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People who use methamphetamine are almost five times more likely to have a stroke caused by a bleed in the brain, many of which are fatal. “We can add stroke to the list of terrible and devastating things that methamphetamine does,” says , of the University at Albany, New York.

Beyond the signature tooth decay known as “meth mouth”, methamphetamine also increases heart rate and blood pressure, and can trigger heart attacks. The drug can lead to psychosis, and has been linked to anxiety disorders, depression, and problems with movement similar to those seen in Parkinson’s disease.

A handful of studies have also linked methamphetamine use to strokes. To explore further, and her colleagues at the Australian National Drug and Alcohol Research Centre in Sydney sifted through published research on the topic.

The team specifically looked for research into people under the age of 45 – a group less likely to be affected by age-related causes of stroke. They assessed the results of 77 studies in total. Most of these studies were conducted in the US, where, in 2012, around in the past year.

Dismal outcomes

Several of the studies the team looked at reported that strokes are responsible for between one and five per cent of methamphetamine-related deaths. And other studies found that methamphetamine was to blame for between two and six per cent of all strokes caused by a blockage in the brain’s blood flow in under 45s.

But strokes caused by a brain bleed were more common  – methamphetamine use accounted for between six and 13 per cent of all cases of this type of stroke in under 45s.

Overall, methamphetamine use increases a person’s chance of having a stroke caused by a brain bleed by almost five times. This increased risk is more than double that associated with cocaine or tobacco – both of which are also known to increase stroke risk – say the researchers.

These strokes are often fatal. Only a quarter of those who experienced “brain bleed” strokes fully recovered – a third of them died, and around forty per cent had lasting symptoms, such as memory loss of problems with speech or vision.

“The rate of death is the most shocking aspect of the study,” says Zuloaga, who was not involved in the research. “These strokes have dismal outcomes, which is pretty depressing.”

“It’s unlikely that this will deter users of the drug,” adds Zuloaga. “But hopefully studies like this will help researchers to discover treatments for methamphetamine users.”

Read more: Sewage reveals crystal meth use has doubled in Australia