Methamphetamine is a central nervous system stimulant with a high potential for addiction that can cause severe structural and functional changes in the brain, affecting areas that control reward, memory, and emotions (NIDA, 2020). Long-term users may also suffer from a variety of other health problems including tooth decay, weight loss, and cardiovascular disease (Kevil, 2019). The unique set of health challenges facing people struggling with methamphetamine addiction make them a particularly vulnerable population during the COVID-19 pandemic. This post will discuss the available evidence regarding whether methamphetamine addiction increases risk for COVID-19 and how the social environment of the pandemic may exacerbate the dangers of methamphetamine use.

One of the most dangerous effects of methamphetamine is dysregulation of the immune system. Animal studies indicate that methamphetamine inhibits both the innate and adaptive immune systems, which could affect the body’s response to pathogens (Canadian Centre on Substance Use and Addiction, 2020). As a result, methamphetamine users could be more susceptible to symptomatic infection with the SARS-Cov-2 virus, the causative agent for COVID-19. Additionally, COVID-19 severity can vary depending on the patient’s immune system, with weaker immune systems predictive of more severe disease progression (Perlman, 2020). Since people struggling with methamphetamine addiction may have impaired immune systems, this suggests they are at risk for more severe symptoms. Risk of severe COVID-19 infections also increases considering the high comorbidity of methamphetamine addiction and HIV/AIDS. Methamphetamine use has been identified as a major driver of the HIV/AIDS epidemic in certain populations, and people living with HIV/AIDS show higher rates of methamphetamine misuse than the general population (Carrico, 2020). Thus, the various consequences of a weakened immune system brought on by chronic use may put methamphetamine users at a higher risk for COVID-19.

Methamphetamine use also has adverse effects on circulatory and pulmonary health. Regular methamphetamine use increases the risk of atherosclerotic plaque formation, cardiac arrhythmias, and heart failure due to toxic effects on the heart (Kaye et al, 2007). In addition, individuals with pre-existing cardiovascular conditions may have an increased risk for mortal outcomes of COVID-19 infection (Yancy, 2020). Therefore, heart damage caused by methamphetamine use could lead to greater risk of dying from COVID-19. Furthermore, some of these cardiovascular effects can lead to problems with pulmonary circulation, such as high blood pressure in the artery that carries blood to the lung. Methamphetamine can also worsen respiratory conditions such as chronic obstructive pulmonary disease and asthma (Zamanian et al, 2018). Since the lungs are a primary target for SARS-CoV-2, and the most life threatening symptoms of COVID-19 are respiratory, the risk that methamphetamine use poses for lung health contributes to more negative outcomes in people with methamphetamine addiction who contract COVID-19.

COVID-19 risks associated with methamphetamine do not end at the biological level, however. The social effects of the pandemic can also have dangerous consequences. Some researchers suggest that the stay-at-home and social distancing orders issued during the pandemic could disrupt the drug supply chain, which could lead to methamphetamine sources being laced with greater quantities of drugs like fentanyl (Ostrach, 2020). Fentanyl is an extremely potent synthetic opioid that has been linked to recent increases in overdose deaths. Methamphetamine users face a higher risk of overdose death if they unknowingly use methamphetamine laced with fentanyl. Nationwide quarantine measures may cause challenges in obtaining safety resources such as drug testing kits. Finally, hospitals that are overwhelmed with COVID-19 patients may not have the medical resources required to dispense the quality of care for overdose patients that is necessary during this challenging time.

In conclusion, people with methamphetamine addiction are likely a high-risk population during the COVID-19 pandemic. Damaging effects on the immune, circulatory, and pulmonary systems could all contribute to negative outcomes of COVID-19. On top of this, the social effects of the pandemic intensify the danger of overdose and death. To combat these heightened risks, addiction treatment specialists and healthcare workers may need to adjust their efforts to meet patients’ needs in these unprecedented circumstances.

Authors: Cory Kittleman and Emma Erickson

Edited by Drs. Robert O. Messing and Emma Erickson, and Niki Garcia-Holmes

Photo by James Ronin on Pixabay

References

1. Canadian Centre on Substance Use and Addiction. “Methamphetamine, the respiratory system, and COVID-19.” 2020.
2. Carrico, Adam W et al. “Double Jeopardy: Methamphetamine Use and HIV as Risk Factors for COVID-19.” AIDS and behavior, 1–4. 7 Apr. 2020, doi:10.1007/s10461-020-02854-w
3. Kaye, S., McKetin, R., Duflou, J., & Darke, S. (2007). Methamphetamine and cardiovascular pathology: A review of the evidence. Addiction, 102(8), 1204–1211
4. Kevil, Christopher G et al. “Methamphetamine use and cardiovascular disease”. Arteriosclerosis, Thrombosis, and Vascular Biology. 21 Aug 2019.
5. NIDA. "What are the long-term effects of methamphetamine misuse?" National Institute on Drug Abuse, 31 Jul. 2020, https://www.drugabuse.gov/publications/research-reports/methamphetamine… Accessed 26 Aug. 2020.
6. Ostrach, B. “COVID-19 and rural harm reduction challenges in the US Southern Mountains”. The Journal of Rural Health. 2020.
7. Perlman, Stanley. “COVID-19 poses a riddle for the immune system.” Nature. 17 Aug 2020.
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