美国国家公共电台 NPR As Meth Use Surges, First Responders Struggle To Help Those In Crisis

 

RACHEL MARTIN, HOST:

While health officials have been focused on the opioid crisis in this country, another drug epidemic¹ has emerged. Overdose deaths from methamphetamine have more than doubled in recent years. Treatment admissions are up, and some law enforcement officials around the country say meth is their biggest drug problem. From member station KQED in San Francisco, April Dembosky reports.

APRIL DEMBOSKY, BYLINE²: One of the main things police are responding to in the meth crisis are psychiatric emergencies.

(SOUNDBITE OF MONTAGE)

UNIDENTIFIED 911 OPERATOR #1: San Francisco, 911.

UNIDENTIFIED PERSON #1: Yeah, I got a white male acting³ crazy. He made threats to...

UNIDENTIFIED PERSON #2: An African American woman was just walking barefoot along Mission Street...

UNIDENTIFIED PERSON #3: There's a black guy outside. He's cursing.

UNIDENTIFIED PERSON #2: ...Going into traffic, stopping buses.

UNIDENTIFIED 911 OPERATOR #2: OK.

UNIDENTIFIED PERSON #3: He's mentally ill.

UNIDENTIFIED 911 OPERATOR #2: OK.

UNIDENTIFIED PERSON #3: He's manic, and he's banging on the window.

UNIDENTIFIED PERSON #2: She just punched somebody a minute ago.

DEMBOSKY: San Francisco received more than 19,000 calls like these last year reporting people on the streets who look mentally disturbed. Thousands of those people get picked up and taken to psychiatric emergency at San Francisco General Hospital. But a lot of them are not mentally ill. They're high on meth.

ANTON NIGUSSE BLAND⁴: They're often paranoid. They're thinking that someone might be trying to harm them. Their perceptions are all off.

DEMBOSKY: Psychiatrist⁵ Anton Nigusse Bland says almost 50% of their psych emergencies are for meth-induced psychosis - 50%.

NIGUSSE BLAND: They can look so similar to someone that's experiencing chronic⁶ schizophrenia. It's almost indistinguishable.

DEMBOSKY: The main way to tell the difference is to wait 12 to 16 hours for the meth to wear off. No more psychosis.

NIGUSSE BLAND: Their thoughts are more organized. They're able to maintain adequate clothing. They're eating. They're communicating. They're able to advocate for themselves. The improvement in the person is rather dramatic because it happens so quickly.

KIM: Meth causes people to act, I mean, like, totally insane.

DEMBOSKY: This is Kim. She first started using meth 20 years ago.

KIM: I mean, it's crazy what people think and what people - you accept as normal.

DEMBOSKY: There was one day last year when Kim went wine tasting with a friend in Sonoma County.

KIM: I was on Xanax and speed.

DEMBOSKY: She and her friend got into an argument in the car. Kim thought someone was following them. She was utterly⁷ convinced she was being chased, and she had to get away.

KIM: He pulled over, and I jumped out the car and started running. And I literally⁸ ran a mile. I had poison oak from head to toe. I had bruises⁹, cuts. I went through water. I went up a tree. And I was literally running for my life. In my head, I was running for my life.

DEMBOSKY: Kim was soaking wet when she walked into a woman's house, woke her from bed and asked for help. When the woman went to call the police, Kim left and found another woman's empty guesthouse to sleep in, Goldilocks-style. Kim says she just wanted to get warm.

KIM: But then I woke up and stole her car.

DEMBOSKY: That's how Kim ended up in jail, and that's why she asked us not to use her last name. She's out now and in a treatment program. She's part of the steady rise in people seeking help from meth addiction¹⁰ throughout the western U.S.

But policymakers along the East Coast haven't kept up. All they see in their backyard are opioids, and so that's where the funding and attention goes. That's according to Steve Shoptaw, an addiction psychologist in Los Angeles. He says, in his practice, he hears one story after another about meth destroying people's lives.

STEVE SHOPTAW: But when you're in D.C., or where people are making decisions about how to deploy¹¹ resources, those stories are very much muffled¹² by the much louder story about the opioid epidemic.

DEMBOSKY: Even within drug treatment circles, where you think everyone would be on the same side, advocates who focus on opioids are afraid their achievements will be threatened if meth advocates demand too much.

SHOPTAW: Bottom line is, as Americans, we have just so much tolerance¹³ to deal with addiction. And if the opioid users have taken that tolerance, then there's no more.

DEMBOSKY: One of the main problems is there are no medication treatments for meth the way there are for opioids. There is a behavioral therapy, something called contingency¹⁴ management. Basically, every time users pee in a cup and test negative for meth, they get paid. It works, but it's controversial. And most insurers, including California's Medicaid program, refuse to cover it.

(SOUNDBITE OF BEEP)

UNIDENTIFIED PERSON #4: Two.

DEMBOSKY: So San Francisco County uses its own money to pay for the 12-week program here at the San Francisco AIDS Foundation. It's focused on men in the gay community, where meth has long been a popular party drug. Program manager Rick Andrews says, these days, he's surprised by who's coming in.

RICK ANDREWS: Older gentleman who maybe they grew up in a time of HIV and AIDS initially¹⁵, right? And maybe they led very safe lifestyles, and now they're older.

