Clinical Characterization of Methamphetamine-related Emergency Department Use in a Canadian Psychiatric Hospital

Objectives:Globally, methamphetamine (MA)-related emergency deparment (ED) visits and hospital admissions have increased. This study examined the characteristics of persons with MA-related ED encounters in a Canadian psychiatric hospital.Methods:A retrospective chart review of ED medical records was conducted between January 2019 and December 2019. Sample characteristics were described using all available 2019 data. Logistic regressions were used to examine predictors of ED visits and hospital admissions.Results:In 2019, there were 659 MA-related ED encounters, of which 438 were unique (single visits=75.6%; admissions=40.9%). Persons were, on average, 34 years old, predominantly male, and homeless. The sample was ethnically diverse, with the largest group identifying as White (58.1%). Psychotic and substance use disorders were common. Younger age and being homeless significantly predicted repeat visits, whereas female gender, non-White ethnicity, psychotic disorder diagnosis, and greater clinical acuity predicted admission.Conclusions:Our findings highlight the multiple intersecting clinical and social dimensions that are associated with more frequent MA-related ED visits and hospital admission. The vulnerable socioeconomic circumstances of this population suggest the need for targeted interventions that address both substance use and mental health concerns from an intersectional perspective to build better pathways to community care. Objectifs:Dans l'ensemble, les visites aux services d'urgence (SU) et les admissions a l'hopital liees a la methamphetamine (MA) ont augmente. Cette etude a examine les caracteristiques des personnes ayant eu des visites aux SU liees a la MA dans un hopital psychiatrique canadien.Methodes:Une etude retrospective des dossiers medicaux des SU a ete realisee entre janvier 2019 et decembre 2019. Les caracteristiques de l'echantillon ont ete decrites a l'aide de toutes les donnees disponibles de 2019. Des regressions logistiques ont ete utilisees pour examiner les predicteurs des visites aux SU et des admissions a l'hopital.Resultats:En 2019, il y a eu 659 visites aux SU liees a la MA, dont 438 etaient uniques (visites uniques=75,6% ; admissions=40,9%). Les personnes etaient en moyenne agees de 34 ans, principalement des hommes et des sans-abri. L'echantillon etait ethniquement diversifie, mais le groupe le plus important s'identifiait comme blanc (58,1%). Les troubles psychotiques et les troubles lies a l'utilisation de substances psychoactives etaient frequents. Le fait d'etre jeune et sans-abri predisaient de maniere significative des visites repetees, tandis que le sexe feminin, l'ethnicite non blanche, le diagnostic de trouble psychotique et une plus grande acuite clinique predisaient l'admission.Conclusions:Nos resultats mettent en evidence les multiples dimensions cliniques et sociales qui s'entrecroisent et qui sont associees a des visites plus frequentes aux SU et a des admissions a l'hopital liees a la MA. Les circonstances socio-economiques vulnerables de cette population suggerent le besoin d'interventions ciblees qui abordent a la fois les problemes de toxicomanie et de sante mentale dans une perspective intersectionnelle afin d'etablir de meilleures voies vers les soins communautaires.