Methamphetamine‐associated cardiomyopathy: an addiction medicine perspective

• Published in: Internal medicine journal Vol. 53; no. 1; pp. 21 - 26
• Main Authors: Somma, Vincenzo, Osekowski, Michael, Paratz, Elizabeth, Bonomo, Yvonne
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.01.2023; Wiley Subscription Services, Inc
• Subjects: Abstinence; Addiction Medicine; Addictions; Amphetamine-Related Disorders - complications; Amphetamine-Related Disorders - diagnosis; Amphetamine-Related Disorders - therapy; Autopsy; Cardiomyopathies - chemically induced; Cardiomyopathies - diagnosis; Cardiomyopathies - therapy; Cardiomyopathy; Central Nervous System Stimulants - adverse effects; Congestive heart failure; heart failure; Humans; Methamphetamine; Methamphetamine - adverse effects; methamphetamine use disorder; methamphetamine‐associated cardiomyopathy; Morbidity; Mortality; Patients; heart failure; addiction medicine; cardiomyopathy; methamphetamine-associated cardiomyopathy; methamphetamine use disorder
• ISSN: 1444-0903; 1445-5994
• DOI: 10.1111/imj.15990

Methamphetamine‐associated cardiomyopathy (MaCM) is an increasingly recognised serious complication from methamphetamine (MA) use. It is characterised as the development of otherwise unexplained heart failure in the context of MA use. MaCM predominantly affects a young and vulnerable population with high morbidity and mortality. It is the second leading cause of mortality in patients with MA use disorder (MUD). Our understanding of MaCM pathogenesis is based on observational cohorts and autopsy studies. Currently, the treatment of MaCM is predicated on abstinence. Medical therapies offer some benefit to a minority of patients; however, without abstinence, medical therapies are often ineffective. Abstinence is difficult for most patients to achieve; all clinicians require an understanding of MaCM and how to educate patients on the risks of ongoing use. Where available, referral to addiction medicine specialists to assist with treatment of MUD is recommended. This review aims to: (i) explain the proposed pathologic mechanisms of MaCM; (ii) summarise recent recommendations of the screening and treatment of MaCM; and (iii) highlight the role of addiction medicine in the management of patient with MaCM.