DEMBOSKY: And things are different with HIV. There's treatment. There's a prevention pill.

ANDREWS: They feel like they've missed out. And they want to have a little fun and make up for lost time, maybe.

DEMBOSKY: This idea of the aging meth user, it's one of the possible explanations for the steep rise in methamphetamine-related deaths. Dr. Phillip Coffin¹⁶ directs substance use research at the San Francisco Department of Public Health. He says most speed deaths are from brain hemorrhage or a heart attack. And that would be highly unusual for a 20-year-old.

PHILLIP COFFIN: Because your tissue's so healthy at that age. Whereas when you're 55 years old and using methamphetamine, you might be at higher risk for bursting a vessel¹⁷ and bleeding and dying from that.

DEMBOSKY: But other people are dying because their meth is contaminated with fentanyl, a synthetic¹⁸ opioid. Most researchers believe this is accidental. The same table or scale that was used to cut fentanyl was later used to package meth. Health officials are now distributing fentanyl test strips to meth users as well as naloxone, the nasal spray that can reverse an opioid overdose. They're telling meth users to carry it just in case. For NPR News, I'm April Dembosky in San Francisco.

1 epidemic   

n.流行病；盛行；adj.流行性的，流传极广的

参考例句：

• That kind of epidemic disease has long been stamped out.那种传染病早已绝迹。
• The authorities tried to localise the epidemic.当局试图把流行病限制在局部范围。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 acting   

n.演戏，行为，假装；adj.代理的，临时的，演出用的

参考例句：

• Ignore her,she's just acting.别理她，她只是假装的。
• During the seventies,her acting career was in eclipse.在七十年代，她的表演生涯黯然失色。

4 bland   

adj.淡而无味的，温和的，无刺激性的

参考例句：

• He eats bland food because of his stomach trouble.他因胃病而吃清淡的食物。
• This soup is too bland for me.这汤我喝起来偏淡。

5 psychiatrist   

n.精神病专家；精神病医师

参考例句：

• He went to a psychiatrist about his compulsive gambling.他去看精神科医生治疗不能自拔的赌瘾。
• The psychiatrist corrected him gently.精神病医师彬彬有礼地纠正他。

6 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。

7 utterly   

adv.完全地，绝对地

参考例句：

• Utterly devoted to the people,he gave his life in saving his patients.他忠于人民，把毕生精力用于挽救患者的生命。
• I was utterly ravished by the way she smiled.她的微笑使我完全陶醉了。

8 literally   

adv.照字面意义，逐字地；确实

参考例句：

• He translated the passage literally.他逐字逐句地翻译这段文字。
• Sometimes she would not sit down till she was literally faint.有时候，她不走到真正要昏厥了，决不肯坐下来。

9 bruises   

n.瘀伤，伤痕，擦伤( bruise的名词复数 )

参考例句：

• He was covered with bruises after falling off his bicycle. 他从自行车上摔了下来，摔得浑身伤痕。 来自《简明英汉词典》
• The pear had bruises of dark spots. 这个梨子有碰伤的黑斑。 来自《简明英汉词典》

10 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

11 deploy   

v.（军）散开成战斗队形，布置，展开

参考例句：

• The infantry began to deploy at dawn.步兵黎明时开始进入战斗位置。
• The president said he had no intention of deploying ground troops.总统称并不打算部署地面部队。

12 muffled   

adj.（声音）被隔的；听不太清的；（衣服）裹严的；蒙住的v.压抑，捂住( muffle的过去式和过去分词 )；用厚厚的衣帽包着（自己）

参考例句：

• muffled voices from the next room 从隔壁房间里传来的沉闷声音
• There was a muffled explosion somewhere on their right. 在他们的右面什么地方有一声沉闷的爆炸声。 来自《简明英汉词典》

13 tolerance   

n.宽容；容忍，忍受；耐药力；公差

参考例句：

• Tolerance is one of his strengths.宽容是他的一个优点。
• Human beings have limited tolerance of noise.人类对噪音的忍耐力有限。

14 contingency   

n.意外事件，可能性

参考例句：

• We should be prepared for any contingency.我们应该对任何应急情况有所准备。
• A fire in our warehouse was a contingency that we had not expected.库房的一场大火是我们始料未及的。

15 initially   

adv.最初，开始

参考例句：

• The ban was initially opposed by the US.这一禁令首先遭到美国的反对。
• Feathers initially developed from insect scales.羽毛最初由昆虫的翅瓣演化而来。

16 coffin   

n.棺材，灵柩

参考例句：

• When one's coffin is covered,all discussion about him can be settled.盖棺论定。
• The coffin was placed in the grave.那口棺材已安放到坟墓里去了。

17 vessel   

n.船舶；容器，器皿；管，导管，血管

参考例句：

• The vessel is fully loaded with cargo for Shanghai.这艘船满载货物驶往上海。
• You should put the water into a vessel.你应该把水装入容器中。

18 synthetic   

adj.合成的，人工的；综合的；n.人工制品

参考例句：

• We felt the salesman's synthetic friendliness.我们感觉到那位销售员的虚情假意。
• It's a synthetic diamond.这是人造钻石。