Aug. 15 (UPI) -- Roughly four of five people using drugs in rural parts of the United States are taking methamphetamines, possibly laced with fentanyl, a study published Monday found.
The researchers from Oregon Health & Science University said it's important not to overlook rural America's problem with this stimulant, which when used with opioids greatly increases the risk of overdose.
The study, published in JAMA Network Open, concludes that while drug overdoses continue to rise in the United States, the contribution of methamphetamine use is understudied in rural communities.
The findings come on the heels of Northwestern University research released July 28 that warned of imminent "mass death" in the opioid crisis. The investigators said they anticipate the most significant spike yet in overdoses from polydrug abuse, which often involves mixing synthetic opioids with stimulants such as cocaine -- and methamphetamines.
The new study also follows recent warnings from two major federal health agencies about widely prescribed pain drug gabapentin's link to fatal opioid overdoses.
The study, which encompassed rural communities in 10 states, found that 79% of people using drugs reported methamphetamine use in the past 30 days.
The scientists also found that non-fatal drug overdosing occurred most in people using both methamphetamine and opioids, as compared to opioids or methamphetamine alone.
Overall, 22% of individuals using both drugs reported experiencing an overdose in the past six months.
By contrast, 14% of those using opioids alone, and 6% of those using methamphetamine alone, reported experiencing an overdose in the past six months.
Yet the people using both substances reported the least access to treatment.
Overall, 40% of all survey respondents reported trying but failing to get treatment in the previous six months. Among those using both methamphetamines and opioids, even more -- 44% -- could not access treatment.
The investigators said the study's findings suggest that strategies for harm reduction and substance use disorder treatment must address methamphetamine use as well as opioids to decrease drug overdoses in rural communities.
"Among people who use drugs in rural communities, methamphetamine use is pervasive," Dr. Todd Korthuis, professor of general internal medicine and geriatrics at Oregon Health & Science University's School of Medicine, said in a news release.
Added Korthuis, who is also head of addiction medicine at the university: "This has been a West Coast problem for a long time, but now we see methamphetamine use in rural communities across the United States."
He said people may think they're using only methamphetamine when they're unknowingly taking illicit fentanyl -- a synthetic opioid 50 to 100 times stronger than morphine, according to the Drug Enforcement Administration.
Korthuis noted that naloxone can reverse fentanyl overdose, but is rarely given to people using methamphetamine. And he called for naloxone distribution to be expanded to people using methamphetamine.
The researchers said economic distress factored in to the problem, noting that 53% of the study's survey respondents reported being homeless in the previous six months.
This increases the risk of so-called "deaths of despair," meaning drug overdose deaths, suicide and disease linked to drug and alcohol use, the investigators said. And rural communities have been hard hit by them.
A total of 3,048 people participated in the Rural Opioid Initiative study from January 2018 through March 2020.
The survey enrolled participants in rural areas with high overdose rates in Illinois, Kentucky, Massachusetts, New Hampshire, North Carolina, Ohio, Oregon, Vermont, West Virginia and Wisconsin.
