People who use methamphetamine are nearly twice as likely to have medical multimorbidity, over three times as likely to have a mental illness, and over four times as likely to have a substance use disorder.
Methamphetamine. Image Credit: Kaesler Media/Shutterstock.com
Investigating the long-term medical profile associated with methamphetamine use
Methamphetamine is a commonly trafficked drug known for its illicit recreational usage, with few medical uses to treat obesity or attention deficit hyperactive disorder (ADHD) that remain rare due to concerns over neurotoxicity. It is a highly addictive and potent stimulant affecting the central nervous system, causing higher focus and energy levels when consumed at low concentrations but can induce psychosis, skeletal muscle breakdown, and brain bleeding at higher concentrations.
The use of methamphetamine has steadily increased in recent years and has led to several overdose-related casualties due to the toxic effects on multiple organs from the heart and lungs to the liver and neurological system. However, the chronic disease profile of users has rarely been considered.
Indeed, methamphetamine usage can also increase the risk to contract a range of infectious diseases, but little is known about its chronic repercussions.
Methamphetamine can complicate the management of existing chronic illnesses, but we know little about the chronic disease prole of people who use it,"
Benjamin Han, MD, Division of Geriatrics, Gerontology, and Palliative Care in the Department of Medicine at the University of California San Diego
Increased likelihood for medical multimorbidity, mental illness, and substance abuse
To fill this gap in medical knowledge, a study published in the Journal of General Internal Medicine funded by the National Institute on Drug Abuse and authored by a team from NYU Public School of Global Public Health estimated the prevalence of medical conditions in adults who reported methamphetamine usage.
Data from the 2015-2019 National Survey on Drug Use and Health, a nationally representative survey of U.S. adults, was collected from individuals that had consumed methamphetamine over the past year. Researchers then examined how many also experienced medical conditions, mental illnesses, and other substance use among the reported individuals.
Results showed that adults who used the drug were nearly twice as likely to have two or more chronic medical conditions, more than three times as likely to have a mental illness, and more than four times as likely to have a substance use disorder.
Moreover, many of the patients experienced combinations of medical, mental, and substance use issues, including all three simultaneously.
The most common illnesses associated with methamphetamine use were liver disease (hepatitis or cirrhosis), lung disease (COPD or asthma), and HIV/AIDS. In addition, patients also had a higher likelihood of consuming other illicit and dangerous substances from opiates to cocaine and heroin.
No cause and effect, but an indication of a population at risk
The study provides key insight into the associated risks with methamphetamine use, although limited information is provided on the dose-dependency of consequences or the breakdown in regional differences affected.
The study author, Joseph Palamar, an associate professor of population health, explains, "Our results certainly do not suggest that meth use causes most of these conditions, but they should inform clinicians that this population is at risk.
Future studies are needed to determine how dose and frequency of use relate to these conditions--for instance, occasional use on a night out versus chronic use that can lead to a host of adverse effects on the body," adding that, "We also confirmed the well-known link between meth use and HIV, which can result from injection drug use or sexual transmission, but more research is needed to determine the extent to which meth use increases the risk for STDs due to the drug's libido-enhancing effects."
The study concluded with key observations on the adaptation of treatments required to address the complexity of methamphetamine usage and its outcomes, noting the importance of patient-centered approaches. Such strategies can help identify, treat, and manage mental, medical, and substance use disorders more efficiently in patients.
Methamphetamine use adds complexity to the already challenging care of adults who have multiple chronic conditions. Integrated interventions that can address the multiple conditions people are living with, along with associated social risks, are needed for this population."
Future research considering the risk pathways associated with this drug can further improve current understanding, yet the lack of sufficient or continuous treatment remains the most pressing concern.
- Han, B.H., Palamar, J.J. Multimorbidity Among US Adults Who Use Methamphetamine, 2015–2019. J GEN INTERN MED (2021). https://doi.org/10.1007/s11606-021-06910-6