Methamphetamine use in trauma patients: A population-based study

Background: There are indications that methamphetamine production and illicit use are increasing. We investigated the epidemiology of methamphetamine use in trauma patients in an area of heavy methamphetamine prevalence. Study Design: This was a retrospective population-based review. We reviewed toxicology and alcohol test results in trauma patients admitted to the University of California, Davis, between 1989 and 1994 to the only trauma center serving a population of 1.1 million. Results: Positive methamphetamine rates nearly doubled between 1989 (7.4%) and 1994 (13.4%), compared with a minimal increase in cocaine rates (5.8% to 6.2%) and a decrease in blood alcohol rates (43% to 35%). Methamphetamine-positive patients were most likely to be Caucasian or Hispanic; cocaine-positive patients were most likely to be African American. Methamphetamine-positive patients were most commonly injured in motor vehicle collisions or motorcycle collisions; cocaine-positive patients were most commonly injured by assaults, gunshot wounds, or stab wounds. Cocaine positivity and alcohol positivity predicted a decreased need for emergency surgery and cocaine positivity predicted a decreased need for admission to the ICU. Conclusions: Methamphetamine use in trauma patients increased markedly in our region between 1989 and 1994, alcohol rates decreased, and cocaine rates remained unchanged. Methamphetamine-positive patients had mechanisms of: injury similar to those of alcohol-positive patients, so injury prevention strategies for methamphetamine should be patterned after strategies designed for alcohol. (J Am Cell Surg 1999;189:442-449. (C) 1999 by the American College of Surgeons).