people who live on the road who want to stay awake all night to fend off attacks. Use among all socioeconomic groups has increased in the past decade, according to the National Institutes of Health and other public health monitors.
Meth rarely matches the presence of fentanyl in news stories, aside from sporadic busts such as last month’s story after a cleanup crew found 235 pounds of meth in an Airbnb home in Alhambra. But sometimes it gets into the discussion. After the April 21 morning break-in to the residence of Mayor Karen Bass’, for example, the police and substance use experts said the intruder’s actions sounded typical of people in a methamphetamine-induced crisis.
And indeed, suspect Ephraim Matthew Hunter told reporters that he had been in the middle of a five-day meth party, paranoid and looking for a place to hide from imaginary hunters. Coincidentally, he said later that the house that was broken into was the mayor’s official house. If that’s the case, it can be home. While there is no basis for denying all such violations or assaults on bus drivers or Metro passengers involved in meth, it is naive to assume that no one does.
LA has a serious meth problem, and it’s time to talk about it – frankly, clearly and publicly in a way we haven’t done before, at least not until we’re talking about fentanyl, mental illness, COVID-19 or even measles.
Why hasn’t this appeared yet? There are many possible reasons for this. Meth can seem less alarming than fentanyl, which can kill quickly when ingested. Meth rarely does that. Rather than suddenly dying of an overdose, long-term meth users tend to collapse, lose teeth and suffer heart and other organ damage along with behavioral changes. Without sudden death, meth use may seem less of an emergency.
There is also less talk about meth because there is little that can be done easily. There is no treatment like naloxone, which can reverse a fentanyl or other opioid overdose. Or Suboxone, which can kill opioid cravings and treat addiction.
Or maybe the treatment we’re doing is controversial. Contingency management is an incentive-based program with a short but solid track record of success, but rewarding users who recover daily with clean drug tests has little appeal for critics who call for traditional treatment and tougher penalties.
Or maybe it’s because officials are aware of how Los Angeles and other jurisdictions responded to the crack epidemic in the 1980s and 1990s and are worried about repeating the same mistakes: fighting a dangerous public health crisis by investing heavily and exclusively in detention and incarceration and also . little in treatment and economic development, magnifying many times through the social damage caused by drugs.
Or maybe it’s because the conversation, when it does happen, is too often ideologically extreme, with one faction insisting that most of LA’s homeless are on the streets because of drug use, and another faction convinced that homelessness just exists. housing cost function and has little connection to drug-induced dysfunction. Meanwhile, many homeless users say they take the drug when they move to the streets, where meth is plentiful and cheap.
In any case, as meth use spreads and affects more lives, we can’t stop the conversation anymore. LA County has important programs aimed at helping meth users, but they don’t always complement each other. A 4-year program to raise awareness was derailed by COVID-19.
The Board of Supervisors last week approved Lindsey Horvath’s call for a report from public health, mental health and other officials on the response to meth use, and it’s a welcome step. But in very typical district fashion, officials were given 90 days to respond. LA needs a greater sense of urgency to understand and address the meth problem.