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Stronach O, Dietze P, Livingston M, Roxburgh A. 20-year trends in Australian methamphetamine-related deaths, 2001-2020. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 131:104548. [PMID: 39141956 DOI: 10.1016/j.drugpo.2024.104548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 07/23/2024] [Accepted: 07/28/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Over the past two decades methamphetamine-related harms have increased in Australia. Previous analysis of methamphetamine-related deaths has covered limited timeframes, and largely focused on drug-toxicity deaths. This paper examines long-term trends in methamphetamine-related deaths over 20 years, including deaths due to a range of specific causes. METHODS Descriptive analyses were conducted on Australian methamphetamine-related deaths (2001-2023) by cause, extracted from the National Coronial Information System, an online database containing deaths reported to coroners in Australia and New Zealand. Joinpoint trend analyses were used to assess changes over time between 2001 and 2020 (with data from 2021 to 2023 likely incomplete and thus excluded). RESULTS Unintentional drug toxicity was the cause of 49.8 % of methamphetamine-related deaths, intentional self-harm (including toxicity) 23.3 %, unintentional injury 15.1 %, natural causes 9.6 %, and assaults 2.3 %. Between 2001 and 2020, joinpoint analysis showed three trend change points among all-cause methamphetamine-related mortality rates, resulting in four distinct periods: two periods where they increased (2001-2006 - annual percentage change (APC) = 15.4 %; 2009-2016 - APC 25.5 %), and two where they decreased (2006-2009 - APC = -11.8 %; 2017-2020 - APC = -2.9 %). Similar patterns were evident among rates of intentional self-harm and unintentional injury. Deaths caused by unintentional drug toxicity saw two trend change points (2011, 2016), and rates increased across all three periods. Natural cause deaths had three trend change points (2007, 2010, 2015), and rates continued to rise after 2015, largely driven by increases in circulatory diseases. CONCLUSION Cause-specific models highlighted diverse trends. Recent trends show unintentional drug toxicity deaths have slightly increased, intentional self-harm stabilised, and unintentional injury and assault deaths have declined. Deaths from natural causes involving methamphetamine continued to increase, highlighting a public health concern and a potential need for early circulatory disease screening among people who use methamphetamine.
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Affiliation(s)
- Oisin Stronach
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia.
| | - Paul Dietze
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia; National Drug Research Institute, Curtin University, Perth, Australia
| | - Michael Livingston
- Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia; National Drug Research Institute, Curtin University, Perth, Australia
| | - Amanda Roxburgh
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia
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Ali S, Al-Yafeai Z, Hossain MI, Bhuiyan MS, Duhan S, Aishwarya R, Goeders NE, Bhuiyan MMR, Conrad SA, Vanchiere JA, Orr AW, Kevil CG, Bhuiyan MAN. Trends in peripheral artery disease and critical limb ischemia hospitalizations among cocaine and methamphetamine users in the United States: a nationwide study. Front Cardiovasc Med 2024; 11:1412867. [PMID: 39022622 PMCID: PMC11251891 DOI: 10.3389/fcvm.2024.1412867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/31/2024] [Indexed: 07/20/2024] Open
Abstract
Background Peripheral artery disease (PAD) is on the rise worldwide, ranking as the third leading cause of atherosclerosis-related morbidity; much less is known about its trends in hospitalizations among methamphetamine and cocaine users. Objectives We aim to evaluate the overall trend in the prevalence of hospital admission for PAD with or without the use of stimulant abuse (methamphetamine and cocaine) across the United States. Additionally, we evaluated the PAD-related hospitalizations trend stratified by age, race, sex, and geographic location. Methods We used the National Inpatient Sample (NIS) database from 2008 to 2020. The Cochran Armitage trend test was used to compare the trend between groups. Multivariate logistic regression was used to examine adjusted odds for PAD and CLI hospitalizations among methamphetamine and cocaine users. Results Between 2008 and 2020, PAD-related hospitalizations showed an increasing trend in Hispanics, African Americans, and western states, while a decreasing trend in southern and Midwestern states (p-trend <0.05). Among methamphetamine users, an overall increasing trend was observed in men, women, western, southern, and midwestern states (p-trend <0.05). However, among cocaine users, PAD-related hospitalization increased significantly for White, African American, age group >64 years, southern and western states (p-trend <0.05). Overall, CLI-related hospitalizations showed an encouraging decreasing trend in men and women, age group >64 years, and CLI-related amputations declined for women, White patient population, age group >40, and all regions (p-trend <0.05). However, among methamphetamine users, a significantly increasing trend in CLI-related hospitalization was seen in men, women, White & Hispanic population, age group 26-45, western, southern, and midwestern regions. Conclusions There was an increasing trend in PAD-related hospitalizations among methamphetamine and cocaine users for both males and females. Although an overall decreasing trend in CLI-related hospitalization was observed for both genders, an up-trend in CLI was seen among methamphetamine users. The upward trends were more prominent for White, Hispanic & African Americans, and southern and western states, highlighting racial and geographic variations over the study period.
