Nine years ago, there were 50 methamphetamine-related deaths in Oregon, but a new report suggests that number now is about five times higher.

The Oregon-Idaho High Intensity Drug Trafficking Area program reported that 272 people in 2018 died from complications related to methamphetamines, and is the area’s greatest drug threat. The increase is due to many factors including a drop in the price, mental health issues, socioeconomic disparities and a more potent drug.

In Multnomah County alone, there were 77 reported deaths, according to the Oregon Health Authority.

Much of the methamphetamine available is imported from Mexico and reconstituted from powder or liquid in California methamphetamine labs into crystal and brought up to Oregon, the report stated. Now, people can easily obtain a cheap, pure form of the drug more than ever.

In 2005, Oregon became the first state to require a prescription to purchase medicines with pseudoephedrine, an ingredient used in the production of methamphetamine.

Regulating pseudoephedrine was the response to the state’s meth problem, Chris Gibson, the executive director of the Oregon-Idaho HIDTA said.

With a significant drop in the number of Oregon’s meth labs, Mexico is filling the gap and is the primary source of the drug in Oregon. It arrives in the state via Interstate 5, where it gets into the hands of the people who can distribute it locally.

“It speaks to the demand, and if there’s a demand, someone’s going to be there to supply,” Gibson said.

Over the last two years in the Portland-metro area, the price for the drug is down 25%, and down 18% throughout Oregon, according to the report.

Although the Multnomah County Sheriff’s Office isn’t seeing as many of the deaths, Sgt. Tim Wonacott at the department’s special investigations unit said it was clear that methamphetamine use was on the rise.

“The difference is pretty stark to me, at least in the meth world,” Wonacott said. “The trends have changed, and there’s a lot more meth in the area than there used to be.”

Across Central City Concern facilities — a Portland nonprofit helping people through homelessness, poverty and addictions — more than 5,000 people with a history of substance abuse are treated every year. At least 15-20% of these patients are being treated exclusively for methamphetamine and another 25-30% are being treated for methamphetamines and another substance.

“That’s a conservative estimate,” Dr. Andy Mendenhall, the organization’s chief medical officer said.

Methamphetamine causes death when people begin to have heart rhythm abnormalities, heart attacks, strokes or experience complications from injecting the drug, Mendenhall said. It’s estimated that 30-50% of the patients being treated for heroine are using methamphetamine by injection, which amplifies the risk of complications and death even more.

The drug floods the brain with neurotransmitters that are pleasurable and rewarding, said Dr. Amanda Risser at the Central City Concern.

“They do that more powerfully than really any other drug,” Risser said.

Methamphetamine is closely tied with opioids because the drug helps people cope in similar ways at a quarter of the price, Risser said. People often return to using it because the recovery from the drug can feel worse.

Deaths related to methamphetamine can also come from people engaging in risky behavior while on the drug, Risser said. Changes in brain function could lead to things like traffic accidents or exposure to cold weather.

Although it’s challenging to recover from an addiction to meth because of the way the brain if affected, Risser said it’s a treatable condition. A bill in the house could consider substance abuse disorder as a chronic illness.

Some autopsies show there is meth and other opioids in people’s system at the time of death, said Nimisha Gokaldas, the medical director for mental health and addiction services in Multnomah County.

It’s unclear if the meth is laced with other opioids or people are taking more than one drug, but Gokaldas said it’s likely it could be a combination of both.

“Everyone knows ‘Breaking Bad’,” Gokaldas said. “But that’s what’s really happening.”

The Oregon and Multnomah medical examiners couldn’t be reached for comment.

A five-year plan starting in 2020 will focus on what drives these health disparities when it comes to substance abuse, said Dr. Tom Jeanne, the deputy state health officer at the Oregon Health Authority.

“I think just to focus on methamphetamine would be too narrow,” Jeanne said.

-- Christina Morales; cmorales@oregonian.com; 503-221-5771; @Christina_M18