Methamphetamine‐related Emergency Department Utilization and Cost

Abstract

Objective: To quantify the frequency, cost, and characteristics associated with emergency department (ED) visits that are related to methamphetamine use.Methods: This was a prospective observational study. The authors performed a training program for ED clinicians on the acute and chronic effects of methamphetamine and the signs of methamphetamine abuse. A standardized two question survey was administered to clinicians concerning the relationship between the ED visit and the patient's methamphetamine use. The survey was embedded in the patient tracking system and was required for all ED patients before disposition. Survey results were merged with administrative data on demographics, diagnosis, disposition, and charges. Univariate analyses were used to determine patient characteristics associated with methamphetamine-related ED visits. Results:The authors examined 15,038 ED visits over a 20-week period from February 2006 to June 2006. There were a total of 353 methamphetamine-related visits, for an average of 17.65 visits per week (2.4% of all visits). Hospital charges for methamphetamine-related ED visits averaged $133,181 per week, for an estimated total of $6.9 M in annual charges. Methamphetamine-related ED patients were more likely to be male (odds ratio [OR] 1.6, 95% confidence interval [CI] = 1.30 to 2.01), white (OR 1.8, 95% CI = 1.38 to 2.29), and uninsured (OR 3.2, 95% CI = 2.21 to 4.69). The top four medical conditions associated with methamphetamine-related visits were mental health (18.7%), trauma (18.4%), skin infections (11.1%), and dental diagnoses (9.6%).Conclusions: Methamphetamine abuse accounts for a modest but substantial proportion of ED utilization and hospital cost. Methamphetamine-related ED visits are most commonly related to mental illness, trauma, skin, and dental-related problems.ACADEMIC EMERGENCY MEDICINE 2008; 15:23-31 ª

Amphetamine Abuse in Emergency Department Patients Undergoing Psychiatric Evaluation

“…Previously published data reported a 13.4% prevalence of amphetamine-positive UDS in trauma patients presenting to our institution in 1994 (7). Additionally, in 2008 at an institution similar to our own, the overall prevalence of methamphetamine-related ED visits (MREDVs) was reported as 2.4%, with 18.7% of MREDVs being for psychiatric disorders (8). Amphetamine use likely plays a significant role in many cases of patients presenting to the ED for psychiatric complaints.…”

Factors associated with professional support access among a prospective cohort of methamphetamine users

“…Specifically, participants were asked to comment on their access of six specialist drug treatment modalities in relation to methamphetamine use and/or associated harms: individual (one-on-one) drug counselling; group counselling; residential rehabilitation; and residential, outpatient and home withdrawal/ detoxification services. Utilisation of GPs and generalist psychiatric services for methamphetamine use was also assessed, in addition to the use of emergency services (i.e., hospital, ambulance) on the basis of previously reported high rates of emergency service access by methamphetamine users (Gray, Fatovich, McCoubrie, & Daly, 2007;Hendrickson, Cloutier, & McConnell, 2008;Lloyd, 2012).…”

The Methamphetamine Problem in the United States

“…In a recent investigation of MA-related emergency department visits (n=353), the most common presentations associated with MA use were mental health problems (18.7%), trauma (18.4%), skin infections (11.1%), and dental pathology (9.6%) (Hendrickson et al, 2008). Seizures and stroke have also been reported in the context of MA intoxication in both emergency department and hospital settings (Westover et al, 2007; Perez et al, 1998; Richards et al, 1999).…”