PORTLAND, Ore. (KOIN) — The State of Oregon was a success story in shutting down the meth labs from the 1980s and 1990s that used Sudafed. But the meth problem is back again in full force, only this time from labs outside the US.

“Oregon was really at the forefront of closing down the old ephedrine-based meth labs and we made a huge dent in the number of people who were using back in the day,” said Dr. Todd Korthuis, the head of addiction medicine at OHSU. Now, though, “it’s more pervasive in our communities than ever before.”

Methamphetamine is different from cocaine or heroin. It’s neurotoxic — it gets into the nerve itself. That’s what causes longer term brain problems.

“My understanding of the methamphetamine that’s in the community now is that it is coming from labs with very sophisticated manufacturing lab processes with people who have a sophisticated understanding of chemistry,” Korthuis said.

It’s easier to get meth than opioids, but both are being used together. Officials are seeing an increase in use of meth among the homeless.

Meth is as much a rural issue as it is an urban issue, Korthuis said. A study across rural counties in 10 states showed half of the drug users reported not having housing — and 80% of those people used meth.

In rural counties, people who use drugs think using meth may decrease the effects of fentanyl and heroin — but there is no data to support that thought.

But the situation is not totally bleak, he said.

“I want to emphasize — people can recover from methamphetamine use and it’s not a one way road,” Korthuis said.