Symptom Profiles and Characteristics of Acute Methamphetamine Toxicity: Implications for Emergency Recognition and Response

BACKGROUND: The increasing prevalence of methamphetamine-associated "overdoses" in the surveillance literature necessitates a better understanding of self-reported symptoms associated with acute methamphetamine toxicity events. This study describes and compares the prevalence, self-reported symptoms, and behavioral correlates of acute methamphetamine toxicity, opioid overdose, and mixed drug overdose events. METHODS: We surveyed 420 people who use drugs in Nevada and New Mexico. Participants reported on their experiences of acute methamphetamine toxicity, opioid overdose, and mixed drug overdose events, including symptoms and healthcare utilization. We conducted descriptive analyses and compared demographics, drug use behaviors, and health indicators across groups experiencing different types of events. RESULTS: Of 217 participants reporting any event, 24% experienced only methamphetamine toxicity, 35% only opioid overdose, 5% only mixed drug overdose, and 36% multiple types. Methamphetamine toxicity events were characterized by anxiety (43%), heart pounding (34%), and rapid heart rate (33%), while opioid overdoses primarily involved loss of consciousness (86%). The methamphetamine-only group reported significantly lower prevalence of recent use of various substances and less frequent naloxone availability. CONCLUSIONS: Acute methamphetamine toxicity events present distinctly from opioid overdoses, with implications for emergency recognition and response. Lower naloxone availability among people who use methamphetamine is concerning given the prevalence of polydrug use. These findings underscore the need for targeted interventions addressing methamphetamine-related harm reduction efforts.