People who work in drug treatment and the criminal justice system have noticed a recent uptick in methamphetamine use in the Keene area, signaling the region is not immune to a problem that has hit other parts of the state and country.
The highly addictive stimulant affects the central nervous system and can cause psychosis and aggressive behavior, as well as a range of short- and long-term health problems.
“It’s never been nonexistent in the area,” said Alex Parsons, managing attorney of the N.H. Public Defender’s Keene office. “It’s always something we would see occasionally. But it’s something we’re starting to see with a lot more regularity.”
Opioids like heroin and fentanyl, which have been driving the drug epidemic for years, remain dominant in the region, according to interviews with local observers and reviews of court cases. Crack cocaine is also relatively common.
But meth use has been growing in New Hampshire and nationally, and several signs point to an increase locally.
At least five people have been charged with possessing meth in Cheshire County this year, compared with two indictments for alleged meth possession in 2018. At least three others violated their probation after admitting to or testing positive for meth use.
Doug Iosue, the case manager at the Cheshire County jail, said he has seen a slight increase since 2017 in inmates who report meth as their primary drug. A higher number — about 6.5 percent of the inmates he has seen in 2019 — said they had used the drug recently, whether or not it was the substance they used most often.
At The Doorway at Cheshire Medical Center, a Keene program that connects people to substance-use treatment, alcohol and opioids still account for about 90 percent of new cases, according to director Nelson Hayden. But he has seen meth cases spike just in the past two months.
“I’ve seen a big increase at The Doorway with people coming in with a primary drug of methamphetamine,” he said. “It’s probably twofold, maybe even threefold what I was getting the previous months.”
‘A matter of when’
Law enforcement seizures of methamphetamine have been rising around the country, increasing 142 percent nationwide between 2017 and 2018, NPR reported this summer. The trend has been similar in New Hampshire, according to N.H. State Police Lt. Chris Roblee.
“We’ve seen a marked uptick in just the amounts of meth that have been seized throughout the state,” he said.
Fatal overdoses involving meth are also rising, from two in 2015 to 22 last year, according to data from the N.H. Office of the Chief Medical Examiner. Nearly all those deaths also involved an opioid.
The meth problem is more severe in some parts of the state than others. WMUR reported in May that Concord police were arresting more people because of methamphetamine than opioids.
Keene has not seen anything to that degree. Police have made meth-related arrests here and there, but it has not been a major problem so far, according to Lt. Jason Short, head of the Keene Police Department’s investigations bureau. He said he does not know of any recent assaults or other dangerous situations caused by meth use.
“It’s out there, just like any of the other ones we deal with,” he said. “But it’s not as prevalent as the crack cocaine and the heroin.”
But he said he would not be surprised if that changes. “We’ll probably see an increase here soon, whether that’s next week or next year or two years from now,” he said. “It’s gonna hit. It’s just a matter of when now.”
No simple treatment
Unlike the slowing effects of opioids, methamphetamine cranks the body up. Hayden says people who binge on meth can stay up for days. “Your body can’t function without sleep for that long a period of time,” he said. “And so at times they end up in a drug-induced psychosis.”
Meth is addictive because the body gets used to functioning at that higher speed, Hayden said.
“It adjusts to this new, increased stimulant,” he explained. “And so when you can’t have it, then you’re [at] even more of a low.”
Long-term use can cause extreme weight loss, dental problems, anxiety, paranoia, memory loss and other cognitive and emotional problems, according to the Drug Enforcement Administration.
“One thing we’ve been learning a lot about is, recovery for people who primarily use meth is going to be a lot slower, because of the specific damage it does to the brain,” said Stacey Lanza Roberts, clinical director and treatment provider for the Cheshire County Drug Court, an alternative sentencing program for people with a history of drug use.
Often, people using meth have also used other substances, underscoring the idea that addressing addiction is about more than cutting off a particular supply, treatment providers said.
“We as a society really need to look at this and say, ‘OK, how do we treat substance use and substance disorders?’ ” said Shorey Dow, who oversees the Phoenix House treatment programs in Keene and Dublin. “Instead of, ‘opiate is the hot topic’ or ‘meth is the hot topic’ or ‘marijuana is the hot topic.’ ”
Treating meth addiction involves similar concepts and methods as other substance-use disorders, aimed at changing behavior and addressing underlying causes like mental health and trauma, Hayden said.
But there is no equivalent of Suboxone or methadone for stimulants. People in recovery from an opioid-use disorder can take those medications to reduce opioid cravings, alongside other forms of treatment.
“The treatment and recovery, it’s just a little bit more precarious for these folks, because there is no medical intervention that we can do,” Hayden said. “And so, basically, we’re relying 100 percent on the therapeutic factor.”
As the community addresses this latest facet of the drug epidemic, Parsons, the public defender, cautioned against an overreaction that demonizes people with meth problems. The people who have entered the Cheshire County Drug Court with a substantial history of meth use have criminal histories similar to heroin users and are not particularly dangerous, he said.
“People addicted to meth, it tends to make them very, very depressed, and they want to change, and they want help,” he said. “And they can be helped. They can respond very well to treatment. But it has to be a treatment of a certain kind. It has to be intensive, and it has to have close case management, and it has to last a long time.”
Those seeking help with a substance-use disorder can visit The Doorway at Cheshire Medical Center at 640 Marlboro Road in Keene (the Curran Building on Route 101) Monday-Friday, from 8 a.m. to 5 p.m., or call the state’s 24/7 hotline at 211.