While the country has been focused on the opioid crisis, another crisis forms.

"Meth is coming back," says Shilo Jama, director of the People's Harm Reduction Alliance in Seattle and the Pacific Northwest, a free needle program and guerilla drug safety organization.

Meth is not much talked about. Historically, even though presidents have used it, meth has been seen a drug of truck drivers and motorcycle gangs. Now, it's spread to the middle and upper classes. And this drug — which makes you feel temporarily wonderful but can be addictive and dangerous — is an at an all-time high. And health officials, nonprofit workers and emergency responders from across North America see the human suffering every day — teeth rot, skin sores, meth-induced psychosis.

Jama's organization sees it close up. His program, run by drug users, for drug users, is serving more stimulant users — mostly meth and cocaine — than opioid users, even in the midst of this opioid crisis. 

And meth heads are not reducing their use, they're ramping it up. Which makes Jama worried about the future. 

"People are gonna tweak out all over the place," Jama predicts. "In five years we're gonna have the same conversation we're having now about the opioid crisis, but about the meth crisis."

Image result for site:www.peoplesharmreductionalliance.org

[Shilo Jama, director of the People's Harm Reduction Alliance in the Seattle area. //photo via Peoplesharmreductionalliance.org.]

Unlike opioids, it takes a lot to overdose on meth. But meth contributes to overdose deaths. See, folks hooked on opioids will take their opioids just to feel ok. But in order to operate, to be good dads or moms or retail clerks, they'll use meth to pep up. Then they increase their opioid dose. Next thing, the opioids overpower the meth, and they're not breathing. 

In King County, home to Jama's needle exchange program, deaths linked to meth are on the rise. Eight percent of overdose deaths in that county were linked to meth in 2012; in 2016, that number had risen to 30 percent, the DEA said.  

Nationwide, deaths linked to stimulants — mostly meth — are up 250 percent between 2005 and 2015, the CDC said.

Meth, like all drugs, has regional variations. But nearly everywhere, use is up. In Ohio, between 2016 and 2017, the state patrol took double the meth off the streets, Fox 28 in Columbus reportered, and Ohio health officials saw meth deaths rise 125 percent at the same time. In Winnipeg, Canada, meth possession charges rose 890 percent between 2012 and 2017, said the Winnipeg Sun.

In Georgia, the most common substance found in the blood of overdoses is meth

Meth is killing more people today than it was in the 2000s, when it was more a part of the national conversation.

Why is meth back?

First, it feels awesome.

Second, entrepreneurs find meth easier to make than cocaine or heroin, which require actual plants. Meth is just chemicals.

Third, Mexican cartels saw their weed profits drop after widespread legalization, perhaps by 40 percent. So the cartels searched for other income sources, and meth was one of the winners.

With production up, meth is cheap as hell: the Atlanta Journal-Constitution, the DEA and users report that prices have plunged. Depending on where you are and who you know, meth costs one-half or one-seventh as much as it did five or ten years ago. At the same time, its purity has increased from 85 to 94 percent, the DEA says.

So there may be no breather between the opioid crisis and the next drug-based crisis, as real people are sniffing, smoking and shooting their way into meth holidays, long stretches of endless energy, self-confidence and less sleep.

Jama says the world needs more meth-specific services. Jama's program, like a quiet few around the country,  offer all kinds of help. The People's Harm Reduction Alliance hands out miso soup to keep users going and offers dark rooms to help folks sleep. His program even gave out meth pipes, so that users wouldn't share needles.

But there's no easy fix, and most observers think the crisis will get worse before it gets better, of what Nick Reding, in his book "Methland," calls "The most American drug."

At the moment, people don't understand meth. But five years from now, Jama says, the country will wonder what it could have done differently to avoid the damage.  

"Right now we have the ability to do something about it," Jama says.

[Cover photo: a meth pipe photo via Shutterstock]