There was a time when methamphetamine, an addictive stimulant with high harmful potential, was legal and used for everything. In Germany, under the trade name Pervitin, it was used by secretaries to type faster, new mothers to combat postpartum depression, truckers to be more alert on the road, and even by the Nazi army to take over France in the well-known Blitzkrieg . the Blitzkrieg In Germany in the 1930s, methamphetamine was “a kind of anti-drug intended to replace all toxic substances,” explains writer Norman Ohler in his work The Great Delirium. Hitler, Drugs and the Third Reich. “A kind of panacea,” he says, which was good for a tear and a tear. “It doesn’t matter: no matter what hurts, the Germans always used the small blue, white and red tube of Pervitin,” says Ohler. With this – or thanks to him – the Nazis even almost won the Second World War.
Today, methamphetamine is considered one of the most dangerous and destructive drugs, second only to heroin and crack: It is a very powerful synthetic stimulant that can produce high levels of addiction and severe cardiac and psychotic disorders. Pervitin no longer exists, but in practice this substance continues to circulate on the streets, in the form of powder, pills or small crystals, which are usually inhaled, smoked or injected. In fact, the same drug that appealed to Hitler’s troops across Europe almost a century ago has now sparked concern in the old continent’s health authorities. A report by the European Monitoring Center for Drugs and Drug Addiction (EMCDDA) last year warned that “the user market in Europe is relatively small but could grow”.
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All radars are pointing in that direction. Given “the growing threat posed by this drug in the Region, as availability increases and use spreads to new areas,” the EMCDDA warned. Emailing EL PAÍS, Andrew Cunningham, head of Markets and Crime at the EMCDDA, insists that methamphetamine is “the most commonly used synthetic stimulant in the world,” and although “compared to Asia, North America and Australia, Europe still is a relatively small market, there are concerns that it could grow here.”
Historically, its use has been concentrated in the Czech Republic and Slovakia, but there are “signs of increasing use in some countries,” Cunningham says. A study of European urban wastewater released Wednesday reported an increase in methamphetamine occurrences beyond its traditional strongholds: it is also present in Belgium, eastern Germany, Spain, Cyprus and Turkey, as well as several countries in northern Europe. “Of the 60 cities with data for 2021 and 2022, nearly two-thirds (39) reported an increase in waste,” the report said.
Data from monitored drug consumption rooms in Barcelona and Oslo, for example, have reported increases in methamphetamine use. “In Athens there were also reports of a growing problem of Sisa (crystal methamphetamine) use,” adds the EMCDDA expert. Between 2015 and 2020 there has also been an increase in reported crimes for possession or use of this substance.
Another radar, entry into addiction treatment, reflects that while requests for help for methamphetamine addiction are low compared to other substances, there has been “a gradual increase” since 2015 in most countries with available data, the expert says. This year, with data from 14 countries, 637 people started treatment for the substance; In 2020 it was 25% more: 797 people.
Methamphetamine is considered one of the most dangerous and destructive drugs, behind only heroin and crack.
In an EMCDDA webinar a few weeks ago, some researchers from Barcelona analyzed the situation observed in the city: although use is still in the minority compared to other drugs, methamphetamine continues an upward trend. “It was mainly discovered in Madrid and Barcelona. This does not mean that methamphetamine is not available in other cities, but Barcelona, for example, has implemented wastewater analysis since 2011 and this allows for monitoring [sustancias]: From 2017 and 2018 we are seeing a slight increase in the use of methamphetamine in very specific populations,” said Ester Aranda, attendee at this conference and staff member of the Drugs and Health Division Directorate of the Well-Beings and Development Association (ABD). His company manages one of the largest drug addiction treatment centers in the city, the CAS Baluard of the Barcelona Public Health Agency (ASPB).
The more – and better – you search, the more you will find. The ASPB has all its alert systems active to detect any movement, and has already seen a slight increase: in 2016, 31 people in the city started drug addiction treatment for methamphetamine; in 2021 there were 133. Among harm reduction services, the ASPB has had a program for the use of whistles for inhalation use in Baluard since 2019, this is how most reported users in Barcelona take methamphetamine. In 2021, the ASPB registered around 3,000 accesses to monitored use rooms — the same person can enter multiple times — for methamphetamine. That’s 6% of the total submissions. In 2022 it was 6.6%: 3,900 hits to consume this substance.
“If we look at all the people who come to use, methamphetamine accounts for a very small proportion, but our duty is to always act on a preventive level,” defends Montse Bartroli, head of drug addiction awareness at the ASPB. You must prepare. Especially given the precedents in other countries where methamphetamine overdose death statistics paint a brick wall, it is the ascending line of exponential growth that worries public health experts.
