Is meth back in Alaska? Or did it never leave?

Opioids like heroin get the most attention when you hear about the drug epidemic in Alaska. But people working at the ground level are warning of a parallel problem that is getting worse.

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Methamphetamine is appearing in the state at greater volumes than ever before. Its negative health impacts are being exacerbated by the opioid crisis, reaching new users and being used in riskier ways.

Sitting at his desk in a one-story building on Wasilla’s Main Street, 30-year-old James Savage explained that the first time he used meth it was to get off painkillers.

“I was absolutely miserable in all facets of my life,” Savage said of his years abusing drugs.

Savage was first prescribed pain medications after breaking his foot falling off a ladder when he was 19 years old. A former wrestler who grew up in Alaska, Savage is big guy, and he was given high doses of strong opioids early in his treatment. It started a spiral into addiction, with years spent circulating through pain management clinics in Anchorage and the Valley. Eventually a prescriber flagged Savage for doctor shopping and his prescription was cut off.

And in recent years, as stories of unintended opioid addiction have become more commonplace, this is usually when people turn to heroin. But Savage did not. He hates needles and was reticent to try replicating a high-potency pharmaceutical high with street heroin. Instead, he got advice from a drug buddy that he could detox by using methamphetamine.

“You have a lot of folks that are under the impression that their addiction is bad enough with heroin,” Savage said. “They decide go to methamphetamine to try and wean themselves off.”

Savage bypassed the debilitating pain and discomfort of opioid withdrawal by going into a days-long meth induced mania, followed by two or three days of coma-like sleep.

What followed was what he called seven months of “white knuckle sobriety.”

Eventually, Savaged relapsed. But instead of returning to opioids he started using meth, “all day, every day.”

In 2015, Savage entered a treatment program and has been in recovery for almost three years. Now he works at Fiend2Clean, a recovery support nonprofit based in Wasilla.

While opioids are getting a lot of media and policy attention, meth never left Alaska after its last devastating iteration in the early 2000s. Though one of the most public manifestations of the problem — meth labs — stopped appearing, the supply merely shifted without demand ever fully going away. Now, use of meth alongside opioids is increasing, as people cope with the drowsy, narcotic effects that can go along with high doses of heroin and painkillers.

“Someone who typically passes out or falls asleep after injecting heroin will be able to stay awake,” Savage explained. “They’ll feel the effects longer, without falling asleep or having an adverse reaction to the amount of heroin they’re using.”

This is essentially a way of balancing out powerful drugs to stay functional for those trying to hold down jobs or mask their addiction by not nodding off in public, according to Savage.

But there’s also a purely recreational reason: the combination makes for an intense rush. In the past, combining shots of heroin with cocaine or other amphetamines was called a speedball. Now, meth has eclipsed other uppers as the most common accelerant in speedballs.

The health calamities associated with meth are rising in Alaska, in part because the drug itself is more potent all the way down to the street level and because of how it is being used in combination with other drugs. The rate of meth-related overdoses increased by more than four times in less than a decade, going from 1.4 fatalities per 100,000 persons during 2008–2010 to 5.8 per 100,000 between 2014–2016, according to a report by the state’s Division of Public Health in November of 2017. Of the 193 lethal overdoses caused by meth in that period, 54% also involved an opioid like heroin.

This is prompting alarm among those closest to the drug problem. Ron Greene has spent 30 years in the treatment field, and is the clinical director of the Narcotic Drug Treatment Center in downtown Anchorage, one of the state’s only methadone clinics.

“We see as much methamphetamine use here as we see opiate use in this clinic,” Greene said from behind his cluttered desk.

Greene forecasted the current heroin crisis as early as 2003, when he saw the drug of choice among people seeking treatment shifted away from prescription pills to potent black tar heroin. From his current vantage point, meth is “out of control.” Based on drug test results among people entering treatment, he estimates 60 to 70 percent of the people seeking care for opioid addiction also have meth in their system.

That overlap is consistent with what similar methadone clinics are seeing outside of Alaska, too.

“We’re seeing the exact same thing: Intravenous drug use, heroin, methamphetamine,” Greene counted off. “We’re seeing the same thing as our counterparts down there in the Lower 48.”

Across the country, meth has never been cheaper or more pure than it is right now. Over a decade ago, most meth in Alaska and across the Western states was manufactured in small domestic operations within houses, RV’s and apartments. But since federal legislation in 2006 limited access to many of the essential ingredients, production has moved abroad.

According to the most recent threat assessment from the Department of Justice and Drug Enforcement Agency, nearly all the meth arriving in the U.S. is made in industrial labs by drug cartels in Mexico. That production model has pushed quality and consistency way up,  even as prices have gone down. The U.S. market, according to the DEA, is awash in inexpensive, potent methamphetamine.

Lieutenant Jack Carson with the Anchorage Police Department says it has been a long time since they’ve seen a “mom’n’pop” meth operation.

“We just don’t see that that often any more,” Carson said, explaining that buying the finished product from Mexican or Lower 48 suppliers is significantly cheaper than trying to collect the necessary precursor ingredients in Alaska.

“What we are seeing is meth coming in bulk from the source states in Lower 48, coming into the mail system, then getting distributed down,” Carson added.

For suppliers who can get drugs into the state, Alaska is an exceptionally lucrative market. Street prices in Anchorage remain several times higher than in Lower 48 cities, both for meth and heroin, though the potency of both has risen. When drugs move out to smaller Bush communities or commercial fishing towns, the price goes up again.

Law enforcement agencies say the size of the shipments they’ve intercepted has risen significantly the last few years, too. Federal drug cases used to be built on one-pound shipments they interdicted. Now it is not uncommon to find five-pound packages being trafficked into Alaska.

Given the country’s widespread issues with addictive drugs, and minimal policy measures affecting the supply of meth, federal officials don’t anticipate the trend reversing any time soon.