Opioid deaths are still rising. Methamphetamine deaths are now rising faster in Spokane, says UW researcher

While fentanyl addiction and overdoses continue to plague Eastern Washington, those addicted to meth need more attention and services.

According to University of Washington researcher Caleb Banta-Green, an aging population of methamphetamine users who have been on the drug for many years are now seeing the long-term consequences.

“Health impacts of methamphetamine accumulate over time, and I think that’s really leading to what we’re seeing in terms of the increase of methamphetamine-related deaths,” the Seattle-based researcher said at a Spokane lecture on the health impacts of methamphetamine and fentanyl this week. “Spokane has long been one of the highest rates of overdose deaths. It continues to be one of the highest rates of overdose deaths for methamphetamine, but we don’t really talk about it.”

Opioid and fentanyl use is much higher than methamphetamine. But deaths related to methamphetamine have increased at a higher rate during the past 20-plus years .

According to Washington state Department of Health data, about 31 per 100,000 Washington state deaths involved opioids from 2002 to 2024. During the same period, only 24.7 per 100,000 Washington state residents’ deaths involved meth. But while opioid-related deaths increased by 438% statewide from 2002 to 2024, methamphetamine-related deaths increased by 1,524%.

That effect is even more pronounced in Spokane County. Opioid-related deaths have increased by 288% in that 20-year period, but methamphetamine-related deaths have increased by 1,660% in the county.

Much of the increase in deaths attributed to meth is not driven by an increase of meth users. Rather, users of the drug who have been on meth for a decade or more are suffering the consequences of long-term use .

Spokane psychiatrist Dr. Amy Burns said those experiencing addiction are often misunderstood by the public.

“A lot of times people think, ‘Why don’t you just stop using. They should just try harder.’ But it is a part of the diagnostic criteria that you have an inability to do that. If you were able to do that, you wouldn’t have the use disorder,” she said.

Often, meth users are not dying from an overdose, rather an underlying heart condition that is being exacerbated by drug use.

“Methamphetamine use is a longer trajectory. It’s further back in time than opioid use. Some of these folks who are dying may well have started using 20 or 25 years ago, and their heart just can’t take it anymore,” Green said.

“It’s not actually an overdose. It’s not more drug than the body could handle that day. It’s quite often the cumulative effects have caught up with that person that day,” he said.

That is not the case for fentanyl. Most fentanyl deaths occur from an overdose occurring in the minutes after drug usage. While that does create an immediate crisis, it means the relatively slow-moving effects of meth addiction can be left unseen until it is too late.

“This matters because if you want to prevent (methamphetamine) deaths, you have to go upstream, providing primary care and heart health,” he said.

Green stressed that he does not believe fentanyl has gotten more attention than it deserves – just that public health needs a greater focus on methamphetamine to match that seen for the fentanyl crisis.

“There’s some people have used for 10 or 20 years, and there’s a lot of them in Spokane, and it’s catching up with them.”