Heat Spikes Death Risk from Drugs

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With relentless heat enveloping much of the nation, no one, it seems is spared. That includes a group at especially high risk of harm from high temperatures: drug users, both therapeutic and recreational, particularly those who take stimulants like cocaine, methamphetamine and Ritalin or antidepressants and other psychiatric medications.

One study found that for every week that the temperature exceeds 75 degrees Fahrenheit, New York City will experience two extra cocaine-related deaths. And, as the temperature climbs, the number of deaths leaps proportionally.  A week like this with temperatures in the 90’s and possibly 100’s might tally 4-7 extra cocaine deaths in New York City alone.

“High doses of stimulants can produce extremely high body temperatures,” says Zheng-Xiong Xi, a researcher at the National Institute on Drug Abuse.  And extremely high body temperatures can kill.

While cocaine doesn’t literally fry your brain, the higher the temperature climbs, the more likely it is that high doses of stimulants like coke, together with the heat, will injure brain cells and the greater the risk is for overdose death.

Two factors combine here.  First, stimulants themselves raise body temperature, which is not what you want during a heat wave. They also interfere with the body’s ability to regulate temperature to cool itself down. The high body temperatures that result are one way that stimulant overdose kills—so extra heat makes matters worse.

Secondly, chemical reactions that injure or kill brain cells can occur when high doses of these drugs are taken. These may be more toxic when the temperature is higher.  High doses of stimulants cause excess release of dopamine and glutamate— if these levels get high enough, the resulting chemical reactions can be deadly to cells. That process may increase overdose risk as well as contributing to long-term harm in those who survive.

Ecstasy (MDMA) is another drug that can be deadly when mixed with high temperatures— just like its chemical cousin, methamphetamine, Ecstasy can kill by overheating the body even in normal temperatures.

The legal recreational drugs aren’t any better:  even a stimulant as mild as caffeine raises body temperature and alcohol does the same.

But these problems aren’t only limited to recreational drug use.  Although therapeutic use of stimulants typically involves much lower doses of medication, these drugs can nonetheless seriously affect body temperature as well.

ADHD medications like Ritalin (methylphenidate), Desoxyn (methamphetamine) and Adderall (mixed amphetamines) have the same effects as their illegal variants— and are especially risky for children during heat waves.

Other medications that increase risk for heat stroke include antidepressants (all classes) and antipsychotics (newer medications like Risperdal, Xyprexa, Seroquel and Abilify may have higher risks than older drugs like Thorazine or Haldol).

So, if you are taking any of these substances for any reason, be sure to cool yourself off by limiting your time outdoors, drinking lots of water and minimizing the amount of strenuous activity that you do.  Keep careful watch over the children and elderly who take medications and be prepared to seek help if someone becomes disoriented or difficult to rouse.  Do not stop prescribed medications without medical advice— just stay as cool as possible!

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