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Higher risk of stroke in young people using methamphetamine

Men twice as likely as women to suffer stroke from drug use

Adrian O'Dowd

Thursday, 24 August 2017

Young people using the stimulant drug methamphetamine, also popularly known as ‘speed,’ ‘ice’ and ‘meth’ appear to have a higher risk of stroke, suggests research* published online today in the Journal of Neurology Neurosurgery & Psychiatry.

A new review of the available evidence also found that men were twice as likely as women to have a stroke after taking the drug with brain bleed (haemorrhagic) rather than a clot (ischaemic) being the most common stroke type.

Methamphetamine use is a significant public health problem, particularly in countries around the Pacific rim (North America, East/Southeast Asia and Oceania), with an estimated 35 million stimulant users worldwide.

Harmful physical and mental health consequences are common, including cardiovascular and cerebrovascular pathology, psychosis, suicide and premature mortality.

A team of researchers from the National Drug and Alcohol Research Centre and School of Psychiatry, both at University of New South Wales, Sydney, Australia, carried out a comprehensive review of research looking at a potential link between methamphetamine use and associated stroke risk in young people (under the age of 45), published up to February of this year.

From 77 relevant pieces of research, 81 haemorrhagic and 17 ischaemic strokes were reported. Both types were around twice as common in men as they were in women.

In the case reports and research series looked at, eight out of 10 strokes associated with the use of methamphetamine use among young people were haemorrhagic.

This was much higher than reported rates of this type of stroke in people under the age of 45 (40-50%) or in older people (15-20%), the researchers pointed out.

Methamphetamine can be swallowed, inhaled, or injected and haemorrhagic strokes were equally associated with swallowing the drug and injecting it while inhalation was the most common method of getting high associated with ischaemic stroke.

Haemorrhagic stroke was associated with vascular abnormalities, such as high blood pressure and inflamed blood vessels, in a third of cases.

Analysis also showed that risk of death was higher after a haemorrhagic stroke – one in four people recovered completely, but a third died. This compared with complete recovery for a fifth of people and death in a fifth after an ischaemic stroke.

The researchers concluded: “With the use of methamphetamine increasing, particularly more potent forms, there is a growing burden of methamphetamine-related disease and harms, particularly among young people, in whom the majority of methamphetamine use occurs.

“Indeed, it is likely that methamphetamine abuse is making a disproportionate contribution to the increased incidence of stroke among young people observed over recent years.”

* Lappin JM, Darke S, Farrell M. Stroke and methamphetamine use in young adults: a review. J Neurol Neurosurg Psychiatry, published online first: 23 August 2017. doi: 10.1136/jnnp-2017-316071

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