“It’s called overamping”: experiences of overdose among people who use methamphetamine

Abstract

Background The USA is experiencing increases in methamphetamine use and methamphetamine-related or attributed deaths. In the current study, we explore qualitative narratives of methamphetamine overdose and strategies used by people who use drugs to reduce the undesirable effects associated with methamphetamine use. Methods We conducted 21 qualitative interviews with people over the age of 18 who reported using methamphetamine in the previous 3 months in Nevada and New Mexico. Interviews were recorded, transcribed, and analyzed using qualitative thematic analysis. Results Respondents described a constellation of psychological and physical symptoms that they characterized as “overamping,” experienced on a continuum from less to more severe. Reports of acute, fatal methamphetamine overdose were rare. Few reported seeking medical attention for undesirable effects (usually related to psychological effects). General self-care strategies such as sleeping and staying hydrated were discussed. Conclusions When asked directly, our respondents claimed that acute, fatal methamphetamine overdose is rare or even impossible. However, they described a number of undesirable symptoms associated with overconsumption of methamphetamine and had few clinical or harm reduction strategies at their disposal. Addressing this current wave of drug-related deaths will require attention to the multiple factors that structure experiences of methamphetamine “overdose,” and a collaborative effort with PWUDs to devise effective harm reduction and treatment strategies.

“That Line Just Kept Moving”: Motivations and Experiences of People Who Use Methamphetamine

“…Experiences with overamping, isolation, and withdrawal mirror the current literature describing the negative consequences of use, 32 but participants also explored how methamphetamine can enhance function and strengthen relationships. This “moving” line between methamphetamine’s risks and benefits highlights the need for nuanced conversations about substance use in medical settings.…”

Suicidal thoughts and behaviors among untreated illicit substance users: a population-based study

“…It has previously been reported that using methamphetamines, heroin or a combination of opioids and stimulants are associated with increased risk of death. Excess mortality among methamphetamine/heroin users may be due to suicide or unintentional drug overdose or long-term medical conditions [ 40 ]. According to the World Health Organization (WHO), globally, 600,000 deaths were attributable to drug overdose in 2019, with approximately one quarter of those deaths caused by semisynthetic opioid overdose [ 41 ].…”

“…According to the World Health Organization (WHO), globally, 600,000 deaths were attributable to drug overdose in 2019, with approximately one quarter of those deaths caused by semisynthetic opioid overdose [ 41 ]. However, differentiating unintentional acute drug toxicity from intentional substance-related deaths is not easy in most cases, particularly in methamphetamine-related deaths [ 40 ]. Although the presence of suicidal thoughts among illicit substance users is a significant risk factor for future suicide attempts and deaths, non-substance-related methods of self-killing, such as hanging or death by firearms, are more frequent methods for suicide deaths among this population [ 42 ].…”

Patterns of and Rationale for the Co-use of Methamphetamine and Opioids: Findings From Qualitative Interviews in New Mexico and Nevada

“…It may be that changes in methamphetamine composition could also underlie some of the experiences described in this study. Specifically, methamphetamine containing d -methamphetamine salts without l -methamphetamine salts, which can be removed during some manufacturing processes ( 29 ), has been associated with stronger and shorter duration effects, a “sleepy” effect (sometimes described as “shutting down”) after using methamphetamine ( 22 ), and more psychiatric symptoms such as delusions and paranoia ( 30 ), some of which were described by our respondents as undesirable effects they sought to mitigate.…”

“…Data for the current study were collected as part of a larger sequential mixed-methods study ( 22 ). Between December 2019 and February 2020, we recruited people who use methamphetamine in Reno, Nevada and Rio Arriba County, New Mexico.…”