The Influence of Methamphetamine (Meth) on Wound Healing

Introduction

Because of my son's hardships with meth addiction and assault wounds while incarcerated over the last decade, I decided to be transparent and use my personal experiences and knowledge in the wound care specialty to provide a different perspective. Wound care professionals often highlight how chronic wounds are a public health crisis. However, substance abuse is also a public health crisis that many do not want to discuss. They both have a direct impact on millions of Americans each year. Consider how substance abusers are more likely to develop diabetes, vascular disease, and wound chronicity. We, as healthcare professionals, need to expand our views and our efforts.

Meth-related Wound Challenges 

Meth-related wounds are a significant wound care problem in various clinical care settings. Many nursing facilities around the country refuse to accept such patients, frequently due to stigma, staff training shortages, and liability. Nurse case managers have reported that it is virtually impossible to find placement for these patients. ₃

Additionally, the annual expense of treating meth-associated chronic wounds is a significant financial burden on our healthcare system. While there is a wealth of evidence addressing the behavioral and cognitive impairments produced by meth use in drug users, there is a shortage of information regarding the drug's effect on wound healing and inflammation. ¹ 

Side Effects of Meth 

Methamphetamine (meth) is believed to be used by 35 million people worldwide, including over 10 million users in the United States. Chronic meth addiction and dependence can have several harmful physical and cognitive health consequences. Because the central nervous system contains a high quantity of dopamine, injecting drugs such as meth generates almost immediate euphoric effects. Notably, everyday meth users frequently experience formication, a sensation that feels like insects crawling on or beneath the skin (referred to as meth mites, meth bugs, ice mites, or crank bugs). As a result of formication, users engage in persistent dermotillomania (skin picking, excoriation), resulting in the creation of ulcers that frequently scar. A severe lack of cleanliness among users may also be associated with increased risks of skin infections.

Chronic Conditions in Meth Users

Adults who use methamphetamine are nearly twice as likely to have multiple comorbidities, more than three times as likely to have mental illness, and more than four times as likely to have a substance use disorder, compared to adults who did not. Many people struggle with a combination of medical, mental, and substance use disorders, sometimes all three at the same time. Researchers found that methamphetamine users had a greater prevalence of liver disease (hepatitis or cirrhosis), lung disease (COPD or asthma), and HIV/AIDS among the chronic illnesses evaluated. Additionally, researchers discovered that people who used methamphetamine had a significantly higher risk of developing substance use disorders (SUD) than those who used heroin, prescription stimulants, prescription opioids, cocaine, or sedatives. ₄

Recent Research 

Recent research data indicate that mice treated with meth had a lower ability to repair wounds. Meth stimulates the production of IL-6 in skin tissue, and higher levels of this cytokine may have a direct role in inflammation. Dopamine, which can activate inflammatory cells, may control IL-6. There is a correlation between the effects of leukocyte recruitment and the increase of IL-6 production via dopaminergic activation, thereby aggravating the inflammatory response and prolonging wound healing. There is limited research on the effect of meth use on immunological function, although it appears to have a profound impact on host immunity. ¹ 

Results in How Meth Alters Wound Healing

  • Impairs wound healing by mediating host matrix metalloproteinase-2 collagen degradation²
  • Promotes apoptosis in thymic and splenic lymphocytes when injected 25 mg/kg of body weight into rats¹
  • Decreases thymic and splenic cellularity and affects peripheral T lymphocyte populations in mice¹
  • Damages the mitochondria and causes primary human T cells to malfunction. ¹
  • Increases MRSA burden¹
  • Alters wound healing¹ ²
  • Decreases the number of phagocytic cells in the blood of treated BALB/c mice. ¹ ²
  • Enhances S. aureus biofilm formation²
  • Affects murine neutrophil functions²
  • Impedes the effector functions of human neutrophils²
  • Weakens macrophage function ²
  • Modifies cytokine expression ¹ ²

Link Between Meth Use and MRSA

Although there is a definite clinical correlation between meth use and MRSA disease, there has been no established biological link between increased susceptibility to S. aureus and a meth user's immune response and wound healing capacity. However, animal studies indicate that meth lowers both innate and adaptive immunity and affects the expression of immune cell genes. The purpose of this study was to determine whether meth enhances MRSA skin infections and to demonstrate that the drug has detrimental effects on phagocytic cells generated from humans. ²

Conclusion

Methamphetamine is a significant health concern to our society as it alters people's behavior, putting users at an increased risk of acquiring cutaneous wounds that can become chronic and infected. In the future, the new data will be used to establish realistic treatment options for preventing and managing chronic wounds in drug users. However, it is critical to treat substance abuse, mental illness, and chronic conditions simultaneously.

References

  1. Martinez, L. R. (2019, July 31). Impact of Methamphetamine Induced IL-6 Production on Wound Healing and Inflammation. Grantome NIH. https://grantome.com/grant/NIH/R15-GM117501-01A1
  2. Mihu, M., Roman-Sosa, J., & Varshney, A. (2015, October 7). Methamphetamine Alters the Antimicrobial Efficacy of Phagocytic Cells during Methicillin-Resistant Staphylococcus aureus Skin Infection. mBio, 6(6), 1622-15. doi:10.1128/mBio.01622-15
  3. Bond, A. (2018, April 17). Nursing homes routinely refuse people on addiction treatment. Stat News. Accessed February 10, 2022, from https://www.statnews.com/2018/04/17/nursing-homes-addiction-treatment/
  4. NYU. (2021, Jun 3) Health and Medicine. People Who Use Methamphetamine Likely to Report Multiple Chronic Conditions. https://www.nyu.edu/about/news-publications/news/2021/june/methamphetamine-multiple-chronic-conditions.html. Accessed February 8, 2022. 

 

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