TCS Daily

Much Ado About Meth?

By Sally Satel - November 4, 2005 12:00 AM

Until Hurricane Katrina blew it off the front pages, methamphetamine was last summer's big story. Readers learned about jerry-rigged meth labs poisoning the ground water with toxic byproducts, jails overflowing with addicted inmates, foster care systems crammed with their children and sheriffs brawling with wild-eyed "tweakers" made paranoid and violent by meth.

But competing with sensational coverage was a backlash of sorts. Spurred by what they saw as drug war propaganda, some journalists tried to soften meth's status as a demon drug. They attributed Newsweek's August cover story ("The Meth Epidemic -- Inside America's New Drug Crisis") and other media coverage to "meth mania." Local politicians, sheriffs and the media, they said, were "crying meth" in order to help (a) get more public funds for law enforcement, treatment or foster care, and (b) manufacture a moral panic intended to condemn drug use in general.

Now I enjoy a good moral panic as much as the next person, but I think methamphetamine deserves its dreadful reputation. No other addictive drug combines so expertly the seduction of intoxication (feelings of supreme confidence and energy) with duration of intoxication (over 10 hours) with memory and concentration deficits (presumably reversible) and paranoia (usually reversible). Because the drug inflames the sex drive for hours on end the large number of different partners in a given session virtually ensures high rates of sexually transmitted diseases such as HIV and syphilis.

In July, the National Association of Counties accused the drug czar's office of inaction. Five hundred of its members were reeling from methamphetamine-related crime, incarceration and child neglect and challenged the drug czar "to put the same kind of emphasis on methamphetamine abuse as they have on marijuana." According to its report, 58% of the counties surveyed (throughout 45 states) said meth was far and away their largest drug problem -- cocaine was ranked as the biggest by 19% of counties with heroin and marijuana endorsed as biggest by even fewer. Three-quarters of the counties estimated that at least 40-50% of all arrests since 2000 have been meth-related.

Soon congressmen piled on. In August, when the White House called for $1 million for an anti-meth ad campaign and $16.2 million in grants for treatment programs in seven states (out of a $12.4 billion drug budget for 2006), Indiana representative Mark Souder called it "pathetic." Indeed, the plan barely began to compensate for the proposed elimination of the $634 million Edward Byrne Justice Assistance Grant in the 2006 administration budget. The grant had been used to help law enforcement officials track, shut down and clean up meth labs. And in September, when a staffer at the drug czar's office briefed members of the House Methamphetamine Caucus on its plan, Brian Baird of Washington state was dismayed. "If they're trying to tell us that they have fully grasped the problem [then] they're either dissembling, or they're clueless."

How did we get to a point where some journalists scoff at the meth problem (the usually sensible John Tierney of the New York Times called it a "fad in some places" and Jack Shafer of Slate sniffed "some epidemic" after looking at the declining rates of use in high schools). How did the drug czar find himself scrambling to answer angry members of congress who felt their states' major drug problem was ignored?

The prickly journalists are probably fed up with the drug war. For the policymakers, though, part of the answer may be demographics. A social problem that fails to afflict major Northeast cities is not as attention-grabbing. Also, poor rural whites, one of the major subgroups afflicted, wield weak political leverage. They don't vote much, their behavior does not affect more affluent citizens, and -- because they are white -- they cannot be championed by advocates who press them into service as ready symbols of failed civil rights policies.

In addition, the standard national indicators of drug use can be deceptively soothing. For example, the federally-funded Monitoring the Future survey is an annual survey of high schoolers in 9th, 10th and 12th grades. It shows a decline in "lifetime" meth use for all grades from 1999 to 2004; about eight percent of seniors tried it in 1999 compared to about six percent last year. Complementing these data is the National Survey of Drug Use and Health survey which shows that rates of use are low and steady -- about 5 percent of the population reporting having ever tried it (and 600,000 having used it within the past month) when asked in 2002, 2003 and 2004.

Then there is the Treatment Episode Data Set. It shows that methamphetamine was responsible for only 6 percent of all treatment admissions in 2003, the last year for which there are data. Meanwhile, patients with alcohol problems represent at least 40 percent of all treatment admissions; heroin and painkillers 17 percent; marijuana 16 percent; and cocaine 13 percent, with assorted hallucinogens and tranquilizers bringing up the rear.

Taken together, these surveys do not yell "crisis."

But national statistics can mislead. If a drug problem is clustered in small pockets, as meth is throughout the Midwest and Southwest, it will be washed out with national-scale data. Youth who are in serious trouble with meth may not be attending school. Adults who are using meth may be hypervigilant, due to the paranoia-inducing properties of the drug, and not about to let the survey taker into their homes.

And while national treatment admissions are not impressive, in some states meth is big. For example, Arkansas, California, Hawaii, Idaho, Nevada, Oklahoma, meth accounted for as many as 20 to 40 percent of all treatment admissions in 2003, easily surpassing alcohol admissions, the next biggest category.

Furthermore, even if the national number of casual users might not be changing, the number of severe cases has escalated. In 2002 a little over a quarter had an abuse or dependence problem that year while in 2004 60 percent did. This probably explains why treatment admissions for meth multiplied about five-fold from 1993 to 2003 -- the largest increase in admissions for any category of drug during that period. Again, a state by state view shows that admissions in some places underwent vast increases: Alabama (25 fold), Iowa (20-fold), Indiana (14-fold) Missouri (16-fold), and South Dakota (17-fold).

We have a rich recent history of drug panics. Take the overreaction to Ecstasy. Or the assumption that OxyContin, a potent painkiller, hooked "innocent" pain patients -- while, in truth, abuse of the medication was uncommon among those without a pre-existing drug or alcohol abuse. And consider the drug czar's misplaced faith in marijuana's role as a gateway to hard drugs like cocaine and heroin. Perhaps false alarms like these desensitize some of us to the real thing.

The fact is that meth is a devastating drug for those who abuse it, casting a vast halo of destruction across communities. To say so is not crying meth.

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