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Affiliation(s)
- Shafaqat Ali
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Zaki Al-Yafeai
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Md. Ismail Hossain
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Md. Shenuarin Bhuiyan
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Sanchit Duhan
- Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD, United States
| | - Richa Aishwarya
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Nicholas E. Goeders
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
- Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
- Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | | | - Steven A. Conrad
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
- Department of Pediatrics, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - John A. Vanchiere
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
- Department of Pediatrics, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - A. Wayne Orr
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Christopher G. Kevil
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Mohammad Alfrad Nobel Bhuiyan
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
- Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
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Al-Yafeai Z, Ali S, Brown J, Venkataraj M, Bhuiyan MS, Mosa Faisal AS, Densmore K, Goeders NE, Bailey SR, Conrad SA, Vanchiere JA, Orr AW, Kevil CG, Nobel Bhuiyan MA. Cardiomyopathy-Associated Hospital Admissions Among Methamphetamine Users: Geographical and Social Disparities. JACC. ADVANCES 2024; 3:100840. [PMID: 39130045 PMCID: PMC11312042 DOI: 10.1016/j.jacadv.2024.100840] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 08/13/2024]
Abstract
Background Methamphetamine is an emerging drug threat. The disparity in cardiomyopathy-associated hospital admissions among methamphetamine users (CAHMA) over the decade remains unknown. Objectives The purpose of this study was to determine the trends and prevalence of CAHMA by age, sex, race, and geographical region. Methods We used data from 2008 to 2020 from the National Inpatient Sample database. We identified 12,845,919 cardiomyopathy-associated hospital admissions; among them, 222,727 were diagnosed as methamphetamine users. A generalized linear model with binomial link function was used to compute the prevalence ratio and 95% CI. Those who used other substances along with methamphetamine were excluded from the analysis. Results CAHMA increased by 231% (P trend <0.001) from 2008 to 2020. CAHMA increased 345% for men (P trend <0.001) and 122% for women (P trend <0.001), 271% for non-Hispanic White (P trend <0.001), 254% for non-Hispanic Black (p trend <0.001), 565% for Hispanic (P trend <0.001), and 645% for non-Hispanic Asian (P trend <0.001) population. CAHMA also increased significantly in the West region (530%) (P trend <0.001) and South region (200%) (P trend <0.001) of the United States. Men, Hispanic population, age groups 26 to 40 and 41 to 64 years, and Western regions showed a significantly higher uptrend than their counterparts (P trend <0.001). Conclusions CAHMA have increased significantly in the United States. Men, Hispanics, non-Hispanic Asian, age groups 41 to 64. and western regions showed a higher proportional increase highlighting gender-based, racial/ethnic, and regional disparities over the study period.
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Affiliation(s)
- Zaki Al-Yafeai
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - Shafaqat Ali
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - Jimmy Brown
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - Maamannan Venkataraj
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - Md. Shenuarin Bhuiyan
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - Abu Saleh Mosa Faisal
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - Kenneth Densmore
- Office of Research, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - Nicholas E. Goeders
- Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - Steven R. Bailey
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - Steven A. Conrad
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - John A. Vanchiere
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - A. Wayne Orr
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Department of Cellular Biology and Anatomy, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - Christopher G. Kevil
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - Mohammad Alfrad Nobel Bhuiyan
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
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Charoenpong P, Dhillon N, Murnane K, Goeders N, Hall N, Keller C, Bhuiyan MAN, Walter R. Methamphetamine-associated pulmonary arterial hypertension: data from the national biological sample and data repository for pulmonary arterial hypertension (PAH Biobank). BMJ Open Respir Res 2023; 10:e001917. [PMID: 38061804 PMCID: PMC10711868 DOI: 10.1136/bmjresp-2023-001917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE This study compares the clinical and haemodynamic severity of methamphetamine-associated pulmonary arterial hypertension (MA-PAH) with idiopathic pulmonary arterial hypertension (IPAH) and connective tissue-associated pulmonary arterial hypertension (CTD-PAH). It also examines sex differences in clinical and physiological parameters among those with MA-PAH. DESIGN This is a cross-sectional study using clinically derived data from the National Biological Sample and Data Repository for Pulmonary Arterial Hypertension (PAH biobank), a US-based registry, to compare clinical and physiological characteristics between males and females with MA-PAH. POPULATION The analysis included 1830 patients enrolled in the PAH biobank, with a diagnosis of MA-PAH (n=42), IPAH (n=1073), or CTD-PAH (n=715). MAIN OUTCOME MEASURES The study assessed and compared the clinical and haemodynamic parameters of patients with MA-PAH, IPAH and CTD-PAH. RESULTS Among the patients analysed, 42 had MA-PAH, with 69.1% being female. There were no statistically significant differences in functional class among patients with MA-PAH, IPAH and CTD-PAH. The per cent predicted 6-min walk distance (6MWD) was comparable between the three groups. Patients with MA-PAH had similar mean pulmonary artery pressure and pulmonary vascular resistance to patients with IPAH but higher compared with patients with CTD-PAH. Male patients with MA-PAH exhibited a worse functional class and lower per cent predicted 6MWD, but no significant differences in haemodynamic findings were observed between the sexes. CONCLUSION There were no differences in haemodynamic between MA-PAH and IPAH but we found that MA-PAH differed from CTD-PAH. The study did not find evidence of sex differences in MA-PAH. Further research is necessary to identify risk factors and underlying mechanisms of MA-PAH, particularly considering the increasing prevalence of methamphetamine use. Such investigations will contribute to the development of effective prevention and treatment strategies for this condition.
