
Methamphetamine, an illegal recreational drug, can cause strokes in both habitual and first-time users, regardless of age. It is a potent stimulant that can be inhaled, injected, or smoked. The drug causes a spike in blood pressure, which can lead to a stroke. Studies have shown that hemorrhagic strokes are more common among methamphetamine users, but the drug can also induce ischemic strokes in young, healthy individuals. The use of methamphetamine has been linked to a heightened risk of stroke in young people, with men being twice as likely to be affected as women.
Characteristics | Values |
---|---|
Age | Those below 45 are at an increased risk of stroke |
Sex | Men are twice as likely to have a stroke as women |
Type of stroke | Haemorrhagic strokes are more common |
Risk factors | High blood pressure, kidney disease, anxiety, depression, smoking, alcohol misuse |
Mortality rate | 1 in 4 people recover completely, 1 in 3 die |
What You'll Learn
How methamphetamine can cause a stroke
Methamphetamine is an illegal and highly addictive recreational drug. It is classified as a stimulant and is primarily used to achieve a sense of euphoria, temporarily relieve symptoms of low self-esteem, or amplify sex drive.
The physical effects of methamphetamine are caused by its chemical action on the body. When the drug is smoked or injected, it triggers an immediate physiological process that results in an unusually high level of dopamine and other potent stimulant neurotransmitters in the bloodstream.
Dopamine is a natural substance that the body produces to maintain life-sustaining actions, such as steady breathing, stable heart function, and brain function. It is also released when we feel happy, satisfied, or peaceful.
During methamphetamine use, the excessive concentration of these natural chemicals can alter a user's heartbeat and blood pressure, speed up their breathing, and produce dizziness, sweating, and an elevated body temperature.
Methamphetamine use can lead to extreme alterations in blood flow, heart rhythm, and blood pressure, which can cause diminished blood supply to the brain and result in a stroke.
The drug can cause precipitously high blood pressure, vasculitis (inflammation of the blood vessels), and direct toxicity to the blood vessels, leading to tears or leaks that result in dangerous hemorrhagic strokes.
Studies have shown that hemorrhagic strokes are more often associated with methamphetamine use. However, the drug can also induce ischemic strokes in otherwise healthy young individuals.
Abnormal and irregular heart rhythms or abrupt closing off (spasm) of blood vessels caused by methamphetamine use can result in a sudden interruption of blood flow to the brain, causing a stroke.
How Chronic Methamphetamine Use Can Lead to Stroke
In addition to the short-term risk of stroke, long-term methamphetamine abuse can accelerate and prematurely develop atherosclerosis, a hardening of the arteries that is a well-known health condition that predisposes individuals to strokes.
The use of methamphetamine can also lead to oxidative stress, inflammation, and heart tissue fibrosis, or the formation of scar tissue in the heart muscle, all of which contribute to cardiovascular disease and increase the risk of stroke.
Signs and Symptoms of a Stroke
It is important for methamphetamine users to be vigilant for early signs of a stroke, such as intense and severe headaches, fits, and loss of feeling or function on one side of the body.
Treatment and Management
There are medical treatments available that may be able to reverse the effects of methamphetamine and improve the outcomes of methamphetamine-induced strokes, which have a high rate of death.
However, it is challenging to stop using potent drugs like methamphetamine due to the almost intolerable withdrawal reaction and the fear of leaving one's community group. Therefore, it is recommended to seek professional help and support when trying to overcome addiction.
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Risk factors for methamphetamine-induced strokes
Methamphetamine use can cause strokes in both habitual and first-time users, regardless of age. The drug is a potent stimulant that causes an unusually elevated blood concentration of dopamine and other potent stimulant neurotransmitters. This can lead to extreme alterations in blood flow, heart rhythm, and blood pressure, which can ultimately cause a stroke.
Several risk factors have been identified for methamphetamine-induced strokes:
- Precipitously high blood pressure: Methamphetamine use can cause a dangerous spike in blood pressure, which can lead to a hemorrhagic stroke.
- Vasculitis: Methamphetamine use can cause inflammation of the blood vessels, which can lead to tears or leaks and result in a hemorrhagic stroke.
- Direct toxicity to blood vessels: The drug's direct toxic effects on blood vessels can also cause them to tear or leak, leading to a hemorrhagic stroke.
- Abnormal and irregular heart rhythm: Methamphetamine use can cause arrhythmias, which can lead to a sudden interruption of blood flow and an ischemic stroke.
- Abrupt closing off of blood vessels (vasospasm): This can result in a sudden interruption of blood flow and an ischemic stroke.
- Acceleration of atherosclerosis: Long-term methamphetamine abuse can lead to the premature development of atherosclerosis, a hardening of the arteries that is a known risk factor for stroke.
