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. 2026 Jan;14(1):185-195.
doi: 10.1016/j.jaip.2025.10.006. Epub 2025 Oct 15.

Joint Association of Methamphetamine and Cannabis Use as Risk Factors for Asthma Exacerbations Requiring Hospitalization: A Retrospective Analysis

Amal M Musa  1 , Jill A Poole  2 , Harlan R Sayles  3 , Andrew C Rorie  4
Affiliations

Joint Association of Methamphetamine and Cannabis Use as Risk Factors for Asthma Exacerbations Requiring Hospitalization: A Retrospective Analysis

Amal M Musa et al. J Allergy Clin Immunol Pract. 2026 Jan.

Abstract

Background: Substance use, including cocaine and heroin, has been associated with severe asthma exacerbations and need for intubation, but data on methamphetamine use in asthma are limited.

Objective: To evaluate the relationship between methamphetamine use alone, co-use with cannabis, and asthma exacerbations requiring hospitalization.

Methods: Subjects aged 19 years or older who were admitted for an asthma exacerbation with an available urine drug screen (UDS) from January 1, 2013 to October 17, 2023 were included in this retrospective medical record review. Outcomes included length of hospital stay, need for mechanical ventilation, fatal exacerbation, need for intensive care unit (ICU) admission, and length of ICU stay using simple and multiple logistic regression modeling. We compared those with and without a positive UDS using Wilcoxon rank-sum, χ2, or Fisher exact tests.

Results: There were 201 hospitalizations from a total of 167 subjects. Of 167 initial subject hospitalizations, 102 (61.1%) revealed a positive UDS; 28 of those (16.8%) were for methamphetamines and 53 (31.7%) were for cannabis. Methamphetamine use alone showed a trend toward requiring mechanical ventilation (P = .117). Co-positive methamphetamine and cannabis UDS was associated with increased intubation (P = .020) and more status asthmaticus (P = .032). Overall, subjects with a positive drug screen of any substance were more likely to require ICU care (P = .022).

Conclusions: Methamphetamine use alone was not linked to worse asthma outcomes in this cohort, but there was a trend toward requiring mechanical ventilation. Importantly, the co-use of cannabis and methamphetamine was associated with more severe asthma exacerbations. Providers should address substance use in asthma management to help improve outcomes.

Keywords: Amphetamine; Asthma; Asthma exacerbation; Asthma hospitalization; Cannabinoids; Cannabis; Fatal asthma; Methamphetamine; Status asthmaticus; Urine drug screen.

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