Suicide Tops Death List for Meth Heads

Methamphetamine Chemical Structure

Methamphetamine dependence can lead to an early death.  The magnitude and mechanism of this effect is not well understood.  One way to better understand effects of drug abuse/dependence on mortality is the prospective outcome study.  These types of studies tend to be costly and may require many years to yield research results.   That’s why there are not many published studies to answer the question of this post.

A recent study from Taiwan provides some valuable insight into this issue.  This study followed a cohort of 1254 individuals with a history of methamphetamine abuse and a psychiatric admission for treatment between 1990 and 2007.  National death records were queried and the methamphetamine abuse cases were compared to an age- and gender- matched control group.  One hundred thirty methamphetamine users died during follow up with the following leading categories of death:  

• Suicide n=42 (32.3%)
• Accidents n=26 (20.0%)
• Undetermined unnatural deaths n=14 (10.8%)
• Cardiovascular disease n=13 (10.0%)
• Undetermined natural deaths n=9 (6.9%)
• Liver disease n=6 (4.6%)

In this Taiwanese sample, methamphetamine abuse carried an overall six fold increase in mortality.  Unnatural deaths (suicides, accidents, homicides, undetermined natural deaths) were particularly elevated.  Male amphetamine abusers had about a 10-fold increase in unnatural deaths while female methamphetamine abusers had a remarkable 26-fold increase in unnatural death during follow up.

Being married appeared to reduce the risk of death from unnatural and natural causes in this cohort.  Use of other substances in addition to methamphetamine increased risk of death.

I would suspect that in the United States, homicide would be a greater contributor to mortality in those with a history of methamphetamine dependence.  Overall homicide rates in Taiwan are much lower than in the United States and may reduce risk for this type of unnatural death.

Interestingly, about two thirds of the cohort had exhibited methamphetamine psychosis-a psychiatric complication of methamphetamine use.  Those with a history of this type of psychosis were no more likely to die than those without a history of the psychosis.

One problem with this type of study is difficulty assessing the specific effect of methamphetamine from other potential confounding factors.  For example, methamphetamine use is higher in smokers than smokers and so some increased mortality risk could be related to effects of smoking.  Methamphetamine dependence is more prevalent in a variety of mental disorders linked to increased suicide.

Nevertheless, this study shows the magnitude and type of mortality risk linked to methamphetamine dependence.  Public health interventions that reduce the prevalence of methamphetamine dependence would like reduce the excess mortality associated with this drug.

Wikipedia Commons chemical structure of methamphetamine image authored by Harbin.

Kuo CJ, Liao YT, Chen WJ, Tsai SY, Lin SK, & Chen CC (2010). Causes of death of patients with methamphetamine dependence: A record-linkage study. Drug and alcohol review PMID: 21355920