Los Angeles has seen a recent spate of knife attacks and other crimes, with suspects not just violent but also behaving oddly in ways that the public often attributes to mental illness, but experts say are symptomatic of something else entirely.
Methamphetamine.
Methamphetamine use is no secret: The highly addictive stimulant is a popular culture staple in movies (“Winter’s Bone”) and TV (“Breaking Bad”), but when authorities talk about the devastating effects of controlled substance abuse, they typically focus on fentanyl, a powerful opioid.
It’s the fentanyl that pretentious politicians falsely claim is in Halloween candy and can be deadly on skin contact (it’s not, and can’t be), that’s the fentanyl that’s flooding our streets across our porous southern border (true, but generally hiding in legal travelers and cargo, not among people crossing into the US illegally), and that’s the target of numerous bills in state legislatures aimed at cracking down on drug crimes through increased penalties.
In contrast, lawmakers have focused little on illegal methamphetamine, and in Los Angeles, they rarely talk about methamphetamine’s effects on public safety and health, including psychosis that resembles serious mental illness. There is a widespread, erroneous belief among users that possession and use of the drug is as legal as marijuana and less dangerous. Some law enforcement officials and doctors also mistakenly believe that the law permits methamphetamine use.
Historically a drug of choice for white biker gangs and unemployed men in the desert and Central Valley, it has exploded among high school students in Los Angeles and the Inland Empire who use it to concentrate on studying for exams, housing complex dwellers who appreciate its extremely low cost and ready availability, and homeless people who want to stay up all night to ward off attacks. Use among all socioeconomic groups has expanded substantially in the past decade, according to the National Institutes of Health and other public health watchdogs.
Aside from the occasional bust, like last month when cleaners found 235 pounds of methamphetamine at an Airbnb in Alhambra, methamphetamine rarely gets as much news coverage as fentanyl. But it does slip into discussions from time to time, like the early-morning break-in at Mayor Karen Bass’ official residence on April 21, in which police and drug-use experts said the intruders’ behavior was typical of someone in a methamphetamine crisis.
And indeed, the suspect, Ephraim Matthew Hunter, told reporters that he was in the midst of a five-day methamphetamine bout, paranoid, and looking for a place to hide from imaginary pursuers. He later said that it was just a coincidence that the house he broke into was the mayor’s residence; if it was, it could have been any house. There is no basis to claim that all of these break-ins, or the attacks on bus drivers and subway passengers, involved methamphetamine, but it would be naive to claim that none of them did.
LA has a serious methamphetamine problem, and it’s time to talk about it openly, clearly, and publicly — at least not to the extent that we discuss fentanyl, mental illness, COVID-19, or even measles.
Why hasn’t this been talked about yet? There are a number of possible reasons. Methamphetamine seems like less of a concern than fentanyl, which is deadly immediately upon ingestion. That’s rarely the case with methamphetamine. Rather than sudden death from an overdose, long-term methamphetamine users simply collapse, lose their teeth, suffer heart and other organ failure, and their behavior changes. Without sudden death, methamphetamine use may not seem like such an emergency.
Maybe the reason not much is talked about about methamphetamine is because there are few easy ways to deal with it: There is no treatment like naloxone, which can temporarily reverse an overdose from fentanyl or other opioids, and there is no suboxone, which can quell opioid cravings and treat addiction.
Or maybe it’s because the treatments we have now are so controversial: Contingency management is an incentive-based program that has had some short-lived but definite success, but rewarding recovering drug users for every day they test free makes it less appealing to critics who want more traditional treatments and harsher penalties.
Or maybe it’s because officials recognize how inadequately Los Angeles and other jurisdictions responded to the crack epidemic of the 1980s and 1990s, and are concerned about repeating the same mistakes: investing too heavily in arrest and incarceration to combat a dangerous public health crisis, and not enough in treatment and economic development, multiplying the social destruction caused by drugs.
Or maybe the conversation, if it takes place at all, too often falls into ideological extremes: One camp argues that most of Los Angeles’ homeless population is on the streets because of drug use, while others are equally adamant that homelessness is solely a matter of housing costs and has little to do with drug-induced impairment, while many homeless users say they turned to drugs when they moved to the streets, where methamphetamine is plentiful and cheap.
Either way, as stimulant use becomes more widespread and affects more people’s lives, the debate can no longer be avoided. Los Angeles County has significant programs to help stimulant users, but they don’t always complement each other well. A four-year-old program aimed at raising awareness has been slowed by COVID-19.
Last week, the Board of Supervisors approved Lindsay Holbert’s request for a report on public health, mental health and other officials’ response to stimulant use. This is a welcome step. But in what is all too typical of county practice, officials were given 90 days to respond. Los Angeles needs to have a greater sense of urgency in understanding and addressing its stimulant problem.