Not only are these cases increasing, but they are more severe than traditional heart failure cases and they are striking all racial and socioeconomic groups.
“The increasing prevalence of meth [heart failure] across racial/ethnic and sociodemographic groups in the setting of rising [meth use] worldwide calls for increased awareness and availability of treatment for methamphetamine addiction,” the study authors reported. “General health care’s successful experience with management of the opioid epidemic needs to be translated and expanded to treatment of [meth use disease].”
Where to start? Public awareness and treatment for meth addiction are needed to stop these increases, urged the researchers, led by Dr. Veena Manja of the VA Center for Innovation to Implementation in Menlo Park, Calif.
For the study, the team reviewed published research on meth use and heart failure, including 21 observational studies that were done between 1997 and 2020, most of them in the United States. The studies involved several thousand people who were an average age of 35 to 60.
The participants had used meth — sometimes called “crystal meth,” “ice” or “speed” — through inhalation, injection, swallowing, smoking and snorting, as often as daily to every other week, with total monthly doses ranging from 0.35 to 24.5 grams.
In addition to heart failure, meth use is associated with high blood pressure, heart attack, stroke and sudden death, the researchers said.
Meth users had used the drug an average of five years before their heart failure diagnosis. For 18% of users who developed heart failure, it happened within 12 months. Sometimes, heart failure happened after one use.
Users who developed heart failure had more severe disease than those who didn’t use meth, in addition to longer inpatient stays and more hospital readmissions, the investigators found.
The report was published online Dec. 1 in the journal Heart.
Meth heart failure was also associated with a greater likelihood of other substance abuse, post-traumatic stress disorder, depression and other heart and kidney diseases, the study authors said in a journal news release.
Improved outcomes were associated with being a woman, cutting out the drug completely and heart failure treatment based on clinical guidelines, the researchers noted.
The cost of treating meth heart failure is substantial. California inpatient data show that it rose from $41.5 million in 2008 to $390.2 million in 2018, an 840% increase. By comparison, for all heart failure cases, the rising costs were only 82%.
Study limitations include that the studies reviewed were small, retrospective, observational and differed substantially in design, methods, eligibility criteria and outcomes.
Dr. Jonathan Davis, an associate professor of medicine at the University of California, San Francisco, said in an accompanying editorial that the review shows meth heart failure isn’t straightforward to study or treat.
“[The researchers] clearly demonstrate that with improved understanding of patients’ relationships with methamphetamine and the other factors impacting their care, we will better characterize the pathophysiology of methamphetamine-associated heart failure and better investigate evidence-based best practices and treatment strategies,” Davis said in the news release. “A multidisciplinary team designed to meet this population’s unique needs and deliver non-stigmatizing, patient-centered care is mandatory.”
The U.S. National Institute on Drug Abuse has more on methamphetamine.
SOURCE: Heart, news release, Dec. 1, 2022
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