Methamphetamine Use Research Articles (Page 1)

Hypocretin signaling in the central amygdala drives methamphetamine self-administration in male rats.

Characterizing an intersection between heat-related illness and overdose deaths in Arizona: Analysis of data from the State Unintentional Drug Overdose Reporting System, 2019-2023.

Methamphetamine use disorder represents a growing global health concern, particularly affecting adolescents and young adults. Beyond its well-established neurotoxic effects, the substance imposes severe psychosocial consequences on individuals, families, and broader communities. This study aimed to provide a multidimensional understanding of methamphetamine dependence by combining psychiatric expertise with the lived experiences of an affected family. A qualitative design was employed, drawing on semi-structured interviews with 21 psychiatrists working in adult psychiatry departments and with members of a family directly impacted by methamphetamine addiction. Thematic analysis identified four overarching domains: (1) perceived trends in use, (2) psychiatric manifestations and diagnostic challenges, (3) social and environmental determinants, and (4) approaches to treatment and prevention. Findings demonstrated a marked increase in methamphetamine use among adolescents and young adults, with both clinicians and family members emphasizing the rapid transition from experimentation to dependence. Prominent psychiatric outcomes observed in methamphetamine dependence included intense paranoia, vivid hallucinations, episodes of aggression, and long-lasting cognitive deficits. These symptoms frequently made it challenging for clinicians to distinguish substance-induced states from primary psychotic illnesses. Beyond clinical manifestations, contextual influences played a critical role. Economic hardship, strained family relationships, parental mental health problems, and broader global uncertainties were repeatedly described as factors that heightened vulnerability. Excessive engagement with digital platforms and the anxiety provoked by constant exposure to social media further intensified these risks, while stigma and cultural silence often postponed both recognition of the problem and access to care. Importantly, the findings suggest that successful responses cannot rely on medication alone. The establishment of trusting therapeutic relationships, the introduction of preventive education during adolescence, the development of coping and problem-solving skills, and coordinated work across medical, psychological, and social domains emerged as vital elements of effective care. Taken together, these insights point to the need to approach Methamphetamine use disorder not only as a neuropsychiatric condition but also as a broader social phenomenon, one that demands integrated strategies spanning clinical practice, family systems, and community support structures.

Methamphetamine abuse among women of reproductive age is a growing concern, necessitating investigation of its intrauterine effects on offspring. In this study, we examined the induction of oxidative stress and apoptosis in the ovaries of rat offspring following maternal methamphetamine exposure. Pregnant Wistar rats received methamphetamine (2 mg/kg or 5 mg/kg) from gestational day 10 until delivery. Control rats received 0.9% saline (1 mL/kg) on the same schedule. Female offspring were raised to puberty and their ovaries were examined, compared to controls. Protein expression levels of FASL and TRAIL were assessed by immunohistochemistry, and antioxidant enzyme levels (superoxide dismutase, SOD) and oxidative stress marker levels (malondialdehyde, MDA) were evaluated by ELISA1. Histological examination of the ovaries was performed using H&E staining. Maternal methamphetamine treatment significantly increased ovarian FASL and TRAIL protein expression in the pubertal offspring (p ≤ 0.001). In utero methamphetamine exposure led to a dose-dependent increase in ovarian MDA levels and a corresponding decrease in SOD activity (p ≤ 0.05). Histologically, exposed offspring showed a reduction in the number of primordial, primary, secondary, and Graafian follicles, as well as a reduction in corpora lutea, compared to controls (p < 0.05). Conversely, the number of atretic follicles increased significantly in a dose-dependent manner (p < 0.05). Prenatal methamphetamine exposure induces oxidative stress and promotes apoptosis in the ovaries of offspring, leading to reduced ovarian follicle reserves. These findings raise concerns that methamphetamine use during pregnancy may impair female reproductive health in offspring.

