Amphetamine-type-substance-related presentations to the Emergency Department Mental Health Team of a local health district in Australia

Chivaurah, Bernard M; Lienert, David; Coates, Dominiek

doi:10.1177/1039856219848836

Cited by 5 publications

(16 citation statements)

References 11 publications

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“…Seven of the 19 studies compared the percentage of stimulant-related presentations to the number of ED presentations in the study period with varying results. Percentages ranged from 0.15% of the total ED presentations [27], 1.2% [16], 2%, [11], 2.4-3% [24] and 11.9% [21]. Di Rico R et al's study reported that 7% of total ED presentations were due to mental and behavioral disorders involving psychoactive substances [28].…”

Section: Percentage Of Ed Presentation Of Patients Who Use Stimulantsmentioning

confidence: 97%

“…Four of the studies [12,19,22,25] focused on methamphetamine-related ED presentations. In six of the studies [11,[15][16][17]23,27], amphetamine and/or amphetamine-type stimulants were the main drug of concern. In contrast, Horyniak D et al [24] focused only on ecstasy-related ED presentations.…”

Section: Main Stimulant Usedmentioning

confidence: 99%

“…According to three studies, psychosis was more likely to be present in patients with a stimulant-related ED presentation when compared to other mental illnesses [16,17,18]. Physical injuries, aggression, and suicide risks were identified as reasons for the ED presentation in five studies [12,14,22,24,27]. Unadkat A et al reported that 66% of people presenting to the EDs who have used amphetamine were aggressive towards staff, while 50% were aggressive towards other patients [12].…”

Section: Reason For Ed Presentation and Comorbiditiesmentioning

confidence: 99%

“…One study used tranquilizers and oral sedation in 15.9% and 14% of patients, respectively [27]. In contrast, another reported that oral sedation was administered in 61% of the stimulant-related presentations [25].…”

Section: Reason For Ed Presentation and Comorbiditiesmentioning

confidence: 99%

“…[14] 11.9%, [19] 27%, [27] 37%, [25] 41%, and [15] 52%. Furthermore, it was reported in one study that all methamphetamine-related ED attendances (n=637) were transported to the ED via ambulance services [18].…”

Section: Reason For Ed Presentation and Comorbiditiesmentioning

confidence: 99%

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Rates and Patterns of Australian Emergency Department Presentations of People Who Use Stimulants: A Systematic Literature Review

Redona¹,

Woods²,

Jackson³

et al. 2022

Cureus

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The use of illicit stimulants continues to pose a significant challenge to different health sectors. In Australia, four particular stimulants, namely amphetamines and their derivatives, methamphetamine, ecstasy or 3,4methylenedioxy-methamphetamine (MDMA), and cocaine cause a significant challenge to EDs as managing patients who use stimulants can be labor and resource intensive. While Australian data are available for stimulant-related ambulance attendances and hospitalizations, little is known about ED presentations of people who use stimulants. The aim of this paper is to systematically review the available literature related to the rates and patterns of ED presentations of people who use stimulants in Australia. A search was conducted on EBSCOhost, CINAHL Complete, and PubMed databases, as well as Google Scholar. Search terms consisted of combinations of the following terms: 1) stimulant AND ED AND Australia; 2) stimulants AND emergency presentations OR accident and emergency AND Australia, 3) amphetamine OR methamphetamine OR ecstasy OR cocaine AND ED AND Australia. Articles that met the inclusion criteria were included in the review and subjected to a quality appraisal. Data were extracted from the selected papers, including patient demographics, presentation rates, type of stimulant, reasons for presentations, police or ambulance service involvement, comorbidities, mental health issues, triage codes, admissions, and separations. The results of the review are reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.Studies were eligible if they were English-language peer-reviewed articles published between January 2011 and December 2021 and if they included data on Australian ED presentations of people who use nonprescription illicit stimulants. Studies were excluded if they did not include stimulant-related ED presentations or focused on ED presentations related to prescription stimulants, including Ritalin and Adderall, non-stimulant drugs, or caffeine for attention deficit disorder (ADD) or attention-deficit hyperactivity disorder (ADHD). The selected articles were appraised for quality, rigor, and risk of bias by two authors. The studies were assessed using the Newcastle Ottawa Scale (NOS) for cross-sectional, cohort, and case-control studies depending on the methodology identified in the study. A total of 19 articles were included in this study. Males represented 53 to 85% of ED presentations of people who use stimulants with an age range of 0 to 65 and are more likely to be transported by police or ambulance. People who use stimulants presented to EDs with varying psychological and behavioral concerns such as psychosis, selfharm, suicidal ideations, hallucinations, agitations, and aggressiveness, as well as medical conditions, including heart palpitations, nausea and vomiting, and significant physical injuries.

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