Methamphetamine Use and Emergency Department Utilization: 20 Years Later.

Background: Methamphetamine (MAP) users present to the emergency department (ED) for myriad reasons, including trauma, chest pain, and psychosis. The purpose of this study is to determine how their prevalence, demographics, and resource utilization have changed.

Methods: Retrospective review of MAP patients over 3 months in 2016. Demographics, mode of arrival, presenting complaints, disposition, and concomitant cocaine/ethanol use were compared to a 1996 study at the same ED.

Results: 638 MAP-positive patients, 3,013 toxicology screens, and 20,203 ED visits represented an increase in prevalence compared to 1996: 461 MAP-positive patients, 3,102 screens, and 32,156 visits. MAP patients were older compared to the past. Mode of arrival was most frequently by ambulance but at a lower proportion than 1996, as was the proportion of MAP patients with positive cocaine toxicology screens and ethanol coingestion. Admission rate was lower compared to the past, as was discharge to jail. The proportion of MAP patients presenting with blunt trauma was lower compared to the past and higher for chest pain.

Conclusion: A significant increase in the prevalence of MAP-positive patients was found. Differences in presenting complaints and resource utilization may reflect the shifting demographics of MAP users, as highlighted by an older patient population relative to the past.