Methamphetamine-related HF hospitalization ‘insidious yet rapidly growing’
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Methamphetamine-related HF hospitalizations and their costs increased at an alarming rate compared with all HF hospitalization from 2008 to 2018, researchers reported.
Those with methamphetamine-related HF hospitalization had greater length of stay, number of procedures and number of hospitalizations compared with all HF, which may be associated with the sharp rise in costs, according to data published in Circulation: Cardiovascular Quality and Outcomes.
Methamphetamine-related HF hospitalizations and their costs increased at an alarming rate compared with all HF hospitalization from 2008 to 2018. Data were derived from Zhao SX, et al. Circ Cardiovasc Qual Outcomes. 2021;doi:10.1161/CIRCOUTCOMES.120.007638.
“Our study results should bring urgent attention to this insidious yet rapidly growing form of severe heart failure — methamphetamine-related heart failure, which is taking the lives of young people, straining health care resources and threatening to spread like wildfire in California, the West and to the rest of the nation,” Susan X. Zhao, MD, cardiologist at Santa Clara Valley Medical Center in San Jose, California, said in a press release. “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.”
Zhao and colleagues used data from the California Office of Statewide Health Planning and Development to identify trends in methamphetamine-associated HF hospitalization, change in inflation-adjusted hospitalization cost and common characteristics of those who were hospitalized for methamphetamine-associated HF from 2008 to 2018.
Methamphetamine-associated HF was defined using the ICD code-based secondary diagnoses.
Prevalence of methamphetamine-related HF
During the 10-year study period, researchers identified more than 1 million HF hospitalizations, of which 4.12% were methamphetamine-related.
By 2018, age-adjusted methamphetamine-related HF hospitalizations increased by 585%, rising from 4.1 per 100,000 people in 2008 to 28.1 per 100,000 people in 2018. During the study period, HF hospitalizations not associated with methamphetamine use decreased by approximately 6%, from 342.3 per 100,000 people in 2008 to 321.6 per 100,000 people in 2018.
Individuals hospitalized with methamphetamine-related HF were younger (49.64 vs. 72.2 years; P < .001), predominantly men (79.1% vs. 52.4%; P < .001) and had fewer comorbidities (44.2% vs. 88.9% with Charlson Comorbidity Index 4; P < .001) compared with those with non-methamphetamine-related HF. However, individuals who were using the drug experienced longer hospital stay (12.47 vs. 9.79 days; P < .001), more hospitalizations per patient (7.77 vs. 3.98; P < .001) and more procedures performed during their stays (2.53 vs. 2.09; P < .001).
“The methamphetamine epidemic is often overshadowed by the surge in opioid-related death and illnesses,” Zhao said in the release. “The long-term health consequences associated with methamphetamine use require recognition from the public as well as the clinical communities. This study was intended more as a public health alarm: The urgency of methamphetamine use disorder cannot be overstated.”
Rising hospitalization cost
After adjusting for inflation, hospitalization costs for methamphetamine-related HF rose 840%, increasing from $41.5 million in 2008 to $390.2 million in 2018.
Additionally, the cost of all HF hospitalization in California rose 82%, increasing from $3.503 billion to $6.376 billion.
“Treating patients with methamphetamine-related heart failure is consuming resources and burdening the health care system,” Zhao said in the release. “Many patients present late in the course of illness with limited options available to them. Proactive, preventive public health outreach and education are needed to stem the influx of methamphetamine-related heart failure at its source.”
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