Kim has been in recovery for a year, and her experience of trying to get off both heroin and meth is becoming more common. In San Francisco, 22% of people who use heroin starting rehab said they also had a problem with meth; that’s up from 14% in 2014.
University of California professor Dr. Dan Ciccarone, who teaches family community medicine, said that is a very high rate.
“That’s alarming and new and intriguing and needs to be explored,” he said.
While heroin and cocaine — a speedball — is traditionally a more common drug combination, using meth and opioids is an odd choice, he said.
“Methamphetamine and heroin are an unusual combination” that makes people feel “a little bit silly and a little bit blissful,” he said.
For Amelia, who has also been in recovery from heroin and meth addiction for a year, using both drugs was a matter of survival. She started using heroin to keep up with work. When that became too expensive, she turned to meth.
“The heroin was the most expensive part. That was $200 a day at one point. And the meth was $150 a week,” she said.
A study published in December 2018 found that 34% of heroin users said they also use meth. In 2011, only 19% of heroin users took meth as well. Researchers speculated that as opioids became harder to come by and heroin more expensive, drug users turned to meth, which is cheaper and more readily available, especially in the west. Meth — an upper — can also help people feel and function more normally despite using opioids.
“Methamphetamine served as an opioid substitute, provided a synergistic high, and balanced out the effects of opioids so one could function ‘normally,'” study authors wrote.
However, for Kim, the progression went from meth to heroin, not the other way.
“I thought, ‘Oh, heroin’s great. I don’t do speed anymore.’ To me, it saved me from the tweaker-ness,” she said.
No matter which drug comes first, the San Francisco Department of Public Healths’ Director of Substance Use Research, Dr. Phillip Coffin, said there is certainly a connection between opioid and methamphetamine use.