Stimulant Summit | Quinones: P2P Methamphetamine Creating Complex Challenges

The rise of phenyl-2-propanone (P2P) methamphetamine over the past decade has devastated communities, damaged the minds of users, driven up homelessness, and confounded addiction treatment providers, Sam Quinones, author of “Dreamland” and the soon-to-be-published “The Least of Us,” told Cocaine, Meth & Stimulant Summit attendees in a session presented on Friday.

From the late 1980s into the 2000s, methamphetamine was made using ephedrine in a simple chemical process. Large factories and labs in Mexico produced quantities that spread west of the Mississippi River in the United States. In 2008, however, the Mexican government made ephedrine illegal for all but a few companies to possess. This sent traffickers down a new path for making methamphetamine, Quinones said.

A new, more complicated process involving the precursor P2P emerged. The chemicals required were found in common items, such as racing fuel, perfume, and photography and tanning products. By 2013, enormous quantities of P2P meth were being produced and sold at historic levels, and over the ensuing years, distribution spread to all corners of the US.

The new meth differed in a significant way from its ephedrine-based predecessor, Quinones said: Whereas the methamphetamine produced before 2008 made users want to socialize and stay up for days, P2P meth has driven its users in the opposite direction.

“I talk to people in many regions of the country and hear the same stories,” Quinones said. “It's no longer a party drug. People go inward. They don't want to talk to anybody. They speak in gibberish… hey talk about conspiracies, they see cheetahs are coming out of the walls. You can't apply normal processes of drug treatment to people you cannot connect with as human to human.”

Quinones said the intense mental impairment being caused by P2P meth is suspected to be the result of those producing P2P methamphetamine not properly cleaning toxic residues from what they are selling.

“Why should they?” Quinones asked. “If they do that, they'll have less weight. Less weight means less profit. For all intents and purposes, they just sell it as they make it. They don't care too much about that. The effect is, however, to create a whole new population of mentally-ill Americans, coast to coast.”

The mental impacts of P2P methamphetamine have created significant challenges for addiction treatment providers, who rely on connections with patients and human-to-human bonding. In many cases, it can take 4 to 5 months of detoxification before patients are ready to begin treatment in earnest.

Quinones said he believes much of the homelessness that preoccupies many parts of the country is rooted in the change in how methamphetamine is produced. And while decriminalization of drug-related offenses may have made sense in other instances, Quinones argued that because it can take nearly half a year to detox from P2P meth, decriminalization is not a solution to the growing problem. The COVID-19 pandemic has illustrated this, he said.

As jails released many inmates, concerned about the spread of COVID in confined spaces, “people were alone with the most dangerous, deadly, and mind-mangling drugs we've ever seen on the street,” he said. “That was essentially, as I said, an unplanned experiment in decriminalizing drugs. I don't think it really works.”

“Those folks are now out on the streets, and you have no way of connecting them. They have no break from the dope. No clean time from the dope. That is a very, very scary thing, given the nature of the drugs we have around today.”

Quinones said he has discussed with treatment center leaders how they are responding to the challenge. A program director in eastern Tennessee told Quinones that whereas in the past, her program kept patients for 6 to 9 months, they are now extending stays to 12 to 14 months.

Finding Signs of Hope

Quinones pointed to Portsmouth, Ohio, a town in the southern part of the state covered in each of his books, as an example of a community coming together to overcome an addiction crisis. While it still wrestles with setbacks, the city has become a hub for addiction treatment, and individuals have come from across the state to get clean and begin a new life, creating “economic vibrancy” and a culture in which those in recovery are moving forward.

“It's really fascinating,” Quinones remarked. “When you're addicted, you become like a fatalistic inert force in the town. … Once you are in recovery, it's almost like a new human being. New energy, new optimism, new gratitude for a second chance, maybe even a third or fourth chance. All these creative ideas begin to pop out, and particularly when people come together like that. That's what's happening down in Portsmouth. It's become a recovery scene.”

Reference

Quinones S. How an opioid epidemic became a meth epidemic, too: a conversation with author Sam Quinones. Presented at: Cocaine, Meth & Stimulant Summit; October 14-16, 2021; Virtual.