Jeff Fowler's addiction began just months before meth splashed across the nation's collective consciousness.
Fowler - then 24 years old - was a regular user of alcohol, marijuana, hallucinogens and occasionally cocaine. So it seemed like no big deal one night in 2004 when someone at a party passed him a pipe filled with crystal meth.
"It was just some drug that came along," he said. "I mean, it wasn't heroin - that was the one you wanted to stay away from. That was the dangerous stuff."
What he didn't know is that meth delivers a shot of dopamine - the chemical basis for most pleasurable human emotions - that is more intense and lasts longer than with many other drugs. Addicts become dependent on the drug to stimulate the release of dopamine in the brain. Without it, they literally cannot feel joy.
A few months after he discovered meth, Fowler found a new girlfriend and they tried it together. The drug became central to their relationship - until she got pregnant and quit.
"That's when I got into my dark times," he said. "That's when I started doing it by myself."
He knew he was getting addicted. "I remember thinking, 'Why don't I care? This is kind of a big deal, but I don't care."
He saw his girlfriend a few days a week, and hid his continuing drug use from her.
"It would stress me out to go visit her," he said. "I'd be thinking, 'I have to go over to her house and I don't get to smoke speed.' It made me angry."
His job allowed him a 45-minute lunch break. It took him 15 minutes to drive home. He would smoke for 15 minutes then drive back to work.
"I needed to get this drug into my system. It was a compulsion. There was no relaxation, there was no fun and there was no food."
He noticed changes in himself.
"My brain started not working the way that it should. Even when I wasn't on it, and especially when I was on it," he said.
He grew more paranoid. The sound of a passing car would send him running to the window.
"I was just freaked out that one of my roommates would come home," he said. "And if somebody had come, it wouldn't have mattered. That's literally how stupid the paranoia was.
"I was very cognizant that I was just slipping away."
With his girlfriend six months pregnant, Fowler lost his job. Hoping to clear his head, he drove to a friend's house to write. Instead, he found himself on a multi-day binge.
"It was the middle of the summer and there were just bugs everywhere all the time. Gnats, flies, whatever - they were all over your skin.
"Normally, that'd be pretty annoying. When you're on speed and prone to paranoia, it was really bad."
He became convinced the bugs were inside his skin and picked up a box cutter.
"I remember thinking, 'This is insane - you're cutting bugs out of your skin.' But I couldn't stop. I had gotten to that point, I was taking a razor blade and putting holes in my skin to cut out bugs that were not there."
When he ran out of speed, he went home and watched his face, arm and legs scab over. Then his girlfriend confronted him. "She pointed at her stomach and she said, 'You have a baby boy on the way, and he's right here.' "
Fowler flushed his bag of meth and smashed his glass pipe. He went to his girlfriend's house to dry out. "In a very real way, I think my son saved my life," he said.
He tried to hold onto his growing family and let go of his drugs.
He started drinking rather than smoking, but his subconscious couldn't let the drug go.
"For at least a year or a year and half, I was dreaming about smoking speed," he said. "Really vivid dreams. I think it was my brain's way of trying to get that fix."
He relapsed once or twice, but never picked the habit back up. It wasn't ever easy, he says, but other things had become more important. He was a stay-at-home dad caring for his son and, later, a daughter while their mother worked.
Fowler has been off meth for about five years now, but acknowledges he is an alcoholic. He and his girlfriend recently split up.
"Meth is a huge part of the reason we broke up," he said. "Even though we broke up six years later, a lot of it is because I let her down so much during that time. She was never able to get over it."
His life with meth still haunts him.
"It's a nightmare," he said. "That thing that starts off seeming so cool and fun turns into nightmare, but by the time you realize it's a nightmare, you can't even care anymore."
E.R. visits linked to drug abuse, misuse
In 2009, the Drug Abuse Warning Network reported nearly 4.6 million Americans admitted to emergency rooms for drug-related issues. Nearly half of those, about 2.1 million, were due to some kind of drug misuse or abuse. Almost 1 million of those admissions were due to illicit drug use.
The first half of 2010 saw about 500 amphetamine-related hospital admissions in Pima County. That number is down from a high point of almost 700 in 2005, but up slightly from 2009 numbers.
Between January 2001 and April 2011, the Pima County Medical Examiner's Office handled more than 2,100 drug-overdose deaths.