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 LAC from 2005 to 2018, there were 162,157 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 367% from 2005 to 2018. By 2018, the annual total for methamphetamine-related ED visits reached 25,327 cases (Figure 1). 

- A total of 44,498 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 274% from 2005 to 2018. By 2018, the annual total for primary methamphetamine ED visits reached 6,772 cases (Figure 2).

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

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

Diagnosis Type

From 2016 to 2018, the most frequently reported diagnosis for methamphetamine-related ED visits was methamphetamine abuse (69.9%), followed by methamphetamine use (17.7%), methamphetamine dependence (9.4%), and methamphetamine poisoning (4.1%) (Figure 3). 


Among primary methamphetamine ED visits, abuse remained the most frequently reported diagnosis type (67.8%), and was again followed by use (14.1%). However, poisoning accounted for a much larger proportion of primary methamphetamine ED visits (10.9%) 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 2005-2018, 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 (57%) of methamphetamine-related ED visits, followed by 18-24 years and 45-64 years which were equally 19% of cases (Figure 9). Cases tended to be among increasingly younger patients, with more patients aged 18-24 and 25-44 years during 2005-2018 (Figure 11). These patterns were also similarly observed for primary methamphetamine ED visits  (Figures 10, 12). 

Race/Ethnicity

In 2005-2018, the proportion of methamphetamine-related ED visits was largest for Latinxs (48%) and whites (31%), and smallest for blacks (13%). 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 2005-2018 decreased among whites and Latinxs, but increased substantially (114%) in blacks (Figure 15). Among primary methamphetamine ED visits, the proportion among blacks increased, whereas that among Latinxs and whites slightly decreased over the period (Figure 16). 

California’s Office of Statewide Health Planning and Development (OSHPD). Data sets 2005-2018.

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.