A Journal of the American Medical Association report released in October found that deaths from psychostimulants increased by 250 percent between 2008 and 2015 but have been “largely overshadowed by the opioid epidemic.” Clark and other law enforcement officers in Pennsylvania say it’s not a matter of one drug replacing the other. With more meth coming in from Mexico since 2010, and some made in portable “backpack labs” instead of the traditional, clandestine, rural meth labs, the drug is easy to obtain and often used as a holdover drug for people going through opioid withdrawal. These small “shake-and-bake” labs can often operate with an empty two-liter bottle, some household chemicals, and pills such as Sudafed.