Amphetamines are the most commonly used illicit drugs after cannabis, and Australia has one of the highest rates of their usage in the world.
There is good evidence that usage is associated with poor mental health and a range of other health problems.
A nine- year study by Professor Daniel Fatovich and colleagues from the University of Western Australia and Curtin University of Technology has found that amphetamine-related presentations to the emergency department are “associated with a significant cluster of hospitalisations around that episode, most prominently for psychiatric diagnoses.”
They are calling for public education and counselling to advocate less risky behaviour in order to decrease the burden of illness.
The study, published in the latest issue of Emergency Medicine Australasia, the journal of the Australasian College for Emergency Medicine, examined records of 138 patients who had 156 amphetamine-related presentations.
Their most common diagnosis was mental disorders, followed by injury and poisoning.
The mean age was 28 years, 71% were male, and over half used amphetamines at least weekly.
Thirty-nine per cent required admission to hospital.
Professor Fatovich said there have been changing patterns of drug usage over time.
In Australia the peak of heroin availability and use occurred around 1998–1999. This was followed by a shortage known as the “heroin drought” and a rise in amphetamine use, which peaked around 2005.
This was followed by a mixed picture of both amphetamine and heroin use.
More recently, it has been reported that amphetamine use has increased, and the drug was easy to obtain.
“We have previously reported a 10-year record linkage study of morbidity associated with heroin overdose presentations to an ED.
“This found that non-fatal heroin overdose ED presentations are associated with a cluster of hospitalisations around that episode, likely to be related to heroin availability.
“Given the extent and consequences of use of amphetamines, surprisingly little attention has been given to examining their impact on health services.”
Professor Fatovich said amphetamine use has been associated not just with mental health problems but also with a growing number of deaths.
“An examination of amphetamine-related deaths in Taiwan from 1990 to 2007 found a six-fold risk of mortality compared with the general population.
“In Australia a review of the National Coroners Information System from July 2000 to June 2005 identified 371 amphetamine fatalities.”
In the present study four people (2.9%) died within two years of attending the ED with an amphetamine-related presentation.
No toxicology reports were available for these cases and it is not known whether other drugs were involved, but polydrug use is common among illicit drug users, Professor Fatovich said.
Amphetamine users have frequent contact with the healthcare system through ED presentations and hospital admissions.
“This provides multiple opportunities for brief interventions, such as giving advice or counselling on reducing or ceasing drug use.”