Meth is Pikeville's 'drug of choice.' It's epidemic, involved in 80% of arrests, and its addiction is harder to treat than opioid addiction.

Dwayne Kilburn messages with a meth dealer in Pike County.
(Photo by Alex Slitz, Lexington Herald-Leader)

Pikeville and Pike County are battling a resurgence in use of methamphetamine, reports Alex Acquisto of the Lexington Herald-Leader. The area has been ground zero for the opioid epidemic, but "a quieter crisis has emerged outside the limelight: meth. People here say meth, which is cheap and addictive, is more prevalent than opioids but gets far less attention," Acquisto writes.

"In Pikeville, at least eight out of every 10 arrests involve meth," according to Pikeville Police Sgt. Chad Branham, Acquisto reports. “I know everybody thinks Eastern Kentucky is the opioid capital of the world, but we don’t see a lot of opioids anymore,” Branham said. “There’s been a lot of laws that have cracked down on opioid use, prescriptions and stuff, so it’s harder to get. Meth is readily available. There’s just an abundance of it.” He said most users inject it; some still smoke it.

Acquisto's object example is Dwayne Kilburn, a veteran with a criminal record and a girlfriend who does meth. He told Acquisto he has used the drug twice, and “It makes me crazier than hell. ... You start seeing [stuff], hallucinating and stuff, you freak out in your mind, like I thought I was in hell. I seen the floor open up, fire, flames come around me, and I was cussin’ at the devil. This been back years ago, and I had to go to the hospital over it.”

Kilburn told Acquisto, “I got people right now on my Facebook trying to sell it to me,” then showed her how easy it would be, messaging a friend who replied, "How much you wanting?"

It's also easy to be a victim of meth. "Aside from fentanyl and its analogues, which played the biggest part in last year’s overdose deaths — 786 of the total, 1,333 — meth is the only other drug that grew in prominence across Kentucky," Acquisto notes. "Though the overall overdose rate dropped 15 percent, use of meth in overdose cases rose by nearly 20 percent. Nationwide, the U.S. Department for Health and Human Services reported that meth now outnumbers fatal fentanyl overdoses in at least a dozen states."

Meth's comeback in the region was illustrated by a three-state investigation that seized 800 pounds of meth this year, 360 pounds in Kentucky. The probe also looked at West Virginia and Tennessee. Meth has been the “drug of choice” for more than a year, Pikeville Police Chief Chris Edmonds said, but it is a “silent epidemic” that “we’re behind on again in Kentucky when it comes to education.”

"Silent in part," Acquisto writes, "because not many people in leadership positions are talking about it, and because its effects on the body are less acute than opioids. Opioids, which are a depressant, block the brain’s sensors that regulate the respiratory system, which makes death from overdosing an immediate risk. More potent fully synthetic opioids like fentanyl greatly increase this risk, and drugs like naloxone or Narcan, carried now by first responders across the state, can instantly reverse its effects."

Acquisto offers more information on meth: "There’s a much lower chance of fatal overdose from meth, unless its used with opioids. A cocktail of poisonous substances, meth is a stimulant that attacks the central nervous system and corrodes one’s body over time, making it much less visible when compared with a drug as lethal as fentanyl, which can kill someone in very small doses.

"Meth abuse can also be harder to treat than other substance use disorders. Unlike opioids, meth induces a state of mind similar to psychosis. Hallucinations, paranoia and erratic behaviors are common side effects. To outsiders, these symptoms can be interpreted as mental illness, said several health and law enforcement officials interviewed for this story, making it difficult for medical providers to discern what the best course of treatment might be. What’s more, while it’s widely believed that medication-assisted treatment is the best way to treat opioid use disorder, there’s no . . . approved drug to treat meth addiction."