Asked if a 160 percent increase in “methamphetamine-involved overdose deaths” reported by the city health department in 2014 over 2013 and a substantial increase in methamphetamine seizures by the federal Drug Enforcement Administration (DEA) supported any particular conclusion, Travis Wendel had a terse response.
“Other than the OD death numbers, which surprise me, I think these stats are not necessarily indicative of anything,” the research director at St. Ann's Corner of Harm Reduction in the Bronx wrote in an email. “Did the OD deaths involve use of other drugs as well or only meth?”
The health department reports that methamphetamine deaths went from 13 in 2013 to 34 in 2014. The DEA told Gay City News that it seized 51 kilograms of crystal in 2014 and 56.7 kilograms in 2015. The agency seized 9.8 kilograms in 2005 and 3.4 kilograms in 2010. The seizures reflect statewide figures.
Wendel’s surprise is not a surprise. Methamphetamine deaths have received little attention among researchers, and the view is that they are uncommon. Where they are reported, the death is often associated with other drugs that commonly cause overdose deaths, such as opiates.
Wendel was the lead author of a 2011 study that described the methamphetamine market in New York City. He also served on the New York City team of the National HIV Behavioral Surveillance Study for several years.
But meth does kill and it can kill all by itself.
A 1999 study in the Journal of Forensic Sciences investigated 413 deaths in San Francisco over a 13-year period in which methamphetamine was detected in the dead person’s body and concluded that 65 percent of the deaths were “due to accidental methamphetamine toxicity” and “methamphetamine was an incidental finding” in the remaining cases. The average was roughly 21 deaths attributable to meth per year over the 13-year period.
A 2007 study published in the Journal of Psychoactive Drugs looked at various measures of methamphetamine use in San Diego from 2001 to 2005 and concluded that among the “245 deaths involving methamphetamine” in 2005, “44 were attributed to overdose involving either methamphetamine alone (n = 13) or in combination with other drugs (n = 31), most commonly heroin/ morphine.”
In 64 deaths in the San Diego study, methamphetamine was a “contributing factor” and “methamphetamine was detected during autopsy but was not listed as a causal or contributing factor” in the remaining deaths.
Gay City News found studies and case reports from Thailand and Taiwan dating to 1994 that documented deaths caused by crystal meth, which is the most widely abused illicit drug in the world, according to some reports.
Meth can kill a number of ways.
“Ingestions of large doses of the drug can cause more serious consequences that include life-threatening hyperthermia above 41°C, renal and liver failure, cardiac arrhythmias, heart attacks, cerebrovascular hemorrhages, strokes, and seizures,” said a 2009 study in Brain Research Reviews that was ominously titled “Methamphetamine Toxicity and Messengers of Death.”
At 41°C, a person’s body temperature is at 105.8°F, which is well above the temperature at which heat stroke occurs. In a meth overdose, an elevated body temperature is a “universal presenting symptom, with lethal overdoses generally associated with extreme hyperthermia,” said a 2014 study that was published in Pharmacology & Therapeutics. That study said that the clinical diagnosis of hyperthermia comes at a body temperature at 40°C, which is 104°F.
The 2014 study noted that “extreme hyperthermia that can be lethal if left untreated” and other “presenting symptoms commonly observed, particularly in high-dose patients, include hypertension, tachycardia, dyspnea, and chest pain, with other features including increased agitation, altered mental status, pupil dilation, shivering, and possible seizure activity.”