In the United States, which has plunged into a deep opioid overdose crisis, a study of methamphetamine-related deaths between 1999 and 2021 reports an “unprecedented increase” in deaths: in two decades, there were around 135,000 deaths and about 43 % of these deaths also involved heroin or fentanyl.
devastating drug
Despite the fame he gained from his role on Breaking Bad, in which chemistry professor Walter White cooked up kilos of the drug in an old trailer, methamphetamine is devastating. For physical and mental health. “It’s a very powerful stimulant. Easily crosses the blood-brain barrier [que protege al cerebro] and has a dopamine-releasing effect. It causes acceleration, energy, euphoria… But there is a risk of psychotic outbursts and these, unlike other substances, can be prolonged over time. Some are diagnosed with schizophrenia because the symptoms persist,” explains Rosa Sauras, a psychiatrist at the Dual Pathology Unit at the Hospital del Mar in Barcelona.
They colloquially call it tina, chalk, crank, meth, or shabú; or ice, crystal, glass, ice or crystal meth when in the form of crystals. According to the National Drug Plan monograph, this substance causes short-term loss of appetite, increased heart and breathing rates, and psychiatric effects such as paranoia, anxiety, insomnia, panic attacks, and aggressive behavior. In the long term, in addition to the addiction, psychiatric symptoms such as optical and acoustic hallucinations or delusions, which persist for a long time or can recur in stressful situations, also increase.
At Hospital del Mar, for several years, they have observed an increase in admissions to the emergency room for overdose, cardiac or psychiatric problems related to methamphetamine use. “In psychiatry we provide care in three devices. In the treatment center for drug addicts we see a slow increase and it is difficult for them to ask for help. Through the counseling service, we see patients who are admitted to other areas of the hospital, such as cardiology for cardiomyopathies, and who report to us because they have a consumption disorder. In the dual pathology department, we have those who are admitted from the psychiatric emergency room because of hallucinations or psychotic episodes and there are symptoms that do not resolve,” warns Sauras. In this department, they’ve gone from a few meth-associated patients a year to two a month.
We have those who come in from psychiatric emergencies because of hallucinations or psychotic outbursts, and there are images that don’t resolve.
Rosa Sauras, psychiatrist at Hospital del Mar
There is no defined consumer profile. It’s heterogeneous and has changed over the years, Sauras points out: “When the cases started coming in in 2016, we saw it in people from the Filipino community who smoked in connection with work to endure more work.” Now there is also traditional users of other substances that combine them with methamphetamine, and on the other hand chemsex users, a phenomenon that affects almost exclusively the group of men who have sex with other men and is characterized by the conscious use of drugs over one have sexual intercourse for a long period of time. It can be associated with recreational contexts or very vulnerable environments such as people living on the streets.
Researchers at the Hospital Clínic de Barcelona analyzed the effects of methamphetamine on the mental health of chemsex users in a study: out of fifty patients, 80% went to the addiction department for using the drug, and the majority used it while smoking; more than a third of the participants had psychotic symptoms. “Barcelona is one of the cities with the greatest influence on chemsex and methamphetamine is one of the most prevalent drugs. Its use has spread through chemsex,” contextualizes Lorena de la Mora, a signatory of the study. Now, he adds, they are “seeing the consequences of prolonged methamphetamine use [en contextos de chemsex]such as psychotic disorders and mental deficits and the neurotoxicity that this substance can leave behind,” he warns.
attack the offer
The therapeutic approach is complex. First of all, because “there is no specific drug treatment,” admits Sauras. And it is not easy for her to comply with therapy: “The person comes to the hospital in full decompensation, and the connection to the treatment center is very difficult. In the Filipino community, for example, consumption is heavily stigmatized, there are language barriers and ignorance of the healthcare system doesn’t help either,” explains the psychiatrist from Hospital del Mar.
Adhering to the care resource is key, Bartroli stresses, and it is important to “work on the professional connection”: “From the area of harm reduction, we do prevention: we prevent compulsive and unsafe use and we try to work with the person so that when you are prepared, you can begin a treatment process. Aranda assures that the work infrastructure in Barcelona is “prepared” for the increase in cases and, he admits, gives him “calm”.
The other area to stop this phenomenon is the “attack on supply,” Bartroli concludes. And it is in this area, according to Cunningham, that there are worrying signs. “Europe is a destination and transit area for methamphetamine, which is made in other production centers like Iran, Nigeria and, more recently, Mexico,” he explains. Industrial-scale production of the drug in Europe has grown and become more sophisticated, and the development of methamphetamine production capacity in Afghanistan, Europe’s main heroin supplier, also poses “a potential threat” to the EU, the expert warns.
If it continues to rise, methamphetamine could become a huge snowball of problems, with very serious health consequences, “the possibility of an increase in serious violence, the spread of organized crime, corruption and money laundering,” Cunningham lists. Although there is no data on how this phenomenon will develop, the expert is not very optimistic: “There is reason to believe that its use could spread to a larger number of people and to a diverse group of users, with serious consequences for the health and safety of Europeans”.
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