The New Mexico Legislative Finance Committee recently published a study that presented two (2) key findings: 1) That drug and alcohol related deaths were at an all-time high in 2020; and, 2) That access to treatment resources has tripled in the last five (5) years. The study concluded that, while treatment is accessible and available, it doesn’t seem to be working. However, the primary reason, in my professional opinion, why treatment isn’t working is found in a glaring statistic also presented in the study: 78% of all drug and alcohol deaths were rooted in Fentanyl and Methamphetamine use. Simply: there are no treatment modalities available that can treat those two (2) substance use disorders.
The main challenge in treating these particular substances is that psychosis is associated with physical dependency to both. Simply, both fentanyl and methamphetamine dependence turn their victims into one of three (3) people/characters:
Jason Bourne: In this case, the addicted person believes that everyone, is out to get them and must hide or fight everyone so that the knowledge they have doesn’t get into the wrong hands. Now, there are variations to this core them, but really, paranoia is common to all cases of this type of delusion and can be fun to listen to and engage with. The belief and behavior is similar to anyone who belives and echos conspiracy theories, only fentanyl/meth are to blame, not social media.
Ghandi: Here, the addicted person believes they are God’s messenger and are out to share whatever good news God has revealed to them. I’ve seen people addicted to meth who actually start wearing robes and building alters and believe they commune with a higher power to which they must bring other people. I’ve even helped build an altar.
Regan MacNeil (the possessed girl in the Exorcist): This character type is by far the most prevalent i’ve encountered when treating people addicted to fentanyl/meth. I’ve even seen this transformation when treating people addicted to heroin. The idea that demons possess people is real, especially in these cases. I’ve seen it so much that I’ve even purchased a copy of the Rite OF Exorcism and have spent countless hours reading documented exorcism cases. I have a few theories in the hopper about the relationship between these drugs and “demonic forces” and hope to describe them at some point.
Therefore, treatment as usual doesn’t have tools to address these types of psychosis. When brain change is added to the mix, the cases of fentanyl/meth abuse become complicated to the point of being a tangled mess that’s nearly impossible to comb out. Further, most treatment providers aren’t really equipped to handle these thoughts, especially the demonic, and don’t know what to do.
I suggest that treatment professionals who want to be a part of a solution must learn to suspend their version of reality. Also, we need to seek counsel with medical doctors such that we can treat the physiological changes that occur within fentanyl/meth use. Really, it comes down to understanding the nature of the psychosis and then figuring out ways to redirect people back to a healthier relationship with reality. Otherwise, the death rate will stay high because treatment providers will not be able to reach people addicted to fentanyl/meth.
