National trends in psychostimulant-related deaths: 1999-2009

Increased methamphetamine use occurred during the last decade and little is known about factors associated with death. This study assesses trends in psychostimulant deaths in the United States.

Using the Centers for Disease Control and Prevention (CDC) Wonder Database, the authors searched deaths among 15- to 64-year-olds from 1999 to 2009 for decedents who died with "psychostimulants with abuse potential, excluding cocaine." The International Classification of Diseases (ICD) code T43.6 was used to identify methamphetamine-related deaths. Trends in death rates and the most common underlying causes of death were determined. For recent trends, age-adjusted death rates/100,000 person-years (p-y) and (95% confidence intervals [CIs]) among those who died with psychostimulants were calculated.

The rate of psychostimulant-related deaths increased 3-fold from 1999 (0.37/100,000 p-y; 95% CI: 0.354-0.39) to 2005 (1.05/100,000 p-y; 95% CI: 1.01-1.10). Deaths steadily declined from 2006 to 2008, but rose again in 2009 to 0.97/100,000 p-y (95% CI: 0.92-1.01). Across all age groups, men had a 2 to 3 times higher rate of death than women. American Indians/Alaska Natives were twice as likely to die a psychostimulant-related death as compared with non-Hispanic whites. The northwestern/western region of the US had the highest rates of psychostimulant-related deaths, whereas the northeastern region had the lowest death rates. "Accidental poisonings" (ICD-10: X40-49) was the most frequently listed cause of death among those who died with psychostimulants.

Psychostimulant-related deaths increased from 1999 to 2006, declined from 2006 to 2008, but rebounded in 2009. Interventions targeting those at highest risk of death must be implemented and studied to prevent increasing deaths.