High Resource Utilization of Psychiatric Emergency Services by Methamphetamine Users

Area of Science:

• Emergency Medicine
• Psychiatry
• Public Health

Background:

• Methamphetamine use is a growing public health concern in the United States, with a historical prevalence in Hawai'i.
• Emergency departments (EDs) face increasing challenges in managing patients with substance use disorders.

Purpose of the Study:

• To evaluate the impact of methamphetamine use on emergency department resource utilization.
• To analyze the association between amphetamine positivity and ED visit outcomes.

Main Methods:

• Retrospective study of emergency department visits from 2007-2011 at an urban hospital in Hawai'i.
• Analysis of 16,018 drug-screened patients, measuring amphetamine positivity rates.
• Primary outcomes: ED length of stay, medication/restraint use, and psychiatric hospitalization rates.

Main Results:

• 15.1% of screened patients tested positive for amphetamines.
• Amphetamine-positive patients had longer ED stays and higher rates of medication and physical restraint use.
• Amphetamine-positive patients were less frequently admitted to inpatient psychiatry compared to negative-testing patients.

Conclusions:

• Methamphetamine use is associated with increased resource utilization in psychiatric emergency services.
• Effective ED stabilization of methamphetamine-affected patients may offset increased ED resource use by reducing inpatient psychiatric burdens.