For 25 years since she sniffed her first line of methamphetamine at a San Francisco club, Kim has often redefined the word "normal." At first, she says, it seemed that methamphetamine had brought her back to herself – the person she was before her parents divorced and before her stepfather moved in.
"I felt normal when I did it for the first time, like" Oh! I'm here, "she says.
Kim is now 47 years old and continues after her adult life all her "normal" life. This pursuit brought her to dark places. So we decided not to use his last name at his request. For a long time, methamphetamine, commonly known as speed, was Kim's drug of choice.
Then she added heroin to the mixture. She tried for the first time while she was in treatment for methamphetamine.
April Dembosky / KQED
"It put me on a period of using heroin for nine years," Kim said. "And I thought to myself:" Oh, the heroine is excellent, I'm not making any more speed. "For me, it saved me from confusion," she says. referring to the agitation and paranoia of many users of methamphetamine and how heroin, an opiate, has calmed the situation.
Kim has just completed an addiction treatment for both drugs.
It was part of the last wave of methamphetamine of the 90s, and it is now part of a new methamphetamine epidemic that is rife in some parts of the United States, especially in the West. Deaths related to methamphetamine are on the rise. Hospitalizations are on the rise.
Take methamphetamine and opioids for a "high synergistic"
Researchers who track the evolution of drug use for decades believe that the epidemic of opioids has given a boost to the new methamphetamine crisis.
"There is absolutely an association," said Dr. Phillip Coffin, director of addiction research at the San Francisco Department of Public Health.
In the United States, more and more opioid users also report using methamphetamine, from 19% in 2011 to 34% in 2017, according to a study published in the newspaper. Addiction to drugs and alcohol last year. The largest increases occurred in the western United States.
This research suggests that efforts to encourage physicians to reduce the number of opioid prescriptions may have prompted some users to buy methamphetamine on the street.
"Methamphetamine served as a substitute for opioids, provided a high synergistic effect and balanced the effects of opioids so that we could function" normally ", the researchers write.
It's a bit like having a cup of coffee in the morning to get up and a glass of wine at night to relax – or use methamphetamine on Monday to get to work and heroin on Fridays for spend the weekend.
Amelia says that's how her drug use has evolved to include methamphetamine.
In the beginning, the drug was only a fun thing that she would do on weekends – ecstasy and cocaine with her friends. On Monday, Amelia would take care of her work week.
"I am a horse trainer, so I worked very hard, but I also partying," she said.
Then a weekend, while Amelia felt a bit like the hangover of the previous night, a friend gave him a pipe and told him it was opium.
"I thought it was like smoking grass or hash, you know?" Says Amelia now. "I just thought it was like that."
She says that she learned to love opium and finally contacted the dealer of the friend.
"The woman said," How long have you been using heroin? "and my jaw almost hit the ground," says Amelia. "I was really, honestly, shocked … I was like:" What? I've been doing heroin all this time? "I felt really naive, really stupid not to have put both together."
Very quickly, Amelia started to feel sick around the same time each day. These were withdrawal symptoms – a clear sign that she was becoming dependent on the drug. His weekend smoke became his daily morning smoke. Then it was part of his lunch routine.
"I just went to that and decided to" fuck in the air, "she said. "I'm going to keep doing it, I'm obviously still working, okay." "
A heroin habit is expensive. Amelia worked six days a week to pay for it. All the horses that had to be ridden, all the lessons that had to be taught, she said yes because she wanted money.
But financing heroin use was exhausting. One day, one of the women she worked with in the stable offered her methamphetamine to get her back.
Methamphetamine is comparatively cheap these days. This is what allowed Amelia to continue making a living so she could earn enough money to buy heroin.
"Heroin was the most expensive part," she says. "It was $ 200 a day at one point, and methamphetamine was worth $ 150 a week."
This trend lasted for three years, until Amelia discovered that she was pregnant. From the birth of her daughter, she enrolled in a residential treatment program in San Francisco – the Epiphany Center – that would accept her as well as her baby.
"I was okay to be addicted," says Amelia. "I agreed to make it my life." she says. "But it did not suit me to have children and to let that be part of my life."
Increased number of rehabilitation admissions for heroin and methamphetamine mixers
Rehabilitation admissions for heroin addicts have remained stable in recent years in San Francisco. But the number of heroin addicts who report that methamphetamine is a secondary addiction problem is increasing. In 2014, 14% of heroin users admitted to San Francisco rehab also said that methamphetamine was also a problem. Three years later, 22% said methamphetamine was also a problem.
"It's very high," said Dr. Dan Ciccarone, a professor of family medicine at the University of California at San Francisco. who has been studying heroin for almost 20 years. "It's alarming and new and intriguing and needs to be explored."
Speedball – heroin and cocaine – is a classic combination, he says.
"It's like a cup of peanut butter, right – chocolate and peanut butter together," he says. "Methamphetamine and heroin are an unusual combination."
Ciccarone adds that the combo of methamphetamine and heroin is a familiar phrase, as it allows the user to feel "a little silly and a little happy".
For Kim, methamphetamine use came first. Then she added heroin.
"I ended up doing both at the same time each day, both," she says.
For Kim, it was always a question of finding the recipe that seemed normal. Start with meth. Add heroin. Retouch the speed.
"You are like a chemist with your own body," she says. "You are in balance, you are trying to find your own way to make you feel good."
Now, Kim is trying to find that balance without drugs. She has been sober for a year. The same goes for Amelia, the coach of the horses. His sober birthday is the same as that of his daughter.
This story is part of NPR's collaboration on health reporting with KQED and Kaiser Health News.