- Cardiomyopathy: Methamphetamine use can cause cardiomyopathy, which can lead to ischemic stroke.
- Infective endocarditis: This is particularly relevant for people who inject methamphetamine and can lead to ischemic stroke.
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Short-term vs long-term effects of methamphetamine use on stroke risk
Methamphetamine is a highly addictive, synthetic stimulant that can be smoked, snorted, injected, or swallowed. Its short-term effects include a rush of euphoria, increased alertness and energy, decreased appetite, and cardiovascular problems such as rapid heart rate, irregular heartbeat, and increased blood pressure. These cardiovascular issues can lead to a stroke, especially when methamphetamine use results in a fatal overdose. Methamphetamine use can also cause hyperthermia, which can lead to brain and organ damage, including to the liver and the central nervous system.
The long-term effects of methamphetamine use include insomnia, memory loss, development of a substance use disorder, and other health problems. It can also result in cerebral small vessel disease, which is a group of pathological processes that affect the small perforating vessels and capillaries in the brain and is a common cause of stroke, cognitive impairment, and vascular dementia. Research has shown that methamphetamine abuse increases the risk of this disease in young patients with acute ischemic stroke. Methamphetamine use has also been associated with an increased risk of both hemorrhagic and ischemic strokes.
In summary, while methamphetamine use can lead to a stroke in the short term, especially when it results in an overdose, its long-term effects on the brain and body can also increase the risk of stroke and other serious health issues.
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Gender differences in methamphetamine-induced stroke risk
Methamphetamine use is associated with a heightened risk of stroke in young people, especially those under 45. This risk is observed for both men and women, with men twice as likely to experience a stroke as women.
A review of the available evidence by Dr Julia Lappin, Professor Shane Darke and Professor Michael Farrell, published in the Journal of Neurology Neurosurgery & Psychiatry, found that 80% of methamphetamine-related strokes reported were haemorrhagic. This is significantly higher than the reported rates of haemorrhagic stroke in the wider stroke population under 45 (40-55%) and the general stroke population (15-20%).
The review also found that of the 98 strokes reported in the literature, 81 were haemorrhagic and 17 were ischaemic. Both types were around twice as common in men. In case reports and series, 8 out of 10 strokes related to methamphetamine use among young people were haemorrhagic.
A separate study by Lappin, Darke, and Farrell (2017) found that, of 1369 eligible patients, 61 (4.5%) had a history of methamphetamine use. These patients were significantly younger, more likely to be male, and more likely to be White than those in the non-methamphetamine group.
The mechanisms by which methamphetamine causes stroke are still unknown. However, it has been shown to produce a dose-dependent elevation of blood pressure and chronic hypertension, which are risk factors for stroke.
Given the often disabling or fatal consequences of a stroke, and the increasing use of methamphetamine among young people, the findings of these studies are concerning. Dr Lappin notes that "a stroke can cause death or devastating and long-lasting disability" and that "methamphetamine users should be alert in both themselves and other users to early signs of stroke such as intense and severe headache, fits, and loss of feeling or function on one side of the body."
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Treatment options for methamphetamine-induced strokes
In terms of acute management, standard therapeutic interventions for acute stroke and approaches to secondary stroke prevention seem appropriate for meth-associated strokes, with the addition of abstinence from continued meth use. Beta-blockers, for example, have historically been avoided due to a theoretical risk of unopposed alpha-receptor stimulation, but there is a lack of real-world evidence for this. Surgical management, including external ventricular drain placement, minimally invasive clot evacuation, decompressive craniectomy, and intervention on aneurysms, should also be considered.
For ischemic strokes, acute therapies such as thrombolytics or thrombectomy may be offered if the patient qualifies. However, there is a lack of high-quality data on the outcomes of these treatments in meth users.
Methamphetamine cessation is critical for optimal patient care. While there are no proven pharmaceutical options for methamphetamine cessation, behavioural therapies such as contingency management are the standard of care.
Finally, it is important to be aware of the prolonged withdrawal period from methamphetamine, which can last up to 6-12 months and overlap with stroke recovery, making it difficult to distinguish the cause of new mood and mental status changes.
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Frequently asked questions
Yes, methamphetamine use can cause strokes in both first-time and habitual users, regardless of age.
Methamphetamine use can cause extreme alterations in blood flow, heart rhythm, and blood pressure, which can lead to diminished blood supply to the brain and therefore a stroke.
Risk factors for methamphetamine-induced strokes include male gender, kidney disease, high blood pressure, and anxiety or depression.
Signs and symptoms of a methamphetamine-induced stroke can include intense and severe headache, fits, and loss of feeling or function on one side of the body.
If you think someone is having a stroke, call emergency services immediately. Time is critical in stroke treatment, and early intervention can improve outcomes.