Background: Methamphetamine Use (MU) is a growing public health concern across the United States and is associated with dilated cardiomyopathy and pulmonary hypertension. For those with end-stage disease, advanced therapies considerations such as heart transplant may be lifesaving; however, these patients are often excluded from candidacy due to MU history. Concerns for MU relapse resulting in missed immunosuppression and risk of rejection is a major concern. In this study, we describe a large single center experience describing outcomes and rates of rejection following Orthotopic Heart Transplant (OHT) in patients with a history of MU. Methods: All consecutive patients transplanted at our center from January 2020 to June 2023 were included. A total of 31 recipients with a history of MU were identified. We evaluated 30-day re-admission and rejection rates following transplant between MU and non-MU recipients. Results: A total of 279 OHT recipients were included, 31 with MU. Patients with MU disorder were more likely to be younger age (51 vs 57, p= 0.04), have more tobacco use (77% vs 34%, P &lt; 0.01) and higher SIPAT scores (31 vs 19, p &lt; 0.01). Over an average follow up time of 29 months, there was no difference in survival between the MU and non-MU groups (96.8% vs 90.3%, p = 0.24), rates of 30-day rehospitalization (22.6% vs 20.5%, p = 0.79), rates of antibody mediated rejection (6.5% vs 9.7%, p = 0.56), and rates of severe cellular rejection (6.5% vs 14.2%, p = 0.23). Conclusion: In short term follow up, we demonstrate similar rates of death, rehospitalization, and rejection between MU and non-MU OHT recipients, suggesting that OHT may be an option for a select population with MU. Further study describing use history, relapse and treatment is crucial to understanding the success of these patients.

Description of Case: A 63-year-old woman with nonischemic cardiomyopathy (CM) with recovered ejection fraction (EF), severe bicuspid aortic valve (AV) stenosis post-transcatheter aortic valve replacement (TAVR) and prior methamphetamine use presented with chest pain, troponin &gt;6000 ng/L, and anterolateral (V2-V6) ST elevation, T wave inversion, and Q waves. She was transferred for possible late or completed STEMI. Echocardiogram showed reduced ejection fraction (25% from 55%), mid-apical wall akinesis to dyskinesis, and a hyperdynamic base. Continuous wave doppler through the AV revealed a mean gradient of 44 mmHg (previously 11 mmHg) raising concern for valve dysfunction. Coronary angiography revealed nonobstructive coronary artery disease. Left heart catheterization via a 55 cm femoral sheath using an end-hole catheter with slow pullback in the left ventricle (LV) demonstrated a significant LV-aortic gradient at the apex that progressively diminished and resolved near the left ventricular outflow tract (LVOT) below the aortic valve, confirming dynamic LVOT obstruction. Cardiac magnetic resonance imaging (MRI) showed patchy late gadolinium enhancement (LGE), raising concern for myocarditis versus stress CM due to methamphetamine exposure. The patient improved with medical therapy and was discharged in stable condition. Discussion: The dynamic LVOT obstruction in this case resulted from hyperdynamic basal contraction against an akinetic apex, causing mid-cavity collapse and a falsely elevated transvalvular gradient, mimicking prosthetic valve stenosis. This underrecognized mechanism can mislead post-TAVR assessments, especially in the setting of catecholamine excess or myocardial inflammation. Initial concern for valve failure or infarction was redirected by invasive hemodynamics and multimodal imaging. Recognition of this physiology avoided unnecessary intervention and guided therapy. Traditionally, the absence of LGE supported stress CM, but recent studies show stress CM can present with LGE. This overlap underscores the evolving understanding of myocardial injury and highlights that myocarditis can mimic stress CM when LGE is present. This case emphasizes the importance of invasive pressure assessment, multimodal imaging, and diagnostic flexibility in evaluating post-TAVR patients with suspected acute coronary syndrome.

