Overdose is not the only cause of death among people who die as a result of using the drug methamphetamine or “ice,” say researchers.

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Other health problems linked to methamphetamine use including heart disease, stroke and suicidal tendencies are also major risk factors.

People tend to think of drug toxicity and overdose when considering methamphetamine-related death. However, in a study that analysed cases of death among users in Australia between 2009 and 2015, a large proportion were found to be caused by other factors.

Professor Shane Darke (National Drug & Alcohol Research Center, University of New South Wales, Sydney) and colleagues found that of 1,649 deaths recorded, 43% were due to drug toxicity and overdose.

As reported in The Conversation, 22% were caused by diseases related to methamphetamine use, particularly heart disease. As a cardiotoxic agent, methamphetamine damages heart muscles, causes arterial disease and puts strain on the cardiovascular system.

There were also 38 cases of stroke among young individuals, a demographic group that is not usually considered at risk of this event.

Three hundred deaths occurred as a result of suicide. Methods used to commit the act tended to be violent, which may be linked to the aggravation, aggression and violent tendencies the drug can cause, says Darke.

In 15% of cases, death was caused by traumatic injury, mainly acquired during motor vehicle accidents. Users of methamphetamine tend to believe the drug increases their ability to drive, when in fact, it is their risk of injury and death that is increased.

Darke and team also report that the footprint of methamphetamine use is far wider than that of many other drugs, with nearly half of the deaths occurring in rural and regional areas. Many of the users were employed and had never injected a drug, contrary to what would typically be expected of people who have died as a result of drug use.

By examining the causes of these deaths we have uncovered that, unlike many other drugs, the harms are very diverse, particularly with regard to the extensive association with heart disease,” Professor Shane Darke, National Drug & Alcohol Research Center, University of New South Wales, Sydney

He advises that drug treatment centres need to be aware that their methamphetamine patients may be at risk of heart disease and that doctors should enquire about methamphetamine involvement if young people are presenting with heart conditions.

“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,” he warns.