Meth-related heart failure hospitalizations – and costs – soar in California

Hospitalizations for methamphetamine-related heart failure – and the cost of treating these problems – skyrocketed in California during a decade, a new study shows.

Published this week in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes(link opens in new window), the study found the hospitalization rate from methamphetamine-related heart failure climbed 585% from 2008 to 2018. And hospitalization costs soared even higher, by 840%. Most of these cases occurred in adults younger than 65, spurring researchers to call for an urgent public health response.

"California is seeing a resurgence of methamphetamine use, and the problem has been made drastically worse in recent years by the increase in purer, more potent methamphetamine throughout our communities," lead author Dr. Susan Zhao said in a news release. Zhao is a cardiologist at Santa Clara Valley Medical Center in San Jose, California.

Heart failure, which typically occurs in adults 60 and older, is a chronic condition in which the heart becomes too weak to properly pump blood. Symptoms include fatigue, shortness of breath and heart palpitations. Roughly 6 million people in the U.S. age 20 and older have the condition.

Using the addictive stimulant methamphetamine, or meth, triggers blood vessel spasms and life-threatening spikes in blood pressure, increases plaque in the arteries and rewires the heart's electrical system. Prolonged use weakens the heart and can lead to heart failure. Roughly 1.6 million people reported using methamphetamines in 2017, with new users averaging just 23 years of age.

Researchers found 94% of all methamphetamine-related heart failure hospitalizations during the 11-year study period were for people under the age of 65. More than half of them were 35 to 54. And while heart failure hospitalizations related to meth skyrocketed, those not connected to the drug actually declined by 6%.

Of those hospitalized for meth-related heart failure, 79% were men and roughly half were white adults. They were more likely to be homeless, consume alcohol and use tobacco or other illicit drugs than those hospitalized for heart failure not caused by drug use. Meth users with heart failure also were more likely to have high blood pressure but less likely to have Type 2 diabetes or atrial fibrillation.

Hospital stays were more costly for meth users who had heart failure because they were longer and required more medical procedures.

"Treating patients with methamphetamine-related heart failure is consuming resources and burdening the health care system," said Zhao, who with her colleagues plans to work with California's public health agencies to develop a statewide awareness campaign. "Many patients present late in the course of illness with limited options available to them. Proactive, preventative public health outreach and education are needed to stem the influx of methamphetamine-related heart failure at its source."

An editorial accompanying the study said meth-related heart failure may get less attention because the risk of immediate death from a meth overdose is lower than from opioids. However, the authors wrote, methamphetamines are "equally dangerous and costly to society but more insidious in nature, its effects potentially causing decades of mental and physical debilitation before ending in premature death."

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