While the opioid crisis is at the forefront of the conversation about drug abuse in Pennsylvania, another much different drug has found its way into rural areas of the state — including central Pennsylvania — and adds another facet to problems of drug addiction.

Methamphetamine, including the lab-created, more potent and pure crystal methamphetamine, is showing up on the streets of Blair and surrounding counties in an abundance not seen before, say area law enforcement.

It was a large-scale crystal methamphetamine trafficking case that brought Attorney General Josh Shapiro to Clearfield County last week.

“I see this as a serious and emerging threat,” Shapiro said after a press conference announcing additional charges against suspected key players in what investigators say was a pipeline between Akron, Ohio, and Clearfield County that pumped $1.5 million of the drug into the rural county during the 11-month investigation.

Shapiro stressed his office will continue to investigate and prosecute “anytime someone injects poison into communities,” whether it’s opioids or drugs such as meth.

“Crystal meth and meth are increasingly on the rise in rural communities,” Shapiro said.

Shapiro said its rural communities in the northwest and central parts of the state that are seeing more and more methamphetamine use, and while that’s concerning, the drug also carries with it the added danger of clandestine labs.

Shapiro said people can expect more busts and continued cooperation between his office and local and state police to address the problem.

The Clearfield County case is one of two major investigations undertaken by the Attorney General’s Bureau of Narcotics Investigation and Drug Control. The other is a $1.6 million meth ring in northwest Pennsylvania, and last year agents seized close to 500 pounds of the drug.

In Blair County, meth isn’t new, but police are seeing more of the powerful stimulant in the past year, Blair County First District Attorney Pete Weeks said last week.

“We have seen a resurgence in cocaine to some degree, but a large amount of methamphetamine is being used and trafficked in the area in the past year,” Weeks said, noting that much of that is among opioid users who are on maintenance drugs such as Suboxone.

It brings with it a couple of problems, Weeks said.

“The problem we are facing is, medically-assisted treatment we can use with someone with a heroin or opioid addiction doesn’t work on meth — which is a stimulant,” Weeks said.

Users unpredictable

Another problem is the unpredictable nature of methamphetamine users. Dealing with someone who is high on drugs, possibly paranoid or suffering the effects of psychosis and who hasn’t slept in three or four days makes for a volatile situation for police, ambulance personnel, emergency room workers or just members of the general public, Weeks noted.

It’s 10-fold the problem of dealing with heroin or opioid users, who are usually not aggressive unless they are sick and needing to use again. Even then, those types of drug users generally commit crimes to get more drugs to keep from getting sick whereas meth users can be quite aggressive.

“When they’re coming off that high, they’re wired, aggressive and they’re paranoid, and they’re doing whatever they can to get back the high,” Weeks said. The potential for violence is much higher than in a police encounter with heroin and opioid users, he added.

Weeks said what police are seeing now is not like the meth that popped up in Blair County in the last decade, the product of a handful of users making the drug with the “one pot” method in small, clandestine labs.

Weeks said today it’s crystal methamphetamine made in labs in other countries and trafficked into the area, often through the mail.

As opioid users move on to meth, questions remain about the long-term affects this could have on the community and that makes the need to find a long-term solution even more critical, Weeks said.

“There’s no pill for meth,” he added.

That is why to physicians, such as Altoona’s Dr. Zane Gates, treating opioid addiction with maintenance drugs is not a solution.

“We all know methadone is a bad idea,” Gates said last week. While drugs such as methadone and Suboxone address the symptoms of opioids — such as staving off withdrawal and helping reduce crime associated with desperate users trying to keep from getting sick, maintenance drugs don’t solve the core problem of addiction.

“Addiction is a disease,” Gates said. “Most of these folks don’t produce enough dopamine. It isn’t the substance. It’s the people with the disease.”

It’s the release of dopamine — that chemical in the brain that produces the feeling of pleasure — that drives addiction, Gates said. So people with an addiction problem no longer getting a high from one drug, either because it’s not available or because they are taking a medication that negates the effects, then turn to another drug or even something else.

“If it wasn’t that, it would be gambling,” Gates said. “They’re not getting dopamine so they’ll do whatever they can get their hands on.”

Chasing the buzz

“It’s chasing the buzz,” Gates said, pointing to the neuropathy and seizure drug gabapentin as an good example. In high doses, the drug can get a person high. It’s also cheap, sometimes even free, and it’s not hard to obtain for the motivated drug seeker.

“The substance doesn’t matter,” Gates said. “Again, it’s if it is available.”

But it’s the way the drugs work in the long term that can have devastating effects because building up tolerance to a drug means it takes more and more to chase that dopamine release in the brain.

“That’s how they overdose,” Gates said. He pointed out that a relapsing user is the most likely victim of an overdose because they try to go back to the levels of the drug they used before they stopped.

This underscores the idea that tackling addiction is a long-term process.

“It’s no different than treating diabetes,” Gates said. “We’ve got to treat it like we treat diabetes. It never goes away, like diabetes.”

Like diabetes, it takes people changing their behaviors and seeking that euphoria they get from drugs somewhere else. Gates admits there is a “certain subset that don’t do well no matter what you do.”

The reality is that is a small percentage of people who face addiction, he said.

Those who want to overcome substance addiction, simply have to live a substance-free life, he said.

Getting there takes an individualized approach, noted Judy Rosser, executive director of Blair County Drug & Alcohol Partnerships Inc.

The Blair County organization’s role is not treatment, but matching people with the treatment that will work best for the person. Part of that process is an intake interview, which gives Rosser and her colleagues an ongoing view into the trends and habits of drug users in the area.

Rosser said they started noticing more meth use in 2017 and it’s intensified in the past year.

Access key to choice

“The biggest risk in all substance abuse is access,” Rosser said. “With the patients we’re seeing, this is just what they have access to.”

The effects of meth and opioids are much different. Meth and other forms of speed are stimulants while heroin and other opioids are depressives. Rosser pointed out they’ve been told by some users that they don’t like the feeling they get from meth as compared to heroin.

With meth, there’s both short-term and long-term effects on the brain that have to be considered when a person stops taking the drug.

“It takes some time after coming off methamphetamine to get the brain stabilized again,” Rosser said. “It’s an extremely toxic drug.”

Treatment for methamphetamine abuse includes more than abstinence and should involve a psychiatric evaluation to make sure the person isn’t suffering from any conditions such as any lasting psychosis or depression brought on by detox, Rosser said.

But addressing the problem is a very individualized process, and Rosser said anyone suffering from substance abuse problems should contact Blair County Drug & Alcohol Partnerships, either on its website at www.blairdap.org, or by calling the Fairview Drive office at 381-0921.

“It’s really about body, mind and spirit,” Rosser said of the recovery process.

Mirror Staff Writer Greg Bock is at 946-7458.