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Live Free Recovery Services on Court Street in Keene is seen earlier this year. The agency’s CEO says the number of clients using meth as their primary substance has gone up about 30 percent in the past year.

Michael Wittier had been using drugs daily since he was 13.

It started with a little marijuana. But over the years, the Nashua resident started experimenting, trying out drugs like ecstasy and cocaine.

“And then it was meth,” the 29-year-old said. “It was nowhere, and then all of a sudden it was [expletive] everywhere.”

He started out selling meth for some extra cash, but it wasn’t long until Wittier was sampling his own product.

“Once you try it, it’s up and running. It’s like you keep doing it because you never think you’re high enough, but at the same time, you’re so high you’re in psychosis,” he said.

And Wittier, who used meth for three years until May, isn’t alone. Over the past year, local substance-use treatment providers have seen a sharp increase in methamphetamine use among their clientele, mainly because of how widely available it’s become in recent years and how cheap it is.

At Live Free Recovery Services — which has locations in Keene and Manchester — the number of clients using meth as their primary substance has gone up about 30 percent in the past year, according to CEO Ryan Gagne.

Similarly, The Doorway in Keene has seen the use of two stimulants, meth and cocaine, creep up recently.

A few years ago, clients using stimulants made up about 3 percent of the Doorway’s clientele, according to Executive Director Nelson Hayden. Just last month, that number has tripled.

There’s also been an uptick in “poly use,” when someone takes two drugs — typically an opioid and stimulant — in tandem. At Live Free, Gagne said that’s increased about 20 percent in the past year.

Often, meth is being paired with fentanyl, the synthetic opioid that has been the leading cause of fatal overdoses in New Hampshire and beyond for years.

In 2020, meth was involved in 59 deaths, according to data from the N.H. Office of the Chief Medical Examiner. Forty-four of those deaths involved meth and an opioid, the data show.

As of Aug. 12, 14 of the 19 deaths involving meth statewide in 2021 involved meth with an opioid.

Wittier said he often used meth with fentanyl or heroin to “level each other out.”

“It got to the point that I got so up that I thought I was going to die, so I had to do a little down to level out my heart rate,” he said. “So it started getting so bad that I had to use them, like, to level each other to keep myself alive.”

While meth certainly isn’t a new drug, its usage paled in comparison to heroin amid the continuing opioid epidemic until recently. In 2012, for example, only one Granite Stater’s death involved meth, according to data from the N.H. Office of Chief Medical Examiner.

But by 2019, that number had increased to 52, and has continued to rise.

Part of the reason for this shift in use is the market, which has moved away from heroin and has doubled down on fentanyl and stimulants in recent years.

“It was weird. It was so fast,” Wittier said.

Because of the dangers associated with fentanyl, those with substance-use disorders steered clear of it when it first came on the scene, typically only using it if it was unknowingly cut into their drugs, area treatment providers said. But now, that fear has subsided.

“This idea of going from [a non-synthetic] product like heroin, going to this fentanyl, that is manufactured, it just kind of opened the door to these manufactured other products,” said Sam Lake, executive director of the Keene Serenity Center. “ … People are like, ‘Well, fentanyl didn’t kill me, so I guess meth won’t kill me either’.”

There’s danger in using any illicit drugs, but people using opioids have more treatment options, such as medication-assisted treatment (MAT), which uses drugs like buprenorphine and methadone to wean users off the opioid and help with withdrawal symptoms.

And if someone overdoses on an opioid, people can administer Narcan, a widely available emergency treatment used to reverse the effects.

“But with meth, there isn’t a Narcan. There isn’t a quick change. There is the risk of ... a heart attack-type death, but most people aren’t dying,” Hayden, of The Doorway, said. “They’re just, when you’re up three, four, five days straight, you are losing all perception of reality.”

Someone using meth may experience a temporary sense of heightened euphoria, alertness and energy because the stimulant increases the brain’s dopamine levels.

Meth use, over time, not only changes how the brain works but also speeds up the body’s systems to dangerous — sometimes lethal — levels, such as increasing blood pressure, as well as heart and respiratory rates.

People using the stimulant repeatedly may also experience anxiety, paranoia, aggression, hallucinations and dramatic mood shifts.

This is what happened to Wittier, who is now four months sober after receiving treatment for meth and heroin use at Live Free in Keene in May.

“There was a couple of times where I locked myself in my truck. I almost shot my neighbor with my gun because I was hallucinating,” he recalled. “ ... Eventually, it started getting me physically too. You start waking up with wounds on your skin, and you have no idea how they got there.”

Treatment for meth and other stimulants like cocaine often involves a 28-day detox, followed by intensive outpatient treatment and then moving into a sober living home — spanning normally about two years. Comparatively, treatment for opioids is usually six months to one year.

It can also be more difficult to get someone who’s addicted to meth into treatment, providers said.

“When my patients choose to leave against clinical advice, it is most often because of meth,” said Emily Wilkins, clinical director of N.H. services for Phoenix House New England.

Wilkins said the cravings are much more intense when withdrawing from meth because there isn’t medication they can take to help. And with the psychosis that accompanies meth use, it can be much harder to get someone to stay in — or even seek out — treatment.

“I’ve never seen so many psychotic symptoms as I have seen in the last year,” she said.

If meth use continues to increase, local substance-use providers say it’ll become even harder to tackle than opioid use.

Wittier said educating the public on meth use is a good start.

“It’s one of those things I want people to know. People who are using meth, I’m not going to say everybody, but chances are there’s a lot of pain and they need to understand that,” he said. “Chances are those people really need help.”

If you or a loved one is struggling with addiction, Cheshire County residents can visit The Doorway at 24 Railroad St. in Keene Monday through Friday, from 8 a.m. to 5 p.m.

Support is also available through the state’s 24/7 hotline at 211.

Olivia Belanger can be reached at 352-1234, extension 1439, or obelanger@keenesentinel.com. Follow her on Twitter @OBelangerKS.