With the list of Colorado libraries that temporarily closed due to methamphetamine contamination at three locations, some residents asked: What’s the health risk of people who were recently in these spaces?

In late December, Boulder Public Library became the first to temporarily close after testing found levels of meth in its restroom exhaust vents. Later, several areas of the Boulder RTD station closed due to contamination as well.

On Jan. 11, the Englewood Public Library and portions of the Englewood Civic Center temporarily closed after test results found meth contamination. 

Most recently, Littleton’s Bemis Public Library temporarily closed Jan. 18 after testing found elevated levels of meth contamination in several bathrooms.

Meth is a highly addictive stimulant drug that is commonly either ingested, smoked or injected, said Eric Hill, an emergency medicine physician and the EMS medical director for the Medical Center of Aurora.

However, experts say the risk that secondary meth contamination in public spaces poses to the public is fairly low.

“We don’t have any data to say that there’s a high public health risk from secondary meth exposure from a public space … those aren’t typically presenting to emergency departments,” Hill said, noting people may feel some symptoms but usually not severe enough that they go to the emergency room. 

Physical symptoms of meth can include increased heart rate, eye irritation if there is chemical exposure in the air and a slight cough, Hill said. Psychological impacts may include paranoia, having an out-of-body experience and hallucinations.

Meth exposure could also cause increased jitteriness, irritability, fatigue, moodiness, a skin rash from irritation or trouble sleeping, said Karin Pacheco, an allergist in the Division of Environmental and Occupational Health Sciences at National Jewish Health.

“But people don't spend that much time in a bathroom,” she said. “So your actual exposure would be fairly low.”

Pacheco said the body breaks down methamphetamine quickly, so even if symptoms were to arise due to secondhand exposure, they would likely reside in one or two hours.

According to Boulder County’s website, there is a low probability of secondary exposure to meth-contaminated surfaces causing someone to experience symptoms, “especially in relation to exposure in a public setting.” 

Arapahoe County Public Health also said health risks to the general public are considered low. 

Throughout his 10 years of working in the Denver area, Hill has never seen a patient have a large symptomatic exposure from secondary meth exposure. 

“They may get a little bit,” he said, explaining a person may feel some symptoms if someone was smoking meth near them. “But as far as causing, like, acute psychosis and that kind of stuff, that’s extremely uncommon.”

Contamination in restrooms and vents

When it comes to meth contamination that has been detected in the exhaust vents and restrooms of libraries, Hill thinks the health risk is low. 

“I seriously doubt someone would be symptomatic related to exhaust vent residue in an exhaust vent. It certainly means that, yes, there was methamphetamine smoked in there, but I think the public health risk is fairly low on that,” he said. “I’ve never seen one (patient), where they were just in a public bathroom, get exposure (and) having true symptoms from that.”

Pacheco agreed that the contamination in air vents is likely from people smoking it, as it would be unlikely for someone to have time to cook meth in a public restroom.

Mark Stephenson, a retired hazardous materials emergency response team chief at Aurora Fire Rescue, added that surface contamination could arise from methamphetamine sitting or spilling on a surface.

Pacheco said a person would probably be more likely to get secondhand exposure from touching a surface than from breathing the air in a contaminated restroom. If meth has been smoked in a space, the aerosols can settle on surfaces.

Hill explained that if there was a large amount of methamphetamine contamination on a surface and a person was to touch their hands to the surface and then eat something, they might get symptomatic from that. 

“You could get some secondary effects from that,” Hill said. “I wouldn’t expect it to be a long-term issue for someone unless they’re really frequently exposed to it, over and over and over again, like if they’re living at an apartment with someone who’s using it.

Pacheco pointed out that children might touch many surfaces in a public bathroom, putting them at a greater risk. In addition, the same dose would affect a child more than an adult because of their size.

When it comes to meth contamination being airborne due to someone smoking it nearby, a person would have to be really close to that location within a relatively close time to when the smoking occurred in order to inhale it and have symptoms from that, Hill explained.

“If you’re in a bathroom where you’re in there for a few minutes, the odds are much less,” he said of developing symptoms. “Not to say you couldn’t get any — if you touched some and you ingested it, yes, you could get it, but certainly the odds are less.” 

If a person does start feeling symptoms, they can always be evaluated for it, Hill said. 

“Even if you don’t seek medical care and you feel a little off or your heart (is) beating a little harder … most times, that does just go away by itself,” Hill said. “Methamphetamine, there is no antidote for that. It’s just a matter of waiting it out.”

Do test results mean more people are doing meth?

Although recent test results show methamphetamine contamination in public spaces, Hill said he doesn’t think it’s a new occurrence.

“I would expect that this has been an ongoing thing for a while. I think we’re just now looking at it,” he said. “I’m not aware of some kind of massive rash of secondary meth exposures presented to ERs all around the city in the last week or two, so I don’t think it’s a … new thing that we’re seeing.” 

He noted he hasn’t seen an uptick in meth recently, though it is “a huge problem.”

“It’s one of the highest used illicit drugs we have in the metro area. I see it several times a day, methamphetamine psychosis,” Hill said.

Pacheco agreed that the new findings represent the high levels of meth use in society, which she said has been an ongoing problem for years.

“It's like many things: if you don't know what to look for, it isn't there,” she said. “And then if you start to look for it, suddenly it's everywhere. But I don't think this is a difference in use, right? It's a difference in detection.”

Now what?

Regarding the ongoing conversation on how to best mitigate meth usage in public spaces and prevent a public space that’s been cleaned from getting contaminated again, Hill said he’s unsure of how to safely do that. 

“I don’t know of anybody that has any kind of, like a smoke detector for meth or if someone’s smoking it then it alerts the crew or something — I’ve never seen anything like that, so I don’t know how you protect your space,” Hill said. 

When asked if he has an opinion on whether public spaces and libraries should be doing regular testing for meth contamination, Hill said he doesn’t have enough information to draw an opinion about the risk. 

He thinks routine screenings and cleanings of public spaces would be worthwhile if public health experts determined there was a significant risk of secondary contamination to the public. 

“I think it’s certainly fine to clean the space, but as far as a routine method to say that we should always endorse a policy where we're going to routinely screen these places and decontaminate them — I don't know if that would be impactful to the public health of the community to do such a thing,” Hill said.

Pacheco, on the other hand, thinks routine testing would be a good step for public spaces because contamination can cause short term impacts to people’s health, even if it’s not very likely.

She also said measuring contamination levels would give “an indirect measure of how these spaces are being used” and could be a deterrent for people who are using the spaces for drug use.

But beyond the minor public health concerns, Pacheco sees the recent contamination levels as a sign of a larger problem. She noted that, while drug use is very common and addiction can touch anyone, there is a tie between drug addiction and people who are facing homelessness.

In order to address problems related to addiction, she said we must also address housing, education, wages and more.

“If you want to fix a problem, you have to understand why it's happening,” she said.

“The people smoking meth… they're not from another planet,” she said. “And I think we have to have some empathy for them. Which is not to say to permit it, but to understand that it's a bigger problem that the whole society has to solve.”