Crystal methamphetamine's impact on frontline emergency services in Victoria, Australia

Jones, Rikki; Usher, Kim; Woods, Cindy

doi:10.1016/j.auec.2019.07.004

Cited by 8 publications

(10 citation statements)

References 6 publications

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“…There is increasing demand for EDs to provide assessment and care to patients affected by illicit substances arriving by ambulance. Ambulance data show there has been an increase in people affected by amphetamines by 227%, and in rural areas, this has increased of 419% in the past 5 years (Jones et al 2019). The implications are significant for rural EDs who have limited resources and access to emergency services and drug and alcohol clinicians on weekends when most arrive.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and clinical outcomes for mental health patients admitted to a behavioural assessment unit: Implications for model of care and practice

Daniel

Mukaro

Yap

et al. 2020

Int J Mental Health Nurs

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Behavioural assessment units (BAU) have been established in emergency departments (EDs) to provide short‐term observation, treatment, and care to people experiencing acute behavioural disturbance. A prospective observational study was conducted in a cohort of adult patients admitted to one BAU located within an ED (July–December 2017) to compare clinical characteristics, treatment outcomes, and use of restrictive interventions for those who received a specialist mental health (MH) assessment with those who did not. Of the 457 patients, 61.5% received a specialist MH assessment. This group had a lower acuity (Australasian Triage Score 10.4%; CI 0.2–2.0% vs 13.6%; CI 9.3–19.5%); more arrived with police (28.8%; CI 23.8–34.3 vs 5.1%; CI 2.7–9.4%); and were subjected to restrictive interventions while in the BAU. Security responses for unarmed threat (code grey) were higher (10.9%; CI 7.8–15.0% vs 4.4%; CI 2.3–8.5%), as was the use of chemical restraint (4.2%; CI 2.4–7.2 vs 0.0% CI 0.0 – 2.1%). Those requiring specialist MH assessment had a longer length of stay (12.7 vs 5.2 hours). Further development of the BAU model of care must include targeted, evidence‐based strategies to minimize the use of restrictive interventions and ensure timely access to acute mental health services.

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Section: Discussionmentioning

confidence: 99%

Characteristics and clinical outcomes for mental health patients admitted to a behavioural assessment unit: Implications for model of care and practice

Daniel

Mukaro

Yap

et al. 2020

Int J Mental Health Nurs

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“…Amphetamine‐type stimulant, especially methamphetamine in crystal form (commonly known as ‘ice’), is a strong psychostimulant (Alarcon Manchego et al, 2015; Degenhardt et al, 2014; Jones et al, 2019, 2019). Throughout the world, amphetamine‐type stimulant addiction contributes to a substantial global burden of disease (Degenhardt et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…Individuals who experience acute amphetamine‐type stimulant intoxication often demonstrate psychological disturbances and aggressive behaviour that warrants immediate management in the emergency department (ED) (Jones et al, 2019, 2019; Sibanda et al, 2019). As a consequence, there has been a significant increase in the number of people presenting to EDs who are negatively affected by amphetamine‐type stimulants (Alarcon Manchego et al, 2015; Jones et al, 2019, 2019; Richards et al, 2017). For example, in 2013 it was estimated that amphetamine‐type stimulant use contributed to more than 20 000 additional ED visits throughout Australia (McKetin et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…The clinical complexity of care for this group can be due to the acute concurrent physical and behavioural effects of intoxication and the long‐term use of the substances (McKetin et al, 2018). There are significant challenges for staff and patient safety due to the high rates of violence and aggression observed among those affected by these substances in both pre‐hospital (Jones et al, 2019, 2019) and ED settings (Jones et al, 2019, 2019; Sibanda et al, 2019; Yap et al, 2017). Long‐term use of amphetamine‐type stimulants is associated with increased risk of cardiovascular disease, namely heart failure and stroke (Sliman et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Amphetamine‐type stimulant use among patients admitted to the emergency department behavioural assessment unit: Screening and referral outcomes

Gerdtz

Yap

Daniel

et al. 2020

Int J Mental Health Nurs

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Amphetamine-type stimulant use, including methamphetamine, amphetamine, and 3,4-methylenedioxymethamphetamine, is associated with a range of behavioural symptoms. Screening for amphetamine-type stimulant use among people presenting to the emergency department with behavioural disturbance and referral to treatment has not been evaluated. The objective of this study was to determine the prevalence of amphetamine-type stimulant use among patients admitted to a behavioural assessment unit and report referral outcomes. A prospective observational design was used. Individuals who tested positive or self-reported amphetamine-type stimulant use were referred to the alcohol and other drug clinician. We measured the prevalence of amphetamine-type stimulant use in saliva and by self-report along with rates of referral. The setting was a behavioural assessment unit located within an Australian emergency department. Admitted adults were enrolled from July to December 2017. Those who tested positive or selfreported amphetamine-type stimulant use were provided with harm reduction advice and offered referral. Four hundred and seventy-two tests were performed. Fifteen were excluded due to invalid results or redundant enrolment. Of the 457 individuals, 59% were male, with a mean age of 35 years (SD 13). Fifty-three (11.6%, 95% CI: 8.9-15.0) tested positive for amphetamine-type stimulants. Of those with a negative test, 44 (9.6%, 95%

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“…The effects of METH can last up to 12 hours, depending on the route of administration. 1 Phases of METH intoxication include rush (increased energy and well-being, heightened libido), tweaking (restless anxiety, irritability), crashing (after days of not sleeping, individuals who use fall into a non-restful sleep), and withdrawal. 2 METH is an extremely addictive stimulant that is misused internationally.…”

Section: Introductionmentioning

confidence: 99%

Back With a Vengeance: The Reappearance of Methamphetamine and its Implications for Health Care Providers

Salani¹,

Valdes²,

Santis³

et al. 2020

The Journal for Nurse Practitioners

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A great deal of attention has been placed on the opioid epidemic that the United States is currently experiencing; however, a resurgence in methamphetamine (METH) use has been occurring during the past 5 years. METH is an addictive stimulant that primarily affects the central nervous system by increasing dopamine, norepinephrine, and serotonin. Ranking second to opioids, METH use has had a significant impact on mortality, morbidity, and health-related costs and remains a serious public health problem in the United States. Individuals who use METH often use an emergency department or community-based organization for health care. Therefore, nurses and other health care providers must be knowledgeable about the harmful physical and psychological health effects of METH.

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Crystal methamphetamine's impact on frontline emergency services in Victoria, Australia

Cited by 8 publications

References 6 publications

Characteristics and clinical outcomes for mental health patients admitted to a behavioural assessment unit: Implications for model of care and practice

Characteristics and clinical outcomes for mental health patients admitted to a behavioural assessment unit: Implications for model of care and practice

Amphetamine‐type stimulant use among patients admitted to the emergency department behavioural assessment unit: Screening and referral outcomes

Back With a Vengeance: The Reappearance of Methamphetamine and its Implications for Health Care Providers

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