The profile of psychiatric symptoms exacerbated by methamphetamine use

McKetin, Rebecca; Dawe, Sharon; Burns, Richard A.; Hides, Leanne; Kavanagh, David J.; Teesson, Maree; Young, Ross McD.; Voce, Alexandra; Saunders, John B.

doi:10.1016/j.drugalcdep.2016.01.018

Cited by 73 publications

(54 citation statements)

References 39 publications

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“…In the absence of a collateral history, meth/amphetamine‐induced psychosis is almost indistinguishable from acute schizophrenia, making a diagnosis based on presenting signs and symptoms challenging. In our study we found that the ED nurses frequently reported signs and symptoms of agitation in most of the people who tested positive for any substance.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of illicit substance use among patients presenting to the emergency department with acute behavioural disturbance: Rapid point‐of‐care saliva screening

Gerdtz

Yap

Daniel

et al. 2020

Emerg Medicine Australasia

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Objective: To determine the prevalence of illicit substance use among patients presenting to one ED with acute behavioural disturbance using point-of-care saliva testing. Methods: A prospective observational study was conducted. Acute behavioural disturbance was defined as any episode requiring a security response for unarmed threat (Code Grey). The setting was a single ED and tertiary referral centre located in metropolitan Australia. Participants were adults presenting to the ED requiring a Code Grey. Saliva was analysed for meth/amphetamine, cannabis, cocaine and opiates using a rapid point-of-care test. Self-reported drug use was recorded at the time of saliva testing. Data collection occurred between August 2016 and March 2017. Results: There were 229 valid saliva samples. Participants were, on average, 35 years (range 18-72) and male (168/229; 73%). Forty percent (95% confidence interval 34-47) of samples tested positive, with 20% positive for two or more substances. Meth/ amphetamines was detected in 92% of positive samples, 17% of samples tested positive for opiates, 8% for cannabis and 7% for cocaine. Among participants, 19% selfreported current substance use and 20% reported using illicit substances within the past 24 h. Conclusions: The prevalence of illicit substance use among this cohort was 40%. Self-reporting was unreliable. Pointof-care saliva testing is feasible. Early identification of harmful drug use may assist clinical decision making in selected or undifferentiated cases and provide an opportunity to implement harm minimisation strategies and make referrals.

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Section: Discussionmentioning

confidence: 99%

Prevalence of illicit substance use among patients presenting to the emergency department with acute behavioural disturbance: Rapid point‐of‐care saliva screening

Gerdtz

Yap

Daniel

et al. 2020

Emerg Medicine Australasia

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“…In addition, previous studies have not examined cognitive predictors in relation to the intensity of stimulant use during treatment. This is critical, as previous research has found a dose-response relationship between methamphetamine use and poorer outcomes (Lappin et al 2016;McKetin et al 2016).…”

Section: Introductionmentioning

confidence: 97%

Working memory predicts methamphetamine hair concentration over the course of treatment: moderating effect of impulsivity and implications for dual‐systems model

et al. 2017

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High impulsivity and poor executive function are characteristic of methamphetamine use disorder. High arousal in the impulsive system has been proposed to compromise the executive system's regulating ability (i.e. the dual-systems model). While interaction between these variables may partly explain poor treatment outcomes associated with methamphetamine use disorder, previous research has tended to examine each factor separately. We investigated whether high impulsivity (measured with an impulsive choice task) and poor executive function (measured with a working memory task) predict methamphetamine use (determined by hair sample) in the 6 weeks following treatment commencement. We also investigated whether impulsive choice moderates the relationship between working memory and methamphetamine use. One hundred and eight individuals with methamphetamine use disorder (75 percent male) were tested within 3 weeks of commencing treatment; 80 (74 percent) were followed up 6 weeks following baseline testing. Cognitive measures significantly predicted drug use after controlling for nuisance variables. Working memory was a significant predictor, while impulsive choice was not. The interaction model included working memory as a predictor and impulsive choice as a moderator. This model was significant, as was the interaction term. Working memory significantly predicted levels of methamphetamine use in early treatment, and impulsive choice moderated this relationship. Those with working memory deficits are particularly vulnerable to using greater amounts of methamphetamine. As working memory increased methamphetamine use decreased among individuals with low/medium delay discounting. Pre-treatment cognitive testing may identify patients at high risk, while remediation of working memory function may be a treatment target for reducing methamphetamine use.

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“…Specifically, high rates of premorbid psychiatric conditions, including major depression and psychotic disorders , occur amongst people who are dependent on methamphetamine. Conversely, methamphetamine dependence is associated with an exacerbation of symptoms in psychotic disorders , the occurrence of psychotic symptoms even in people who do not have a psychotic disorder , and increases in the severity of depression and suicidality . Symptoms of self‐neglect (e.g.…”

Section: Discussionmentioning

confidence: 99%

Health‐related quality of life among people who use methamphetamine

McKetin

Voce

Burns

et al. 2019

Drug and Alcohol Review

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Introduction and Aims. We assessed health-related quality of life amongst people who use methamphetamine, examined how this related to different patterns of methamphetamine use and what other factors were associated with decrements in quality of life in this sample. Design and Methods. A cross-sectional survey of 169 at least monthly methamphetamine users. Health utility scores were derived using the Assessment of Quality of Life -4D for the past month (0 reflects death and 1 represents full health; the population mean Assessment of Quality of Life score in Australia is 0.81). Dependence on methamphetamine was a score of 4+ on the Severity of Dependence Scale. Other measures included days of methamphetamine use and other substance use in the past month, injecting methamphetamine, demographics, psychiatric symptoms (score of 4+ on the Brief Psychiatric Rating Scale items) and a lifetime DSM-IV diagnosis of schizophrenia. Results. The mean utility score was 0.52 (95% confidence interval 0.48-0.56). Methamphetamine dependence was associated with lower utility (−0.10, P = 0.003) after adjustment for other univariate correlates of utility. Other factors independently associated with lower utility were being a woman (−0.14, P < 0.001), depression (−0.10, P = 0.008), self-neglect (−0.08, P = 0.035), schizophrenia (−0.17, P = 0.003) and fewer years of schooling (0.02 per year, P = 0.037). Discussion and Conclusions. We found poor quality of life in this sample of methamphetamine users relative to the general population, this being associated with both dependence on methamphetamine and other factors, particularly poor mental health. We also found poorer health amongst women. [McKetin R, Voce A, Burns R, Shanahan M. Health-related quality of life among people who use methamphetamine. Drug Alcohol Rev 2019;38:503-509]

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The profile of psychiatric symptoms exacerbated by methamphetamine use

Cited by 73 publications

References 39 publications

Prevalence of illicit substance use among patients presenting to the emergency department with acute behavioural disturbance: Rapid point‐of‐care saliva screening

Prevalence of illicit substance use among patients presenting to the emergency department with acute behavioural disturbance: Rapid point‐of‐care saliva screening

Working memory predicts methamphetamine hair concentration over the course of treatment: moderating effect of impulsivity and implications for dual‐systems model

Health‐related quality of life among people who use methamphetamine

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