The scourge of methamphetamine: Impact on a level I trauma center
ABSTRACT Methamphetamine (METH) use is associated with high-risk behavior and serious injury. The aim of this study was to assess the impact of METH use in trauma patients on a Level I trauma center to guide prevention efforts.
A retrospective registry-based review of 4,932 consecutive trauma patients who underwent toxicology screening at our center during a 3-year period (2003-2005). This sample represented 76% of all trauma patients seen during this interval.
From the first half of 2003 to the second half of 2005, overall use of METH increased 70% (p < 0.001), surpassing marijuana as the most common illicit drug used by the trauma population. Other illicit drug use did not significantly change during this interval. METH-positive patients were more likely to have a violent mechanism of injury (47.3% vs. 26.3%, p < 0.001), with 33% more assaults (p < 0.01), 96% more gunshot wounds (p < 0.001), and 158% more stab wounds (p < 0.001). They were more likely to have attempted suicide (4.8% vs. 2.6%, p < 0.01), to have had an altercation with law enforcement (1.8% vs. 0.3%, p < 0.001), or been the victim of domestic violence (4.4% vs. 2.1%, p < 0.001). METH users had a higher mean Injury Severity Score (11.2 vs. 10.0, p < 0.01), were 62% more likely to receive mechanical ventilation (p < 0.001), and 53% more likely to undergo an operation (p < 0.001). They were more prone to leave against medical advice (4.9% vs. 2.1%, p < 0.001) and 113% more likely to die from their injuries (6.4% vs. 3.0%, p < 0.001). The average cost of care per METH user was 9% higher than that for nonusers, and METH users were more likely to be unfunded than nonusers (47.6% vs. 23.1%, p < 0.001). The annual uncompensated cost of care of METH users increased 70% during the study period to $1,477,108 in 2005.
METH use in trauma patients increased significantly and was associated with adverse outcomes and a significant financial burden on our trauma center. Evidence-based prevention efforts must be a priority for trauma centers to help stop the scourge of METH.
- SourceAvailable from: Stephen Mburu Kimani
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- "At a larger societal level, the financial burden of methamphetamine use on communities is significant. In the U.S., the average cost of healthcare per methamphetamine user was 9% higher than that for non-users, and methamphetamine users were less likely to be insured compared with non-users (Swanson et al., 2007). Beyond direct health care costs, resources forgone because of reduced productivity among methamphetamine users may pose a bigger economic burden on a community. "
ABSTRACT: Over the last decade, South Africa's Western Cape has experienced a dramatic increase in methamphetamine ("tik") use. Our study explored local impressions of the impact of tik use in a peri-urban township community in Cape Town, South Africa. We conducted individual in-depth interviews with 55 women and 37 men who were regular attendees of alcohol-serving venues. Interviews were recorded and transcribed. A content analysis approach was used to identify themes related to the impact of tik use based on levels of the socio-ecological framework (individual, inter-personal and community). Tik use was reported to be a greater issue among Coloureds, compared to Blacks. At an individual level, respondents reported that tik use had adverse effects on mental, physical, and economic well-being, and limited future opportunities through school drop-out and incarceration. At an inter-personal level, respondents reported that tik use contributed to physical and sexual violence as well as increased rates of sexual risk behaviour, particularly through transactional sex relationships. Respondents described how tik use led to household conflict, and had negative impacts on children, including neglect and poor birth outcomes. At a community level, respondents linked tik use to increased rates of crime, violence and corruption, which undercut community cohesion. Our results highlight the negative impact that tik is having on individuals, households and the overall community in a peri-urban setting in South Africa. There is a clear need for interventions to prevent tik use in South Africa and to mitigate and address the impact of tik on multiple levels.The International journal on drug policy 10/2013; 25(2). DOI:10.1016/j.drugpo.2013.10.007 · 2.54 Impact Factor
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- "Close to 25 million people worldwide are estimated to use methamphetamine and amphetamine (United Nations Office of Drugs and Crime, 2007) and many urban centres across North America are experiencing a significant increase in use of crystal methamphetamine (CM) (Buxton and Dove, 2008). Methamphetamine use has been associated with multiple adverse health outcomes, and interpersonal risks such as self-harm and violence (Boddiger, 2005; Buxton et al., 2008; Newman et al., 2004 and Semple et al., 2004b), which represent a heavy social burden to communities (Brouwer et al., 2006 and Swanson et al., 2007). Unlike other illicit drugs, such as cocaine or heroin that are produced and/or refined outside North America, CM can be produced locally and inexpensively using easy-to-access precursor chemicals. "
ABSTRACT: Given growing concern of the sexual risks associated with crystal methamphetamine use and the dearth of research characterizing the use of methamphetamine among street-based sex workers (FSWs), this study aimed to characterize the prevalence and individual, social, and structural contexts of crystal methamphetamine use among FSWs in a Canadian setting. Drawing on data from a prospective cohort, we constructed multivariate logistic models to examine independent correlates of crystal methamphetamine among FSWs over a two-year follow-up period using generalized estimating equations. Of a total of 255 street-based FSWs, 78 (32%) reported lifetime crystal methamphetamine use and 24% used crystal methamphetamine during the two-year follow-up period, with no significant associations between methamphetamine use and sexual risk patterns. In a final multivariate GEE model, FSWs who used crystal methamphetamine had a higher proportional odds of dual heroin injection (adjOR=2.98, 95%CI: 1.35-5.22), having a primary male sex partner who procures drugs for them (adjOR=1.79, 95%CI: 1.02-3.14), and working (adjOR=1.62, 95%CI: 1.04-2.65) and living (adjOR=1.41, 95%CI: 1.07-1.99) in marginalized public spaces. The findings highlight the crucial need to move beyond the individual to gender-focused safer environment interventions that mediate the physical and social risk environment of crystal methamphetamine use among FSWs.Drug and alcohol dependence 01/2011; 113(1):76-81. DOI:10.1016/j.drugalcdep.2010.07.011 · 3.28 Impact Factor
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- "; O'Malley and Johnston, 2003; Rivara et al., 1997; Rootman et al., 2007; Shoptaw and Reback, 2007; Stein and Friedmann, 2006; Strathdee et al., 2001; Sullivan et al., 2005; Swanson et al., 2007; Sweeney et al., 2000; Volkow et al., 2007; Westover et al., 2007; Wilson and Saukkonen, 2004; Yeo et al., 2007). SBIRT provides a opportunistic teaching moment for primary care or emergency service providers to take proactive measures for their patients who may be engaged in risky use of substances, but are not currently seeking assistance and are not in need of specialty treatment. "
ABSTRACT: Alcohol screening and brief interventions in medical settings can significantly reduce alcohol use. Corresponding data for illicit drug use is sparse. A Federally funded screening, brief interventions, referral to treatment (SBIRT) service program, the largest of its kind to date, was initiated by the Substance Abuse and Mental Health Services Administration (SAMHSA) in a wide variety of medical settings. We compared illicit drug use at intake and 6 months after drug screening and interventions were administered.Drug and alcohol dependence 10/2008; 99(1-3):280-95. DOI:10.1016/j.drugalcdep.2008.08.003 · 3.28 Impact Factor