Increasing emergency department attendances in central London with methamphetamine toxicity and associated harms

Harnett, James T; Dargan, Paul I.; Dines, Alison; Archer, John R. H.; Greene, Shaun L; Hunter, Laura; Wood, David M.

doi:10.1136/emermed-2020-209550

Cited by 9 publications

(13 citation statements)

References 19 publications

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“…Overall, the clinical toxicities were similar to those reported in other ED-based studies 7 –10,17 with a comparable triage acuity. 9,17 This study adds to the literature by showing that up to one-fifth of the patients developed hypokalaemia, which is under-reported before.…”

Section: Discussionsupporting

confidence: 85%

“…Another challenge ED staff need to face is the behavioural disturbances. Methamphetamine use is often associated with agitation, psychotic symptoms, 8,17,35 violent behaviours and aggression, 7,9,17,29,36 requiring chemical and/or physical restraints, 7,17,37 police and ambulance service, 7,9,17,30 and is resource intensive. 7,17,19,37,38 Compared with other drugs, methamphetamine users are more agitated, violent and aggressive, 30,36 posing a higher risk to staff and other people around.…”

Section: Discussionmentioning

confidence: 99%

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The epidemiology of acute methamphetamine toxicity presenting to emergency departments in Hong Kong

Lam

Chan

Tse

et al. 2023

Hong Kong Journal of Emergency Medicine

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Introduction: Recreational use of methamphetamine is increasing worldwide, but epidemiology studies from Asia are lacking. We aimed to characterise the trends, drug use pattern, clinical presentations and health services utilisation of acute methamphetamine toxicity presenting to emergency departments and the current practice of emergency department psychosocial interventions in Hong Kong. Methods: This was a secondary analysis of a retrospective study on emergency department patients reported to the Hong Kong Poison Information Centre between 2010 and 2019 for acute toxicity related to recreational methamphetamine use. We studied the trend using a negative binominal regression model. Results: During the study period, 1225 episodes (involved 979 patients; 68.9% men; with a median age of 33.0 years) were reported. Acute methamphetamine toxicity did not increase significantly (odds ratio = 1.10, 95% confidence interval = 0.86–1.40, p = 0.46). Polysubstance abuse predominated. Many patients developed hypokalaemia (24.0%), rhabdomyolysis (17.2%), acute kidney injury (9.4%) and myocardial injury (4.7%); psychotic symptoms including auditory hallucination (23.8%) and paranoid delusion (21.1%); various acute behavioural disturbances and injuries. Overall, 66 patients required intensive care and 14 patients died. Only a minority of the patients were referred to social workers and voluntary drug treatment and rehabilitation services. Conclusion: Methamphetamine has a significant impact on physical and mental health in Hong Kong. Our findings highlight the need for screening for hypokalaemia, rhabdomyolysis, acute kidney injury, myocardial injury and psychosis in methamphetamine users and support policies that address polysubstance abuse, prevent drug use through continued public education and strengthen the referral system by integrating substance abuse services at the emergency department.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

The epidemiology of acute methamphetamine toxicity presenting to emergency departments in Hong Kong

Lam

Chan

Tse

et al. 2023

Hong Kong Journal of Emergency Medicine

View full text Add to dashboard Cite

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“…It is well known that there has been a significant increase in methamphetamine-related health issues in emergency admissions in recent years (10,19,20). In a recent meta-analysis, methamphetamine-related presentations in emergency departments have been shown to be characterized by cardiac complications, psychiatric symptoms, and aggression (28).…”

Section: Discussionmentioning

confidence: 99%

“…Methamphetamine is one of the synthetic substances frequently associated with psychiatric symptoms (20,32), as with synthetic cannabinoids, one of the most important health problems of recent years (33). The most common symptoms in emergency admissions associated with methamphetamine have been reported to be neuropsychiatric symptoms, such as agitation, anxiety, hallucinations, and psychosis (19). The methamphetamine-associated psychotic disorder is one of the reasons for psychiatric emergency admission (28,34), and inpatient treatment is often required (34).…”

Section: Discussionmentioning

confidence: 99%

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The use of methamphetamine in the probation population

Alniak¹

2022

Dusunen Adam

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Objective: Our research aimed to determine the frequency of methamphetamine use among people referred to health institutions for treatment with the probation decision and to reveal the sociodemographic and clinical profile of people who use methamphetamine.Method: Four hundred and forty-two consecutive cases between 18 and 65 years of age who were referred for treatment to the Probation Outpatient Clinic in Bakirkoy Prof. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery were included in the study. Sociodemographic and clinical information of the cases, substance use and treatment histories, and criminal histories were recorded and evaluated with a semi-structured form. Urine toxicology results, which were taken as one of the obligations of the probation treatment program, were examined.Results: Substance metabolites were detected in the urine toxicological analysis of 81% of the cases. Methamphetamine use was detected in 24.4% of the sample. It was the second most common illicit substance after cannabis and the fourth common seized. Inhalation was the most common method of methamphetamine use. Of the cases still using methamphetamine, 90.7% (n=98) were found to use at least one substance other than methamphetamine. Emergency admissions for substance-related problems, inpatient addiction treatment, outpatient psychiatric treatment, and forensic histories were significantly higher in the group with methamphetamine use than in the group without methamphetamine use. Conclusion:Our study is the first to evaluate the rate of methamphetamine use in the probation population and the sociodemographic and clinical profile of people with methamphetamine use. According to the data obtained, one-fourth of the probation population was using methamphetamine. This group represented a more criminally engaged subgroup of substance users with more inpatient addiction treatment and outpatient psychiatric treatment needs with a high rate of polysubstance use. Recognizing the profile of methamphetamine users is essential to develop strategies to meet their treatment needs. In addition, a probation program might provide an opportunity to raise awareness of substance-related medical and social problems and to motivate individuals who are relatively less engaged with treatment to initiate a therapeutic process.

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Emergency Room Utilization and Methamphetamine Overdose Symptoms Among Syringe Services Program Participants in Washington State

Frank,

Banta-Green,

Guthrie

et al. 2024

Substance Use & Misuse

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Increasing emergency department attendances in central London with methamphetamine toxicity and associated harms

Cited by 9 publications

References 19 publications

The epidemiology of acute methamphetamine toxicity presenting to emergency departments in Hong Kong

The epidemiology of acute methamphetamine toxicity presenting to emergency departments in Hong Kong

The use of methamphetamine in the probation population

Emergency Room Utilization and Methamphetamine Overdose Symptoms Among Syringe Services Program Participants in Washington State

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