When it comes to drug abuse in Minnesota, opioids get all the attention.

But there’s another drug raising concerns among law enforcement and treatment professionals in the state: meth.

You might remember this drug from the early 2000s: it inspired anti-drug campaigns that were the stuff of nightmares, depicting methamphetamine users with deteriorated teeth and oozing scabs. Meth lab busts and sometimes meth lab explosions, frequently made the news. But after measures were taken to restrict access to precursor chemicals required for manufacturing the drug, meth use seemed to taper off.

Now it’s back, in a big way.

More meth seized

For a little while, it looked like meth’s days might be numbered in Minnesota. In 2005 and 2006, new state and federal laws made it a lot harder to manufacture meth in large quantities by restricting the sale of cold medicines used to make it. Such products could no longer be sold over the counter, and the amount consumers may buy is now subject to daily and monthly restrictions.

In one way, the restriction seemed to have an effect. At the height of the wave of methamphetamine use, the Minnesota Department of Public Safety recorded 410 meth labs in 2003 — more than one for each day that year. In 2016, there were 13, said Brian Marquart, the department’s statewide gang and drug coordinator.

Seizures of methamphetamine by the state’s Violent Crime Enforcement Teams, 21 task forces that work across county lines in 70 Minnesota counties, saw a sharp decline, too.

But those seizures are going back up. Last year, Minnesota’s Violent Crime Enforcement Teams seized about 490 pounds of meth.That’s more than twice as much as the amount seized in 2015. And that’s just meth confiscated by VCETs; seizures made by other law enforcement agencies, which are not reported to the state’s Office of Justice Programs, could push that total even higher.

This year, between January and the end of March, VCETs already seized 188 pounds, Marquart said. If they continue at that rate for the rest of the year, they could beat last year’s record with more than 750 pounds of the stuff.

Busts of meth labs didn’t typically yield big seizures, but lately, the average size of seizures has increased dramatically, according to DPS. The Anoka-Hennepin Narcotics and Violent Crimes Task Force, for example, recorded one 140-pound seizure last year, said Lt. Wayne Heath. But even excluding that bust, total pounds seized were up significantly from the prior year, he said. Statewide, methamphetamine arrests have seen an increase too, Marquart said.

More seeking treatment

There are other signs there could be more meth on the streets, and more people using it.

Admissions to treatment programs for methamphetamine were second only to alcohol last year, numbering 12,050, up 76 percent over their previous peak in 2005, and accounting for about 23 percent of all substance abuse treatment admissions, data from the Minnesota Department of Human Services show. Methamphetamine was responsible for more admissions than the 10,404 primarily for heroin and prescription opioids combined last year.

Admissions to treatment aren’t a perfect indicator of underlying usage, of course. Many people who are addicted do not enter treatment programs, Claire Wilson, assistant commissioner for community supports at the Minnesota Department of Human Services. More access to treatment due to the expansion of Medicaid, which made treatment accessible to some single adults could also be a factor, she said.

But Dr. Joseph Lee, the medical director of the Hazelden Betty Ford Foundation Youth Continuum, who specializes in youth addiction, says he’s seen indications of more widespread use.

In particular, he’s seen an increasing number of young people come to Hazelden from all over the country for meth addiction for a few years now. But, he said, with the focus on opioids, his efforts to get the word out have been somewhat drowned out.

“It just didn’t take,” he said.

Treatment admissions data indicate the problem is statewide. Not a single one of Minnesota’s 87 counties was immune to sending residents to treatment for meth use last year. But Lee says he’s seeing new demographics involved, with more of it among urban and suburban young people than before.

More people are dying from meth, too, it seems.

According to data from the Minnesota Department of Health, 78 people in Minnesota died from overdoses of “psychostimulants with abuse potential,” a category of drugs that includes methamphetamine. Five years prior, in 2010, there were only 18 overdose deaths.

That increase mirrors a national trend. According to Stateline, meth was involved in 3,700 deaths in 2014 — more than double the number associated with the drug in 2010. In 2015, meth was involved in 4,900 deaths, a 30 percent increase over the prior year. That number may be an undercount, as many people addicted to meth are longtime users and die of organ failure, which may not show up in overdose records.

New suppliers, new marketing

So what’s behind meth’s apparent resurgence?

Hazelden’s Lee attributes the increase in cases he’s seen to two things: new distributors and a new image.

Before the state cracked down on cold medicines used to make meth, it was a domestic cottage industry. Now, it’s global, mostly run by cartels who have sophisticated distribution networks in the state. Meth arrives in Minnesota by passenger car, commercial vehicle, mail, Fedex and planes, Marquart said.

And the product is much better. Mass manufacturers have figured out how to produce methamphetamine that’s purer at a much lower price.

Test results by state officials show wholesale methamphetamine seized recently coming back around 90 percent pure. Back when people made it at home, the purity was lower, Marquart said.

And it’s cheaper. Five or six years ago, a pound of methamphetamine would cost between $21,000 and $22,000 wholesale, Marquart said. Today, it’s going for about $5,000.

That’s because it’s coming from much bigger, more sophisticated manufacturers, Marquart said, and it’s now largely being distributed by the cartels.

The cartels’ takeover of the meth trade has resulted in a rebranding for the drug, Lee said.

“Historically, synthetic chemical drugs like methamphetamine have really been more popular in rural areas where they didn’t have access to higher-branded drugs like cocaine,” he said. “We’ve seen the quality of it and the branding of it change from a kind of backwoods, rural (drug) to kind of a poor man’s cocaine. We see kids who are high-performing and going to college who use meth. We see girls who have eating disorders who use meth.” Meth has also become popular in the LGBT community, particularly among gay men, he added.

Breaking a bad habit

State officials are alarmed by indicators of meth’s prevalence in the state, and more generally, in a major increase in drug overdoses.

Wilson, of the Department of Human Services, says she hopes reforms passed this legislative session to expand the breadth of treatment in the state will help reduce the human toll of substance abuse.

The goal of the reforms is to shift the focus from episodic care — identifying the problem, accessing treatment and undergoing it and being done — to treating addiction “more like the disease that it is,” she said, the hope being that a broader continuum of services, before and after treatment, will better support people in kicking addiction.

“Most who enter treatment complete it and show considerable improvement. We just need to make sure we continue to invest in treatment,” she said.