Characterising methamphetamine use to inform health and social policies in Manitoba, Canada: a protocol for a retrospective cohort study using linked administrative data

Abstract

IntroductionRising use of methamphetamine is causing significant public health concern in Canada. The biological and behavioural effects of methamphetamine range from wakefulness, vigour and euphoria to adverse physical health outcomes like myocardial infarction, haemorrhagic stroke, arrhythmia and seizure. It can also cause severe psychological complications such as psychosis. National survey data point to increasing rates of methamphetamine use, as well as increasing ease of access and serious methamphetamine-related harms. There is an urgent need for evidence to address knowledge gaps, provide direction to harm reduction and treatment efforts and inform health and social policies for people using methamphetamine. This protocol describes a study that aims to address this need for evidence.MethodsThe study will use linked, whole population, de-identified administrative data from the Manitoba Population Research Data Repository. The cohort will include individuals in the city of Winnipeg, Manitoba, who came into contact with the health system for reasons related to methamphetamine use from 2013 to 2021 and a comparison group matched on age, sex and geography. We will describe the cohort’s sociodemographic characteristics, calculate incidence and prevalence of mental disorders associated with methamphetamine use and examine rates of health and social service use. We will evaluate the use of olanzapine pharmacotherapy in reducing adverse emergency department outcomes. In partnership with Indigenous co-investigators, outcomes will be stratified by First Nations and Métis identity.Ethics and disseminationThe study was approved by the University of Manitoba Health Research Ethics Board, and access datasets have been granted by all data providers. We also received approval from the First Nations Health and Social Secretariat of Manitoba’s Health Information Research Governance Committee and the Manitoba Métis Federation. Dissemination will be guided by an ‘Evidence 2 Action’ group of public rightsholders, service providers and knowledge users who will ensure that the analyses address the critical issues.

Perceived need for care and stigma experiences among individuals with methamphetamine-related admissions to inpatient mental health wards

“…Psychosis is a symptom experienced by many people who use methamphetamine [3,4] and a common indication for inpatient admission. This study attenuates the potential of confounding by indication by surveying a population admitted to hospital, who would have been admitted for psychiatric concerns such as mood or psychotic disorders that may be related to methamphetamine use.…”

“…A recent meta-analysis revealed that 36.5% of people who use methamphetamine develop symptoms of psychosis, a figure far higher than with any other illicit drug [3]. Local data show that Manitobans who used methamphetamine were 43.7 times more likely to be diagnosed with a psychotic disorder within 12 months of their first methamphetamine-related contact with the healthcare system than the general population [4]. It can be difficult to differentiate acute symptoms of psychosis related to methamphetamine use from those related to a chronic primary psychotic disorder [5].…”

A rare incidence of acute ischaemic stroke with reversible middle cerebral artery occlusion in a methamphetamine addict: Case report

“…Methamphetamine, a widely used illegal drug, has become a significant public health concern worldwide [ 1 ]. The biological and behavioral effects of methamphetamine range from wakefulness, vigour, and euphoria to adverse outcomes such as myocardial infarction, arrhythmia, haemorrhagic stroke, and psychosis [ 2 , 3 ]. A strong association has been found between methamphetamine abuse and non-lethal haemorrhagic stroke by previous studies [ 4 ].…”

Amphetamine-Related Emergency Department Visits in Ontario, Canada, 2003-2020

“… 1 In Canada, the number of Manitobans that received first-time care for methamphetamine use increased from 208 in 2013 to 1,454 in 2018. 10 Moreover, amphetamine-related emergency department (ED) visits in Winnipeg increased from 10 to more than 150 visits between 2013 and 2017. 11 Furthermore, hospitalizations in British Columbia and Alberta doubled from 591 to 1,210 visits, and from 217 to 460 visits, respectively, between 2012 and 2014.…”