ED Visits

Meth has become an emerging problem in the US, particularly in the western region


- The western region of the US had the highest rate of emergency department (ED) visits for methamphetamine-related poisoning in 2016 (7.8 per 100,000 population) compared to other regions (ranged from 2.1 to 5.8 per 100,000 population) (CDC 2019). 


The number of meth ED visits has been increasing and remains high in LAC


- In Los Angeles County (LAC), from 2005 to 2020, there were 207,290 ED visits that listed any methamphetamine abuse, dependence, use, or poisoning as a diagnosis or external-cause-of-injury (methamphetamine-related). Methamphetamine-related ED visits increased 315% from 2005 to 2020. By 2020, the annual total for methamphetamine-related ED visits reached 22,497 cases (Figure 1). 

- A total of 56,955 ED visits listed methamphetamine abuse, dependence, use, or poisoning as the principal diagnosis or principal external-cause-of-injury (primary). Primary methamphetamine ED visits increased 220% from 2005 to 2020. By 2020, the annual total for primary methamphetamine ED visits reached 5,808 cases (Figure 2).

Meth-related: Any mention of meth abuse, dependence, use, or poisoning (excluding in remission) as a diagnosis or external-cause-of-injury mentioned on discharge record

Primary meth: Meth abuse, dependence, use, or poisoning (excluding in remission) as the principal diagnosis or principal external-cause-of-injury on the discharge record.

Diagnosis Type

From 2016 to 2020, the most frequently reported diagnosis for methamphetamine-related ED visits was methamphetamine abuse (70.4%), followed by methamphetamine use (18.7%), methamphetamine dependence (7.3%), and methamphetamine poisoning (4.8%) (Figure 3). 

Among primary methamphetamine ED visits, abuse remained the most frequently reported diagnosis type (68.1%), and was again followed by use (14.7%). However, poisoning accounted for a much larger proportion of primary methamphetamine ED visits (12.7%) than of all methamphetamine-related ED visits (Figure 4).

Although overdose accounted for a relatively small proportion of all methamphetamine ED visits, this problem is becoming more apparent in the US (Hoots 2020). 

Demographics

Gender

In 2005-2020, over two-thirds (69%) of methamphetamine-related ED visits were among males. Since 2005, the gap between genders has remained constant, with the proportion of males at consistently double that of females. This gender distribution was similar for primary methamphetamine ED visits (Figures 5-8)

Age

Overall, adults aged 25-44 years accounted for over half (58%) of methamphetamine-related ED visits, followed by 45-64 years (20%) and 18-24 years (18%) (Figure 9). Cases tended to be among younger patients, with more patients aged 18-24 and 25-44 years during 2005-2020 (Figure 11). These patterns were also similarly observed for primary methamphetamine ED visits  (Figures 10, 12). 

(Note: Years where methamphetamine ED visits were <10 were suppressed for confidentiality in Figures 11 and 12.)

Race/Ethnicity

In 2005-2020, the proportion of methamphetamine-related ED visits was largest for Latinxs (48%), followed by whites (29%) and blacks (14%). These race/ethnic distribution patterns were reflected in primary methamphetamine ED visits (Figure 13-14).

The race/ethnic distributions for overall methamphetamine-related ED visits from 2005-2020 decreased among whites, but increased among blacks (Figure 15). The pattern was similar for primary methamphetamine ED visits (Figure 16). 

Department of Health Care Access and Information (HCAI, formally OSHPD). Nonpublic Inpatient Discharge and Emergency Department data, 2005-2020. California Department of Public Health (CDPH).

Centers for Disease Control and Prevention. (2019) Annual Surveillance Report of Drug-Related Risks and Outcomes — United States Surveillance Special Report. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Published November 1, 2019. Accessed [Feb 10, 2020] from https://www. cdc.gov/drugoverdose/pdf/ pubs/2019-cdc-drug-surveillancereport.pdf.

Hoots, B., Vivolo‐Kantor, A., & Seth, P. (2020). The rise in non‐fatal and fatal overdoses involving stimulants with and without opioids in the United States. Addiction.