Heart failure linked to illicit meth use is rising

Dec. 1 (UPI) -- Heart failure linked to illicit use of methamphetamine is on the rise worldwide across racial, ethnic and socioeconomic lines, and the disease is more severe in meth users than non-users.

That's according to a new study published Thursday in Heart, an international journal from The British Medical Journal and British Cardiovascular Society.


The new research on the disease -- which affects about 6.2 million adults in the United States, and men more than women -- highlighted the expense involved in meth heart failure treatment.

The U.S.-Canadian team of researchers, led by Dr. Veena Manja, a cardiologist at the VA Center for Innovation to Implementation in Menlo Park, Calif., said the findings show the urgent need for more research to help create better prevention and treatment strategies.

Yet, the research also underscores that meth-induced heart failure "is not straightforward to study or treat," Dr. Jonathan D. Davis, director of the heart failure program at Zuckerberg San Francisco General Hospital, said in an accompanying editorial.


For example, "a patient with a single positive urinary drug screening will be at a different phase in the disease course than a patient who has used methamphetamine daily for years," said Davis, associate professor of medicine at the University of California-San Francisco School of Medicine.

Methamphetamine, a powerful stimulant, causes the heart muscle to work much harder than it ordinarily would, said Dr. O. Trent Hall, an addiction medicine specialist and assistant professor of psychiatry and behavioral health at The Ohio State University Wexner Medical Center and College of Medicine.

Hall, who was not involved in the study, told UPI that meth also causes blood vessels to tighten, increasing blood pressure: something that can lead to heart failure and stroke.

Also, Hall said in an email, when meth is injected, outside bacteria can infect the heart, causing it to fail.

According to the researchers, previous studies have shown that use of the potent stimulant, popularly known as "crystal meth", "ice" and "speed," is associated with serious health problems, including high blood pressure, heart attack, stroke and even sudden death.

But the scientists said they failed to find a comprehensive, systematic review of the published literature on meth use and heart failure, so they set about to conduct one.


They focused on 21 observational studies from different countries, but mostly U.S.-based, between 1997 and 2020. Collectively, the studies involved several thousand adults who ranged in age from 35 to 60, on average.

According to the study, the average duration of meth use before a heart failure diagnosis is five years; but for 18% of people who go on to develop the disease, it happens within 12 months.

In some cases, heart failure was diagnosed after a single use.

The researchers said meth heart failure is associated with a greater likelihood of other substance abuse, post-traumatic stress disorder, depression, and other heart disease and kidney disease.

They acknowledged limitations to their analysis, noting most reviewed studies were small and observational, and "differed substantially in design, statistical methods, eligibility criteria, and outcomes." This, they said, may undermine its usefulness.

The researchers also touched on treatment and hospitalization costs.

In California, the investigators said, annual hospital charges for meth heart failure increased by 840%, from $41.5 million to $390 million, from 2008 to 2018, according to statewide data.

That compares with an 82% hike, from $3.5 billion to $6.4 billion, for all heart failure hospitalizations in the state over the decade.

Dr. Michael Kilkenny, the top public health official in Cabell County, W.Va., an area hard hit by prescription opioid and street drug overdoses, told UPI that public health officials there aren't measuring the clinical impact of illegal meth and heart failure.


But, Kilkenny said in an email, "certainly we are willing to educate about the risk as another reason to avoid the use of illicit methamphetamine."

Currently, there is no FDA approved medication for methamphetamine use disorder and the most effective behavioral treatment is often difficult for patients and families to access, said Hall, the Columbus, Ohio, physician.

"Nevertheless, some medications have early evidence they may help people with methamphetamine use disorder and a wide variety of counseling services can increase the chance of recovery," he said.

Hall said that in his role as an addiction medicine consult physician, he often cares for patients with meth use disorder in the hospital.

"Many of these patients have severe medical problems related to methamphetamine use, including heart failure," he said.

"We try to reduce the risk of these problems by providing addiction treatment, or harm reduction services to those who are not ready to stop using methamphetamine."

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