Stroke is a leading cause of death and disability worldwide. In young people (less than 45 years old), stroke can have particularly devastating consequences by reducing quality of life, as well as a person’s ability to work.
Identifying risk factors and potential warning signs of stroke offers the opportunity for intervention, through either lifestyle changes or prescription drugs. Identifying factors also plays an important role in reducing stroke prevalence.
Ice, Speed and Stroke
Stimulants like amphetamine (speed) and methamphetamine (ice) increase stroke risk.
Evidence from stroke patients suggests that amphetamine use causes between 6-13% of haemorrhagic (bleeding from brain vessels) and 2-6% of ischaemic (blood clot) strokes.
Young people are at higher risk of amphetamine-associated stroke. Around 1.3 million Australians over the age of 14 have used methamphetamine in their lifetime and use in younger people is more common. In addition to increased risk of stroke, methamphetamine use is more strongly associated with haemorrhagic stroke when compared to ischaemic stroke, which presents an increased risk of death and disability.
In a young population of methamphetamine users, haemorrhagic stroke accounted for 80% of all stroke, while ischaemic stroke accounted for 20%. In young stroke patients without methamphetamine use, haemorrhagic and ischaemic stroke usually present equally. This highlights that not only is stroke risk higher with methamphetamine use, but the consequences are likely to be more devastating.
How Does Stimulant Use Lead to Stroke?
Amphetamines and methamphetamine are sympathomimetic drugs, which means they stimulate the sympathetic nervous system to increase heart rate and blood pressure while releasing the excitatory neurotransmitters dopamine and serotonin. This causes an initial rush that makes people feel alert, focused and stimulated. Regular use will cause a repeated elevation in blood pressure and may even lead to chronic hypertension.
High blood pressure strains blood vessel walls and can cause them to weaken. Additionally, methamphetamine may cause direct structural damage to blood vessels, increasing the risk of haemorrhagic stroke. High blood pressure can also cause plaque accumulation within blood vessels. Fragments of this plaque can break off and travel through the circulation to the brain where narrow vessels become blocked, leading to ischaemic stroke.
People who use methamphetamine are more likely to have polydrug use. Around 73% of people using methamphetamine drink alcohol to risky levels and 52% smoke tobacco daily. Drinking and smoking are risk factors for stroke in their own right; therefore, the prevalence of stroke in people who use methamphetamine may be a cumulative effect of several risk factors.
What AOD Clinicians Should Know
Common symptoms of a methamphetamine-associated stroke are headache, nausea, vomiting and confusion. Some symptoms may be experienced temporarily in the period leading up to stroke and may act as an early indicator in some people. Stroke is an extremely time-sensitive condition, it’s therefore crucial to seek medical attention as soon as possible when symptoms present.
Importantly, clinicians should routinely assess methamphetamine use in young patients to identify opportunities for brief intervention and to reduce the risk of future stroke.
Written by Steven Bothwell, 360Edge Research Consultant, you can check out full bios of our team here!