San Francisco is handing out antipsychotic drugs to homeless methamphetamine users who frequent psychiatric emergency services to help them cope with symptoms like paranoia, delusions and hallucinations, the San Francisco Chronicle reports. Top addiction researchers believe it may be the next promising intervention for a portion of people languishing in San Francisco's streets. Under a pilot program discreetly launched by the city more than two years ago, medical professionals at the Zuckerberg San Francisco General Hospital's Psychiatric Emergency Services are giving certain patients with methamphetamine use disorders "chill packs." The "chill packs" consist of four doses of the antipsychotic medication Olanzapine, which is commonly used to treat schizophrenia and bipolar disorder. A 2021 study found the drug helped to reduce the frequency and severity of methamphetamine-induced psychosis. Patients are instructed to take the tablets when they're experiencing psychiatric side effects that can also include excitability and irritability.
While fentanyl accounted for four out of five accidental overdose deaths in San Francisco last year, city officials say methamphetamine contributes greatly to the homelessness crisis, the burden on emergency rooms and neighbor complaints about street conditions — a hot-button issue in the coming mayoral election. Methamphetamine-related hospital visits and deaths have reached record high levels. Nearly half of all patients who visited S.F. General's Psychiatric Emergency Services in 2017 and 2018 were related to methamphetamine use. From 2013 to 2017, people who were admitted into treatment programs and primarily used meth increased 30 percent. Unlike opioids, there are no FDA-approved drugs to treat methamphetamine use or to prevent psychiatric symptoms associated with the substance. "We're in a really bad spot for simple pharmacologic interventions for people who have stimulus-induced psychosis," said Michael Ostacher, a psychiatry professor at Stanford University. "And there's a tremendous need for it." Ostacher called the city's program a "really novel way to approach trying to help these patients and to mitigate some of the symptoms and suffering."
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