Description of Case: A 66-year-old man with polysubstance use and chronic kidney disease presented with dyspnea, chest pain, urinary retention, and abscesses one week after high-risk sexual activity and ongoing methamphetamine use. Labs demonstrated leukocytosis (40.95 x 10^3/uL), elevated creatinine (3.2 mg/dL), HS-troponin (22 ng/L), and prostate-specific antigen (PSA) (229 ng/mL). Periareolar eschar and an indurated knee lesion were noted (Figure 1). His ECG showed diffuse ST-segment elevations and PR depressions (Figure 2). Transthoracic echocardiogram revealed normal biventricular function and a moderate pericardial effusion without tamponade physiology (Figure 3A). Left heart catheterization revealed non-obstructive coronary artery disease. He was found to be in septic shock requiring significant fluid resuscitation and vasopressor support. Continuing antibiotics, he underwent incision and drainage of both abscesses. Blood, wound, and urine cultures grew methicillin-resistant Staphylococcus aureus (MRSA). Antibiotics were narrowed, and colchicine and aspirin were started for pericarditis after renal function improved. Transesophageal echocardiogram ruled out endocarditis. Persistent positive blood cultures, tachycardia, and leukocytosis prompted imaging to investigate other sources of infection, including the prostate, indicated by elevated PSA and recent ano-rectal intercourse. A CT scan revealed a large pericardial effusion and prostatic abscesses. While tamponade physiology remained absent, pericardiocentesis and drainage of prostatic abscesses were performed for source control. They yielded large volume purulent fluid drainage (Figure 3B), positive for MRSA, and sterile prostate drainage, respectively. After the pericardial drain output decreased, it was removed, and he continued an extended course of antibiotics, resulting in rapid improvement. Discussion: We report a case of a patient with purulent MRSA pericarditis. Although exceedingly rare, it poses a significant risk of morbidity and mortality, mainly due to cardiac tamponade potential. Recent literature includes sporadic cases, indicating a mortality rate of about 60% and tamponade progression in 42-77% of cases. The use of antibiotics has greatly reduced incidence of purulent pericarditis. Historically, this condition can spread contiguously or hematogenously, both of which are possible here. Prompt recognition and drainage is essential for timely treatment and effective source control.

NB/GQ individuals represent a distinct population with unique sexual health care needs. We characterize trends in clinic attendance, sociodemographics, STI, and drug use among NB/GQ patients at an urban SHC. We analyzed Public Health-Seattle & King County (PHSKC) SHC visit data collected between January 2016- October 2023. We used the Cochran-Armitage trend test to identify trend in reported gender identity and chi-squared tests to identify sociodemographic characteristics associated with cisgender, transgender, and NB/GQ. We evaluated the associations between gender identity and the prevalence of syphilis, urogenital gonorrhea, rectal chlamydia infection, methamphetamine, and non-prescribed injection drug use using generalized estimating equations. Of 82,384 visits, 1672 (2.0%), 867 (1.1%), and 79,845 (96.9%) were NB/GQ, transgender, and cisgender patients, respectively. From 2016-2023, the proportion of visits among NB/GQ and transgender patients increased from 0.7% to 3.5% and 0.7% to 1.7%, respectively (p-trend<0.001). NB/GQ identity was more common among patients assigned to female vs. male sex at birth (3.2% vs 1.8%, P < 0.001), younger vs older patients (14-25 years: 3.1% vs >46: 0.2%, p < 0.001), and white vs black patients (2.3% vs 1.0%, p < 0.001). Compared with MSM, NB/GQ patients had significantly lower odds of urogenital gonorrhea (aOR 0.50; 95% Confidence Interval (CI) 0.32-0.80). The differences in rectal chlamydia (aOR 0.78; 95% CI 0.59-1.02) and syphilis (aOR 0.96; 95% CI 0.87-1.06) were not statistically significant. There were no significant differences between the NB/GQ and transgender visits. Gender diversity among SHC attendees increased significantly over the eight years. Continues monitoring is essential for tailoring STI/HIV prevention strategies.

