Acute intoxication and substance abuse among patients presenting to a Psychiatric Emergency Service

Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence

“…Most of these studies have reported substance specific detection rates by using both immunoassay screening and chromatographic confirmation. We have identified one study using blood drug analyses, but quantitative results were not presented (122). The latter study concluded that the impact of substance abusing patients was substantial; they presented often with acutely suicidal conditions, required high levels of behavioural management, spent more time in the emergency department, but had less need for psychiatric hospitalization.…”

Prevalence and Predictors of Substance-Related Emergency Psychiatry Admissions

“…Our results indicate that substance-involved emergency psychiatry admissions were significantly more likely to be uninsured, whereas the cohort of emergency psychiatry admissions who's presenting problems were not documented to be substancerelated were significantly more likely to be on public assistance. Though the groups did not differ in their likelihood of being on private insurance, the finding that substance-involved emergency psychiatry admissions were significantly more likely to be uninsured is a cause of concern alongside findings indicating that this population also requires more intensive and costly services [12][13][14], including a greater number of emergency department readmissions if substance use remains unaddressed. Thus, improved identification, referral, and treatment of substance use disorders in emergency departments could result in decreased use of emergency healthcare services and overall costs as well as improved patient health outcomes.…”

“…While Sanguineti and Brooks (1992) found that emergency psychiatry patients screening negative for substances were more likely to be committed for suicidal behavior (total sample size=247), Breslow et al (1996) found that substance abusing psychiatric emergency room patients were more likely to present as suicidal (total sample=294). Using a markedly larger sample of emergency psychiatry patients which resulted in increased statistical power to detect significant differences, the present study of 2,161 consecutive admissions failed to find any differences in rates of suicidality between emergency psychiatry patients varying in their substance involvement.…”

“…With respect to demographics, African American ethnicity and male gender have been related to increased risk [10,11]. Clinically, studies have documented higher rates of substance use among emergency psychiatry patients with a psychotic disorder [12,13].…”

“…First, these patients are more difficult to treat. Compared to emergency psychiatry patients who do not abuse substances, those with substance abuse problems often require higher levels of behavioral management, spend more time in the psychiatric emergency room, and are more likely to present as suicidal [12]. Second, emergency psychiatry patients with comorbid substance abuse problems are typically more costly to treat; this is because they often utilize significantly more emergency department services, including a greater number of emergency department readmissions, as compared to those with no co-occurring substance use issues [13,14].…”