Methamphetamine use made a deadly comeback in El Paso County and across Colorado last year while festering in the shadow of the nation's opioid epidemic.
Meth-related deaths in the county nearly doubled from 2016 to 2017, from 36 to 67, while meth ranked among the fastest-growing drugs in fatalities elsewhere in the state.
The rise in meth deaths helped push Colorado's drug fatalities above 1,000 in 2017 for the first time on record -- hundreds more than the state's traffic death toll for the year.
But the trend comes as Colorado communities battle the epidemic of prescription painkillers and their illicit cousin, heroin, still the top cause of fatal overdoses in the state.
Colorado had 560 opioid-related deaths last year, 92 of them in the county. So that epidemic has dominated headlines, public health work and lawmakers' time, from the statehouse in Denver to Capitol Hill in Washington, D.C.
"You'd think we have no meth problem. We do, but it's been overshadowed by opioids," said Tom Gorman, director of the Rocky Mountain High Intensity Drug Trafficking Area program.
Given the record-breaking death toll across the county and state, new approaches are needed to prevent overdoses, no matter the drug, said Dr. Leon Kelly, deputy chief medical examiner for the county Coroner's Office.
"There's certainly a component of this that is a law enforcement issue, but this is overwhelmingly a public health issue," Kelly said. "And that's the way it needs to be treated. It needs to be treated like we treat infections and outbreaks, and allowing people to get help when they need it."
Meth-related overdose deaths have been on the rise in the county and across Colorado for about a decade.
County meth fatalities grew from one or two in 2008 to last year's record of 67, say recent data from the Colorado Department of Public Health and Environment.
The same deadly trend goes for the rest of Colorado.
After recording a few dozen meth-related deaths through the early 2000s, the body count reached 299 last year. Much of the increase came over the past five years, and 2017 marked the first time in at least a decade that meth caused more deaths than heroin.
Methamphetamines are stimulants that can speed the body's heart rate, possibly causing heart attack or stroke. That's in stark contrast to opioids, depressants that can cause people to stop breathing.
The meth trend represents a step back in the state's years-long battle against the highly addictive drug.
A public service campaign featuring posters with graphic depictions of the drug's side effects, such as rotting teeth, appeared several years ago throughout the state to dissuade children and teenagers from using it.
And lawmakers restricted access to many over-the-counter cold and flu medicines whose main ingredients can be used to make the drug. The goal: stop dealers from turning houses into meth labs that could supply home-grown batches while putting neighbors at risk of house explosions and myriad related crimes.
The law appeared to work. The number of meth labs seized in Colorado dropped from 401 in 2002 to just two last year, according to the Rocky Mountain High Intensity Drug Trafficking Area program.
But the black market appears to have adapted, Gorman said. Cartels from Mexico appear to be supplying much of the meth sold in Colorado, leading to an increase in the drug's purity and a decrease in its price.
Gorman said the drug task force has been too overburdened responding to the opioid epidemic and illegal marijuana grows to battle meth.
"In a way, I'd hate to say this, it's almost a forgotten drug," he said.
Meth's resurgence comes as the opioid epidemic continues to worsen across Colorado.
Statewide, 1,012 people died of accidental overdoses last year, 100 more than in 2016, state health department records show.
More than half of those people, 560, used an opioid when they died, a more than five-fold increase from 20 years ago. Those drugs include prescription painkillers, such as morphine or oxycodone, as well as illegal heroin.
Heroin overdoses historically accounted for much of that increase. But another type of opioid on the black market burst onto the scene last year -- a synthetic variety that has ravaged communities along the East Coast.
Overdose deaths related to fentanyl, an extremely potent painkiller that can be produced by black-market manufacturers, rose from 49 to 81.
The drug's rising popularity did not appear to reach El Paso County. Fentanyl-related deaths dropped slightly here in 2017.
But experts say it's a troubling sign, given the drug's deadly reputation and the dangers posed by mixing it with heroin, a common practice elsewhere in the nation.
The ever-rising death toll points to a need for better education about the county's opioid epidemic, said Cathy Plush, executive director of Springs Recovery Connection. The nonprofit coordinates peer support groups for people struggling with drug addiction, as well as for their families.
She pointed to a report released in February by Community Health Partnership that found county residents had only a "vague awareness" of the scores of lives claimed every year by opioid-related overdoses.
"It's all about education and learning, that it's not to be messed with," Plush said.
She and other experts also said more access to medication-assisted treatment, such as methadone or buprenorphine, is needed here, along with harm-reduction measures, such as a needle-exchange program, to limit the spread of Hepatitis C and other bloodborne diseases. An effort to create the county's first such program was shot down by the county's Board of Health in December.
Many public health officials are focused on programs to prevent opioid misuse, such as educating physicians on safer ways to prescribe narcotics, said Andrés H. Guerrero, manager of the state health department's opioid overdose prevention program. And more work is needed to destigmatize addiction so more people seek help.
Now the rise in meth-related deaths threatens to complicate those efforts.
"Because this problem -- especially the opioid problem -- was a very long time in the making, it's going to take us some time to be able to get out of it," Guerrero said.
(c)2018 The Gazette (Colorado Springs, Colo.)