Background: Cardiac dysrhythmias (CDs) are serious cardiovascular complications increasingly observed in association with illicit stimulant use. Methamphetamine and cocaine are known to exert cardiotoxic effects, yet national trends and demographic disparities in CD-related hospitalizations among users remain underexplored. Objective: To assess national trends and demographic disparities in cardiac dysrhythmia hospitalizations among methamphetamine and cocaine users in the U.S. from 2008 to 2020. Methods: We used data from the National Inpatient Sample (2008–2020). We used ICD-9 (427) and ICD-10 (I46, I48, I48) codes to identify adult hospitalizations with a primary diagnosis of cardiac dysrhythmias who were also diagnosed as methamphetamine or cocaine users. National estimates were generated using sampling weights. Linear trend analysis and Cochran-Armitage trend tests assessed annual changes. Subgroup analyses were conducted by sex, race/ethnicity, age, region, and mortality status. Results: The overall number of cardiac dysrhythmia (CD) hospitalizations remained stable at ~5 million annually (p = 0.95), but significant increases were observed among males (p = 0.03), non-Hispanic Whites (p = 0.02), Hispanics (p = 0.02), and Asians (p &lt; 0.01). In contrast, CD-related hospitalizations among methamphetamine and cocaine users rose sharply, increasing by 105% from 2008 to 2020 (p &lt; 0.01). Male admissions increased by 122% (p &lt; 0.01) and female admissions by 72% (p &lt; 0.01). Asian and Hispanic populations saw the most significant increases (481% and 189%, respectively (p &lt; 0.01)), followed by Whites (192%) (p &lt; 0.01), African Americans 80% (p &lt; 0.01), Native Americans 360% (p &lt; 0.01), and other races 300% (p &lt; 0.01). Admissions in the 26–40 age group rose 23.8% (p &lt; 0.01), while the 41–64 and 65+ age groups increased by 110% and 230%, respectively (p &lt; 0.01). Regionally, the West experienced the most significant rise 319% (p &lt; 0.01), though the South consistently had the highest number of cases. The Midwest and Northeast saw increases of 93% and 32%, respectively (p &lt; 0.01). In-hospital mortality for this group rose 283% over the study period (p &lt; 0.01). Conclusions: Cardiac dysrhythmia hospitalizations related to methamphetamine and cocaine use have risen sharply across all major demographic groups. Despite stable overall incidence, mortality has significantly increased, highlighting a growing clinical burden and urgent need for targeted prevention strategies.

Background: Infective endocarditis (IE) recurrence is common among patients with substance use disorder (SUD) and is often met with repeated cardiac interventions due to their young age and perceived procedural candidacy. However, the impact of such interventions on survival remains unclear, particularly in high-risk populations. Methods: We conducted a retrospective cohort study (2014–2024) using ICD codes at a safety-net community hospital in downtown Minneapolis. We stratified patients with SUD into three groups: no IE (n=31231), single IE episode (n=149), and recurrent IE (≥2 episodes; n=35). We compared all-cause mortality, cause of death, mean age, and procedural rates across groups. SUD was defined as opioid, methamphetamine, or cocaine use disorders (OUD, AmUD,&amp;CoUD). Group comparisons used Fisher’s exact test or Welch’s t-test. Results: All-cause mortality increased with IE recurrence: 14% in the “no-IE”, 34% in the “single”, and 57% in the “recurrent” groups (p&lt;0.001). The recurrent IE group had a younger age (36.3 ± 9.6 years) with higher cardiac intervention rates (15% in single vs. 20% in multiple IE; p&lt;0.001). In patients with single IE, 40.9% of deaths were SUD-related and 34.3% were IE-related ( Figure ). In recurrent IE, IE-related deaths were higher (44.8%), but SUD-related deaths remained substantial (40.3%). Notably, over 40% of deaths in both groups were attributed to SUD rather than IE. Conclusion: Among patients with recurrent IE and SUD, cardiac procedural interventions are higher and associated with a higher risk of mortality. Over 40% of deaths in this population are attributed to SUD. These observations emphasize the critical importance of individualized, multidisciplinary, and risk-adapted care strategies to address SUD in the complex trajectory of single and recurrent IE, as well as careful determination of utility of cardiac procedural interventions.

Naltrexone blocks the sleep-disrupting effects of methamphetamine in male rhesus monkeys.

Sex-Specific Alterations in Brain Network Topology in Methamphetamine Use Disorder: A Graph Theory-Based fMRI Study

"What's the point of telling them?": Unspoken struggles of pregnant women with substance use history in Australian prisons.