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Affiliation(s)
- Prangthip Charoenpong
- Internal Medicine, Division of Pulmonary and Critical Care, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
- Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Louisiana Addition Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
| | - Navneet Dhillon
- Internal Medicine, Pulmonary and Critical Care, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kevin Murnane
- Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Louisiana Addition Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Department of Pharmacology Toxicology and Neuroscience, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
- Department of Psychiatry, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Nicholas Goeders
- Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Louisiana Addition Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Department of Pharmacology Toxicology and Neuroscience, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
- Department of Psychiatry, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Nicole Hall
- Department of Pharmacology Toxicology and Neuroscience, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Courtney Keller
- Department of Pharmacology Toxicology and Neuroscience, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Mohammad Alfrad Nobel Bhuiyan
- Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Internal Medicine, Division of Clinical Informatics, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Robert Walter
- Internal Medicine, Division of Pulmonary and Critical Care, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
- Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
- Louisiana Addition Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, USA
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Edinoff AN, Kaufman SE, Green KM, Provenzano DA, Lawson J, Cornett EM, Murnane KS, Kaye AM, Kaye AD. Methamphetamine Use: A Narrative Review of Adverse Effects and Related Toxicities. Health Psychol Res 2022; 10:38161. [PMID: 36118981 PMCID: PMC9476235 DOI: 10.52965/001c.38161] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2023] Open
Abstract
Methamphetamine has been labeled "America's most dangerous drug" and has received significant public health attention. Stimulant addiction and tolerance are heavily documented in the literature; increasingly larger doses maintain euphoria in short time periods to withstand stimulant tolerance. Stimulant deaths are high in the United States and abroad. Between 2013 and 2019, deaths related to methamphetamine use quadrupled from 3,616 to 16,127. Methamphetamine use increased four-fold from 2015 to 2016. Due to this increase in methamphetamine use and its associated medical complications, the mortality rate associated with methamphetamine use has doubled over the past ten years. Cardiopulmonary symptoms include chest pain, palpitations, and shortness of breath. Methamphetamine-related myocardial infarction can also occur. Central nervous system symptoms include agitation, anxiety, delusions, hallucinations, and seizures. Methamphetamine-induced psychosis may unmask underlying psychiatric disorders. It can also cause cerebral vasculitis, which elicits cortical blindness and ischemic strokes. Methamphetamine-induced neurotoxicity in serotonergic systems is more diffuse, involving the striatum, hippocampus, septum, amygdala, and hypothalamus leading to mood changes, psychosis, and memory impairment. This narrative review will aim to highlight the adverse effects as well as the toxicity that can occur with methamphetamine use.
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Affiliation(s)
- Amber N Edinoff
- Department of Psychiatry, Harvard School of Medicine, Massachusetts General Hospital; Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Shreveport; Louisiana Addiction Research Center
| | - Sarah E Kaufman
- Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Shreveport; Louisiana Addiction Research Center
| | - Keionne M Green
- School of Medicine, Louisiana State University Health Science Center Shreveport
| | - Daniel A Provenzano
- School of Medicine, Louisiana State University Health Science Center Shreveport
| | - Jesse Lawson
- Department of Emergency Medicine, Louisiana State University Health Science Center Shreveport
| | - Elyse M Cornett
- Department of Anesthesiology, Louisiana State University Health Science Center Shreveport
| | - Kevin S Murnane
- Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Shreveport; Louisiana Addiction Research Center; Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Science Center Shreveport
| | - Adam M Kaye
- Thomas J. Long School of Pharmacy and Health Sciences, University of The Pacific
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Science Center Shreveport
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