Urine drug screen trends from 1998 through 2011 among emergency department patients treated in a University Teaching Hospital

Abstract

The emergency department (ED) at Louisiana State University-Health Science Center in Shreveport (LSUHSC-S) serves an urban population with a large rural catchment area. This study focuses on demographic variables in substance abuse trends in this region based on urine drug screen (UDS) results. A database of de-identified UDSs ordered in the ED at LSUHSC-S between 1998 and 2011 was analyzed. Samples were tested for the presence of amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, 3,4-methylenedioxymethamphetamine (MDMA), methadone, methamphetamine, opiates, phencyclidine, and propoxyphene. The patient population was categorized by age group, gender, and race. The majority of tests were performed on African-American and Caucasian patients ages 18 to 54 followed by the 0 to 11-year-old group. Of the drugs tested, cannabinoids represented the highest percentage of positive results in both the African-American and Caucasian populations. Opiates returned the highest percent of positive results among all prescription drugs. The Caucasian population predominated in positive tests for prescription drugs (opiates and benzodiazepines), while the African-American population predominated in results positive for illicit drugs (cannabinoids and cocaine). The increasing presence of opiates and cannabinoids, particularly in very young patients, should prompt policy makers and healthcare providers to develop intervention strategies to protect the most vulnerable populations.

Treatment of Amphetamine-Induced Truman Show Delusion and Delusional Parasitosis with High-Dose Ziprasidone

“…In 2005, several governments took steps to reduce availability of ephedrine and pseudoephedrine in an attempt to stem increased use of methamphetamine 13 . After a short-lived reduction, reformulated methamphetamine was introduced in which the reductive amination step used phenyl-2-propanone instead of pseudoephedrine 14 .…”

“…[10][11][12] In 2005, several governments took steps to reduce availability of ephedrine and pseudoephedrine in an attempt to stem increased use of methamphetamine. 13 After a short-lived reduction, reformulated methamphetamine was introduced in which the reductive amination step used phenyl-2-propanone instead of pseudoephedrine. 14 The reformulated methamphetamine is associated with greater number and duration of methamphetamine-related hospitalizations, and greater in-hospital mortality.…”

Retrospective chart review of substance abuse in patients with psychiatric emergencies in an emerging urban county

“…Obtaining a urine drug screen on patients presenting with psychiatric emergencies can provide information regarding use of psychotropic drugs in this patient population, but it also increases costs and length of stay while not changing referral patterns. [9][10][11] In addition, urine drug screens have limitations and do not always correlate with acute intoxication for some substances; however they have utility in determining changing patterns of drug use in a community 12 and can be an adjunct to history. Some psychiatric consultants request that urine drug screen be routinely performed on patients presenting to the ED if psychiatric consultation and intervention is requested.…”