D1-like dopamine receptors in the dentate gyrus mediate cannabidiol's facilitation of extinction and prevention of reinstatement in methamphetamine-induced conditioned place preference.

Does regulating drug precursors affect illicit drug markets? An expanded and updated systematic review.

Although 11% of all US drug overdose deaths have been attributed to methamphetamine, there are limited treatments for it that have a substantial impact on clinical outcomes. Online access to the community-based fellowship Narcotics Anonymous (NA) may offer support for remission for some persons with methamphetamine use disorder (MUD). Our objective was to characterize the role that online NA participation can play in remission of MUD. Persons who accessed a website for participating in online NA meetings were offered the option of participating in an anonymous, structured survey consisting of items related to their clinical status, substance use, and prior experience with the website. Responses of those who designated their primary drug problem as methamphetamine were analyzed. Of the 1645 respondents who accessed the NA online meeting site in 2023, 356 indicated that methamphetamine was their principal drug problem. Levels of remission by respondents who reported turning to the website primarily for MUD were analyzed for those: (1) new to the online site (44%), (2) longtime abstinent (mean 2.3y), or (3) still using methamphetamine (13%). Respondents' subjective experiences, such as their belief in the 12 Steps, spiritual awakening, and level of relief provided from distress, were also associated with remission. Online NA meetings can provide support for promoting abstinence for some persons with MUD, and can be studied relative to their clinical status. Such meetings can therefore be useful for professional referral, and their function and utility merit further investigation.

Childhood maltreatment (CM) significantly increases the risk of depression in patients with methamphetamine use disorder (MAUD). However, the underlying psychological mechanism remains unclear. The purpose of this study was to explore whether impulsivity mediates the relationship between CM and depression in patients with MAUD. We recruited 577 Chinese male inpatients with MAUD. CM, depression, and impulsivity were assessed using standardized questionnaires. A total of 321 of 577 (55.63%) patients with MAUD had experienced at least one form of CM. Maltreated patients exhibited elevated impulsivity and severe depression compared to nonmaltreated patients (both p < .001). CM, impulsivity, and depression were significantly interrelated (all p < .01). In addition, impulsivity partially mediated the CM-depression link in patients with MAUD (β = .015, 95% CI [0.007, 0.026]). Our findings indicate that CM has a long-term effect on depression, and impulsivity is an essential contributor to depressive symptoms in patients with MAUD who have experienced CM. Future research should investigate these associations using multimodal approaches and assess focused interventions that may reduce impulsivity and mitigate the psychological impact of adverse childhood experiences (ACEs) in patients with MAUD. We identified impulsivity as a key mechanism in the CM-depression link, offering a novel intervention target. Our findings advance the understanding of the psychological mechanisms in addiction psychiatry and suggest that interventions targeting impulsivity may help mitigate depression in this population.

Background/AimRosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare, benign, histiocytic proliferative disorder characterized by nonpainful lymphadenopathy. Nonmalignant histiocytes can also infiltrate extranodal sites such as in the skin and central nervous system. On imaging, RDD can mimic other disorders such as meningioma, which is more common, and requires histology and immunohistochemistry to elucidate diagnosis.Case ReportHerein we report a case of a 20-year-old female who presented to the emergency department (ED) after near-syncope episode following methamphetamine and opioid use. Initial computed tomography (CT) found a 2.3 cm mass in the right frontoparietal region. Further examinations with magnetic resonance imaging (MRI) revealed findings compatible with meningioma. After one month of persistent symptoms, the "meningioma" was resected and the intraoperative frozen sections (FS) and touch preparation cytopathology of the mass showed mixed inflammatory infiltrates and scattered large, atypical appearing cells that display emperipolesis, raising suspicions of an RDD diagnosis instead of meningioma. The permanent sections confirmed the histological findings on FS. The large atypical lesional histiocytes showing emperipolesis with engulfment of lymphocytes, plasma cells and neutrophils. The lesional cells were immunoreactive for protein S100, cluster of differentiation 163 (CD163), and B cell lymphoma 1 (BCL-1), negative for CD1a. Based on histology and immunohistochemical profile, the final diagnosis was Rosai-Dorfman Disease. Postoperatively, there was immediate improvement in patient’s strength and symptoms. At the 9-month follow up post-surgery, she was doing well, and MRI revealed no evidence of residual or recurrent disease.ConclusionThis case is a rare example of RDD clinically and radiologically mimicking meningioma and illustrates the importance of rigorous histological analysis for accurate diagnosis, particularly during the intraoperative consultation, to ensure proper treatment.

