Deaths of Victorian children with exposure to methylamphetamine

A new study has revealed there were 50 child deaths involving exposure to methylamphetamine (MA, also known as ‘ice’ or ‘crystal meth’) in Victoria in the decade after 2011, with most being under the age of one year old, and more than two thirds of that 50 having died between 2018 and 2020.

General population surveys suggest that in Australia, recent amphetamine-type stimulant use (i.e. use in the past 12 months) has decreased in the past 10 years from 2.2% in 2010 to 1.4% in 2019. However, rises in the global supply of crystal MA have been associated with increases in MA-related harms including deaths involving MA.

Led by PhD student Dylan Mantinieks and Associate Professor Dimitri Gerostamoulos from the Monash University Department of Forensic Medicine, the study looked at methylamphetamine exposures in the deaths of children 12 years old and less that were reported to the Coroner in the state of Victoria between 2011 and 2020. The findings were published in the journal Forensic Science, Medicine and Pathology.

In the study period:

  • 64% of the children in the study died between 2018 and 2020.
  • 66% of the children were aged 1–365 days old.
  • the cause of death was unascertained in 62% of cases.
  • methylamphetamine was toxicologically confirmed in hair in almost all cases, with only 18% of cases registering the drug in their blood.
  • prenatal drug use was self-reported in 44% cases.
  • caregiver drug use self-reported in 42%.
  • only 54% of deceased children were a child protection client at their time of death.

In almost two thirds of cases the cause of death was unascertained, however, coronial investigations revealed a number of living child siblings that are likely exposed to the same drug environment.

According to Mr Mantinieks, hair analysis provided additional means to identify cases that were unknown to child protection services. “This may have implications for other children in the same drug exposure environment,” he said. Because most drugs in blood and urine may be detected for hours to days, hair can represent many months of drug exposure depending on the length of the hair fibre. “Therefore, hair analysis offers the longest window of detection to identify previous methylamphetamine exposure,” he added. “The detection of methylamphetamine in the hair of children may be attributed to exposure during pregnancy or through breastmilk when the mother is using the drug.”

It has been previously reported that prenatal and postnatal exposure to some illicit drugs is associated with an increased risk of sudden infant death syndrome (SIDS) and sudden unexplained death in children older than 1 year, however this study found that most of the children who died were under one year of age.

Other avenues of drug exposure are: accidental consumption by the child or deliberate administration by the caregiver; or environmental contamination including but not limited to exposure to second-hand smoke or close contact with caregivers using methylamphetamine; thirdhand smoke (i.e., household surfaces contaminated with methylamphetamine from previous manufacture or use) may also represent another way drug deposits in hair.

Other studies have shown MA exposure in up to 73% of children removed from clandestine laboratories.

The study authors cautioned that the structurally thinner and more porous hair of children may increase its susceptibility to second-hand or thirdhand contamination, and that hair concentrations of MA in children removed from clandestine laboratories were higher than those in children removed from home environments of alleged substance misuse.

It was concluded the greater supply of crystal meth in Australia, which is commonly smoked, has likely resulted in an increased exposure to methylamphetamine among children, and further research to understand the long-term adverse health effects of it is needed.

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