04 Mar Gastrointestinal Complications of Methamphetamine Abuse
Like most other stimulant drugs of abuse, methamphetamine is widely known for its potential to cause serious disruptions of normal function in the cardiovascular system (heart and blood vessels), as well as in the central nervous system. However, use/abuse of the drug also produces disruptions in the normal function of the gastrointestinal (GI) tract, which forms the body’s passageway for nutrient intake and the elimination of food wastes. Most meth users only develop relatively minor changes in their gastrointestinal health; however, some users of the drug develop severe, potentially fatal GI problems.
The mind-altering effects of methamphetamine and other stimulant drugs stem from their ability to boost levels of a chemical in the central nervous system called dopamine, which acts as a neurotransmitter and relays the specific messages required to activate the portions of the brain responsible for producing pleasure. However, most of the body-related effects of methamphetamine and other stimulants stem from these drugs’ ability to boost levels of another neurotransmitting chemical called norepinephrine. The body relies on this chemical to trigger its “fight-or-flight” response, which produces a range of system-wide changes designed to increase alertness and quicken reaction times during periods of danger or high stress. Among these changes is a narrowing of the blood vessels, known medically as vasoconstriction. In the cardiovascular system, methamphetamine-related vasoconstriction can produce a number of potentially fatal changes in normal heart function. This same blood vessel narrowing also produces changes in normal gastrointestinal function.
Vasoconstriction causes problems because it produces a reduction in the amount of blood flowing through all affected blood vessels. When blood flow drops, cells and tissues lose some of the oxygen and other nutrients they rely on to work properly and make their contributions to ongoing health. In methamphetamine users, the most common effects of gastrointestinal vasoconstriction and blood flow reduction include abdominal or stomach cramping, constipation, diarrhea, and tissue dehydration. Generally speaking, these problems are not usually very serious when compared to the problems associated with vasoconstriction in the cardiovascular system.
In a relatively small number of cases, methamphetamine abuse produces enough blood flow reduction in the GI tract to trigger a condition called ischemia. This conditions sets in when blood flow to a given area falls low enough to trigger oxygen deprivation and nutrient deficiencies in the affected tissue. In turn, these problems produce serious reductions in normal tissue health, and in some cases, outright tissue death.
According to a study published in 2012 in the Hawaii Journal of Medicine & Public Health, one potential consequence of methamphetamine-related ischemia is a blockage of the large intestine (bowel) known as paralytic ileus. People with this form of bowel blockage have nothing physically obstructing the intestine; instead, loss of blood flow effectively paralyzes the intestinal muscles responsible for normal bowel function. Potential consequences of paralytic ileus include severe infection, tissue death (gangrene), the formation of holes in the intestinal wall, jaundice and serious disruptions in the levels of vital substances in the bloodstream called electrolytes.
Doctors sometimes refer to ischemia by another medical term: infarction. When infarction occurs in the heart muscle, it’s known as a myocardial infarction, or heart attack. In its own way, methamphetamine-related infarction in the GI tract can have just as big an impact on gastrointestinal health as infarction in the heart muscle has on cardiac health. In severe cases, people with this condition develop large-scale gangrene that kills off normal function in entire sections of the small or large intestine. In the worst cases, gangrene spreads throughout multiple sections of the small or large intestine and creates life-threatening changes in intestinal health that can only be corrected through emergency surgical procedures.
Most of the severe gastrointestinal complications of methamphetamine use stem directly from narrowing of the blood vessels in the GI tract. However, according to a study published in 2004 in Medscape General Medicine, gastrointestinal complications can also occur as a secondary effect of methamphetamine-related strokes originating elsewhere in the body. While doctors and researchers can at least partially predict the circumstances in which heart-related complications of meth abuse will appear, they generally don’t have enough information to determine the circumstances that lead to serious GI-related complications in any given methamphetamine user. However, in most cases, users with severe gastrointestinal complications have enough methamphetamine in their systems to produce vasoconstriction-related problems in several different organ systems.
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