Methamphetamine-associated pulmonary arterial hypertension (Meth-PAH) represents a growing subset of PAH. Relative to idiopathic PAH (iPAH), it is unknown whether patients with Meth-PAH treated with continuous prostacyclin have similar outcomes and treatment response. The aims of this analysis are to evaluate survival, response to therapy, and right ventricle function in similarly treated patients with Meth-PAH and iPAH. A prospective protocolized cohort of 138 incident patients (64 Meth-PAH, 74 iPAH) was followed longitudinally, with all patients being treatment-naïve at baseline. Hemodynamic assessments, cardiac imaging, and response to therapy were evaluated. A standardized therapeutic approach involving parenteral subcutaneous treprostinil was applied. Survival was analyzed using Kaplan-Meier and Cox regression. Both groups had similarly advanced PAH at presentation. Improvement in hemodynamics and reduction in European Respiratory Society risk scores were seen over the course of follow-up in both groups. Twenty-nine of 64 (45%) Meth-PAH and 51/74 (69%) of iPAH were initiated on parenteral prostacyclin. During treatment, only 4 patients (2 iPAH and 2 meth-PAH) were taken off treprostinil because of safety concerns. Transplant-free survival was 54/64 (84.4%) for meth-PAH over a mean follow-up time of 46 months and 54/74 (72.9%) for iPAH over a mean follow-up time of 67 months. Additionally, continued methamphetamine use did not adversely affect disease progression or mortality. Among Meth-PAH patients treated with an aggressive parenteral prostacyclin strategy, there is not a large difference in mortality and treatment response to iPAH. Further research is warranted to explore the long-term effects of methamphetamine use on PAH pathogenesis and outcomes.

Previous studies have shown that regular physical activity combined with the use of the superfood NBS supplement can reduce the cardiac damage caused by methamphetamine. However, the genetic mechanisms affecting apoptosis in the myocardium affected by these methods have not been fully identified. The aim of this research was to examine the impact of aerobic training and NBS superfood intake on apoptosis and cardiac damage in methamphetamine- withdrawn rats. 104 male Wistar rats were randomly assigned to eight distinct groups. Methamphetamine was given intraperitoneally at a dose of 10 mg/kg twice a day during the first week. The dosage was then steadily raised by 1 mg/kg every week from the second to the sixth week. The training plan included five days a week, 60 min of moderate-intensity treadmill aerobic training across six weeks. Moreover, for a duration of 45 days, the NBS Superfood supplement was given daily at a dose of 25 g/kg. Myocardial sampling was performed to measure the levels of Melusin and caspase-3 gene transcripts, while blood serum analysis was performed to examine the concentrations of creatine kinase (CK) and lactate dehydrogenase (LDH) enzymes. Data analysis utilized a one-way analysis of variance (p ≤ 0.05). The results show that methamphetamine use greatly raised caspase-3 gene expression as well as CK and LDH levels while simultaneously lowering Melusin gene expression (p ≤ 0.05). Furthermore, lowering serum CK and LDH levels, enhancing Melusin gene expression, and lowering caspase-3 gene expression were all accomplished through aerobic training, nutritional supplementation, and the synergistic intervention (p 0.05). The results of the study showed that the combined intervention (training and supplementation) had better effects than the single intervention (exercise alone or supplementation alone). This was manifested in a significant decrease in caspase-3 levels and a significant increase in Melusin expression. The results of this study indicate that combining endurance training with the NBS Superfood supplement NBS can modulate genetic changes associated with methamphetamine-induced cell death and myocardial damage. This combined approach can be proposed as a novel method for addiction cessation in animal studies that can pave the way for future research in human populations.