Frequent methamphetamine injection predicts emergency department utilization among street-involved youth

British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.
Public health (Impact Factor: 1.43). 11/2011; 126(1):47-53. DOI: 10.1016/j.puhe.2011.09.011
Source: PubMed


Methamphetamine (MA) use has been associated with health problems that commonly present in the emergency department (ED). This study sought to determine whether frequent MA injection was a risk factor for ED utilization among street-involved youth.
Prospective cohort study.
Data were derived from a street-involved youth cohort known as the 'At Risk Youth Study'. Behavioural data including MA use were linked to ED records at a major inner-city hospital. Kaplan-Meier and Cox proportional hazards methods were used to determine the risk factors for ED utilization.
Between September 2005 and January 2007, 427 eligible participants were enrolled, among whom the median age was 21 (interquartile range 19-23) years and 154 (36.1%) were female. Within 1 year, 163 (38.2%) visited the ED, resulting in an incidence density of 53.7 per 100 person-years. ED utilization was significantly higher among frequent (i.e. ≥daily) MA injectors (log-rank P = 0.004). In multivariate analysis, frequent MA injection was associated with an increased hazard of ED utilization (adjusted hazard ratio = 1.84, 95% confidence interval 1.04-3.25; P = 0.036).
Street-involved youth who frequently inject MA appear to be at increased risk of ED utilization. The integration of MA-specific addiction treatment services within emergency care settings for high-risk youth is recommended.

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Available from: Brandon David Lewis Marshall
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    • "The literature also suggests that only heavy illicit drug users were reported to use EDs rather than non-drug users (French et al. 2011) and longer and more frequent drug users were more likely to have unmet health care needs (Narevic et al. 2006). Injection drug users were more likely to visit an ED than non IDUs (Kerr et al. 2005) and frequent drug injectors were more likely to use an ED (Marshall et al. 2012; Stein & Anderson, 2003). Among women, stigma caused by drug use and incarceration increases the need for health and social services, but restricts access to those services (van Olphen et al. 2009). "

    Full-text · Article · Jan 2014
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    • "Methamphetamine use is a serious public health concern (Marshall et al. 2012) as it is one of the most widely abused illicit drugs globally (Cruickshank and Dyer 2009). Its use is associated with numerous adverse physical, behavioral, and mental health outcomes. "
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