Methamphetamine users died at a rate three to six times higher than the general population. Credit:Justin McManus Lead author Professor Shane Darke at the National Drug and Alcohol Research Centre (NDARC) said the findings amounted to a major public health problem that would have a deleterious effect on the lives of young users, their families and the health system for decades to come. "Heart disease and stroke are just not known among young [meth] users, but the risk is real," Professor Darke said. "I am not so naive as to think that if we inform people about the risk of heart disease they will stop [using meth] tomorrow.

"But we have to start with knowledge. People can't react to something they don't know about." Methamphetamines can significantly damage the hearts of people who already have heart problems, as well as young people with no history of heart disease. Even small amounts of methamphetamine could trigger cardiac arrhythmia, the authors reported. Doctors should check their meth patients for cardiovascular issues, and ask young people his heart problems whether they use the substances, Professor Darke said. Violent, impulsive suicides

Suicide accounted for just under one fifth of all methamphetamine-related deaths (18 per cent). "That's 300 preventable suicides," said Professor Darke, who trawled through police reports, family statements, coroner's reports and forensic evidence. But the methods of suicide were most alarming, he said. Suicides among women in the general public were most commonly poisonings, but female meth users were hanging themselves. "[These people] we often highly agitated and angry during the day and then later they just went out and killed themselves," Professor Darke said.

"They look different to other suicides," which often followed periods of withdrawal and loneliness, Professor Darke said. "They are very impulsive ... to see women hanging themselves [at this rate] there is only one explanation. It's the drug itself," he said. Deadly overconfidence A total of 245 deaths were from traumatic accidents, including 156 cases where the individual was driving a car or motorbike.

"These people were driving erratically, or on the wrong side of the road, or overtaking in blind corners," Professor Darke said. The deaths did not include passengers or people in other motor vehicles who died in these crashes. "The impact extends far wider than simple the person in this study," he said. There was a belief among meth users that the stimulants improved their reflexes, Professor Darke said. "What it does is improves your risk of death."

Others drowned, fell from heights or were pedestrian deaths. "That overconfidence [among meth users] needs to be addressed," Professor Darke said. Homicide accounted for 25 meth-related deaths, but Professor Darke said this was an underestimation, considering links to methamphetamine use and murder were notoriously difficult to report. For every one methamphetamine-related death, the average years of potential life lost was 44 years. The mean age of people who died of methamphetamine-related deaths was 36.9, and 78.4 per cent were male.

"To see such large and significant increases in mortality rates over the study period indicates a major methamphetamine problem," Professor Darke said. "Without increased awareness of the connection between methamphetamine use and cardiac and/or cardiovascular disease we could expect to see a significant increase in cases of this kind in the coming years," Professor Darke said. Clinical director of St Vincent Hospital's Alcohol and Drug Services, Professor Nadine Ezard. Credit:Daniel Munoz Overall substance use a public health imperative Clinical director at St Vincent Hospital's Alcohol and Drug Services Associate Professor Nadine Ezard said she was not convinced methamphetamine deaths alone were a major public health issue.

The number of deaths from accidental toxicity of methamphetamine was only 91 of the total 1649. Dr Ezard said it would be difficult to determine the role methamphetamine played in the other deaths amid multi-drug use, and other factors, including a history of heart disease. "They may have had methamphetamine in their blood, but a whole lot of other things were going on," Dr Ezard said. The addiction specialist said methamphetamine deaths were still relatively rare compared to high mortality rates linked to risky drinking, smoking and opioid use. But she said substance use overall was a major national public health problem that needed to be addressed. "We need a system in place to address this as a whole … early intervention is what is required."

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