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Regarding the meth, I think it depends on method of use. A meth smoker has a lot different appearance than a meth snorter.
I worked with a guy who died. Turned out he was a long time meth user. He was fairly heavy set and tall. He'd have this weird thing where his eyes would get bloodshot and he would get thirsty. I innocently thought he was pre-diabetic or had developed type 2 diabetes. He went home after work one night, snorted some meth and died on his couch. The drug use came out when we met his family.
Anyway, I imagine David's medical episode to be similar. He snorted some meth and had a massive heart attack seconds later.
Thanks...I learned something new today.