Methamphetamine may increase hospitalization risk of pulmonary diseases

USA: Methamphetamine use is associated with an increased hospitalization risk of pulmonary diseases such as pneumonia and acute respiratory failure (ARF) in both males and females, finds a recent study published in the ERJ Open Research journal. It is also associated with increased chronic obstructive pulmonary disease (COPD) exacerbation among women when compared with those with no methamphetamine use diagnosis.

This association, however, was not seen for methamphetamine use and asthma exacerbation in both sexes, or COPD exacerbation in men.

Methamphetamine is a psychostimulant of the phenethylamine and amphetamine classes of drugs mainly used as a recreational drug. According to the National Institute on Drug Abuse 2012 data, amphetamine-type stimulants, of which methamphetamine is the most common, are the second-most used class of illicit drugs worldwide.

Because of the increased rates of methamphetamine use, there has been a subsequent investigation into its toxic effects on health. Previously reported associations have been predominantly in the cardiac and respiratory systems. However, there is a lack of investigation towards the scope of pulmonary toxicity related to methamphetamine use.

Halley Tsai, Stanford University, Stanford, CA, USA, and colleagues aimed to determine whether methamphetamine use is associated with more hospitalization codes for asthma exacerbation, COPD exacerbation, pneumonia, and ARF.

The researcher used data from the State Inpatient Databases from California included in the Health Care Utilization Project database. They then identified hospitalizations for asthma exacerbation, COPD exacerbation, acute pneumonia, and acute respiratory failure and methamphetamine use through ICD-9 codes. A total of 21,125,249 adult inpatient discharge abstracts, including 182,766 with methamphetamine use, from 2005 to 2011 were included in the analysis.

The median age was 37 years for methamphetamine users and 57 years for nonusers. There were more men among methamphetamine users than among nonusers (58% vs. 38%), and a dual diagnosis of tobacco use was more common among methamphetamine users vs. nonusers (37% vs. 14%).

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Key findings of the study include:

• For methamphetamine users vs. nonusers, the rate ratio for having a principal hospital discharge abstract for acute pneumonia was 1.4 in women and 1.18 in men.


• The rate ratio for having a discharge diagnosis of acute respiratory failure among methamphetamine users vs. nonusers was 1.77 for women and 1.24 for men.


• The rate ratio for having a principal hospital discharge abstract for acute exacerbation of COPD among methamphetamine users vs. nonusers was 1.23 for women but 0.9 for men.


• Neither male nor female methamphetamine users were more likely than nonusers to have a simultaneous principal hospital discharge abstract for acute exacerbations of asthma.

"While future investigation for is warranted, this finding may help to further characterize the pulmonary toxicity of methamphetamine," the authors concluded.

The study, "Methamphetamine use association with pulmonary diseases: a retrospective investigation of hospital discharges in California from 2005 to 2011," is published in the journal ERJ Open Research.

DOI: 10.1183/23120541.00017-2019