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Characteristics of methamphetamine-related deaths in the United Kingdom, 1997-2024
Emmert Roberts1,2, Rebecca McKetin2, Caroline Copeland3
1National Addiction Centre, King's College London, London, UK.
Background And Aims:
People who use methamphetamine have a standardised mortality ratio 6.8 times greater than the general population, with several countries reporting concerning increases in methamphetamine-related mortality over the past decade. Methamphetamine use in the United Kingdom (UK) has been reported as largely confined to communities of men who have sex with men (MSM) with no previous large-scale studies describing mortality associated with methamphetamine. We aimed to determine trends and case characteristics of methamphetamine-related deaths in the UK.
Design:
Retrospective cohort study.
Setting:
Coronial records submitted to the National Programme on Substance Use Mortality (NPSUM) in the UK, 1997-2024.
Cases:
Decedents for whom methamphetamine was determined as implicated in death following coronial investigation.
Measurements:
Information was available on decedent sociodemographics, characteristics of death and drugs implicated in death.
Findings:
136 decedents had methamphetamine implicated in death. The number of deaths per year were observed to be higher over time since the first death recorded in 2006 (2005-2010, 8 deaths; 2011-2015, 24 deaths; 2016-2020, 47 deaths; 2021-2024, 57 deaths). Decedents were predominantly male (n = 124, 91%) of White ethnicity (n = 68, 50%) with a mean age of 41.5 years (standard deviation 10.4; range 18-71); 77% had a history of substance dependence, 48% of which involved injecting drug use, and 88% had a history of a mental disorder. The median blood methamphetamine concentration detected at post-mortem was 0.83 mg/l (interquartile range 0.26, 2.5). Multiple drug toxicity was implicated in the majority of cases (n = 88, 65%), the most common implicated other drugs being cocaine (n = 27, 20%), gamma-hydroxybutyrate (n = 20, 15%), opioids (n = 20, 15%), benzodiazepines (n = 18, 13%), mephedrone (n = 13, 10%) and ketamine (n = 12, 8%). Accidental poisoning was the most common direct cause of death (n = 89, 65%), with other causes including intentional poisoning, cardiovascular disease, aspiration pneumonia and ischemic bowel disease.
Conclusions:
Over the past two decades there appears to have been an increase in the number of methamphetamine-related deaths in the UK. These deaths largely involve polysubstance use within an overwhelmingly male population with a high prevalence of substance dependence and mental health disorders.
Insights
Methamphetamine-related deaths in the UK have increased over two decades, primarily affecting males with substance dependence and mental health issues. Polysubstance use was common in these fatalities.
Area of Science:
- Public Health
- Toxicology
- Epidemiology
Background:
- Methamphetamine use is associated with significantly higher mortality rates globally.
- Recent decades show a concerning rise in methamphetamine-related deaths internationally.
- Limited research exists on methamphetamine mortality trends within the United Kingdom (UK).
Purpose of the Study:
- To investigate the trends and characteristics of methamphetamine-related deaths in the UK.
- To analyze sociodemographic factors and co-occurring conditions in decedents.
- To identify patterns in drug toxicity and causes of death.
Main Methods:
- A retrospective cohort study design was employed.
- Data were sourced from the National Programme on Substance Use Mortality (NPSUM) in the UK, spanning 1997-2024.
- Coronial records of decedents with methamphetamine implicated in their death were analyzed.
Main Results:
- 136 methamphetamine-related deaths were identified between 1997 and 2024, with a notable increase over time.
- Decedents were predominantly male (91%), White (50%), with a mean age of 41.5 years.
- High prevalence of substance dependence (77%), mental health disorders (88%), and polysubstance use (65%) were observed.
Conclusions:
- Methamphetamine-related fatalities in the UK have increased over the past two decades.
- These deaths predominantly involve males with pre-existing substance dependence and mental health conditions.
- Polysubstance use is a significant factor contributing to methamphetamine-related mortality.
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