We present the case of a 51-year-old man hospitalized with cardiovascular complications associated with chronic methamphetamine and cannabis use. Upon further evaluation, patients presented with cardiotoxicity, including acute to chronic congestive heart failure (CHF) exacerbations, hypercoagulable states, and electrolyte abnormalities.
Methamphetamine And Cannabis: A Tale Of Two Drugs And Their Effects On HIV, Brain, And Behavior.
Cardiotoxicity has been identified with chronic use of methamphetamine. However, the cardiovascular effects of marijuana are not well documented. Even less information is available on the simultaneous use of methamphetamine and cannabis.
As interest in the use of marijuana for medical purposes grows, it is imperative to study all associated toxicity and side effect profiles. The global pattern of concomitant drug administration also highlights the importance of this issue. This case report aims to provide insight into this information gap.
Between 2015 and 2018, an average of about 1.6 million adults in the United States used methamphetamine each year. Among adults who used methamphetamine within the past year, he had a 68.7% prevalence of other substance use or abuse, including cannabis use. In 2011, approximately one-fifth of methamphetamine-related visits involved a combination with marijuana.
The trend toward co-administration of drugs is increasing worldwide. A high likelihood of methamphetamine abuse is associated with existing marijuana abuse, with an odds ratio of 3.33.
There are mixed results in the literature when evaluating the cardiovascular effects of cannabis use. A multicenter study of cannabis-related hospitalizations published in 2011 reported a 9.5% association with side effects due to cardiovascular disease.
According to U.S. vital statistics data from 1990 to 2014, mortality rates in states with legal marijuana were 2.3% and 1.3% higher in heart death rates for men and women, respectively, compared with states with legal marijuana showed to increase.
The association between the development of heart failure or exacerbations and marijuana use has not been fully established. However, marijuana use was identified as an independent predictor of heart failure in a retrospective database review of patients with heart failure at discharge with an odds ratio of 1.1 (95% confidence interval, 1.03 to 1.18; p-value < 0.01) was diagnosed.
Methamphetamine is a powerful stimulant that is also a synthetic amine. Methamphetamine is often referred to as “speed,” “crystal,” “crank,” and “go,” but the term “ice” or “crystal meta” refers to d-methamphetamine, which appears as translucent crystals.
This case was complex with multiple high-priority issues including exacerbation of congestive heart failure, left leg swelling and cellulitis, left leg DVT, hemodynamic instability, and electrolyte abnormalities.
Urinary drug screening protocols to assess methamphetamine toxicity that involves only urine and serum evaluations are not affected by recent methamphetamine exposure. Hair toxicity testing is an option to consider when methamphetamine use is suspected and should allow for more sensitive analysis of use.
Little literature specifically mentions the effects of combining methamphetamine and cannabis on cardiovascular health. Rarely, withdrawal from methamphetamine has shown improvement in cardiovascular function, but cardiomyopathy is often chronic.
The reversibility of the cardiotoxic effects of concomitant use of marijuana and methamphetamine has not been documented. Analysis of this case showed that the development of cardiotoxicity may persist even after drug discontinuation.
Most of the available sources were several years old and very limited in both scope and external validity. The need for further research in this area of medicine is reflected in the lack of reliable and applicable primary research.