Frequent methamphetamine injection predicts emergency department utilization among street-involved youth

• Published in: Public health (London) 2012-01, Vol.126 (1), p.47-53
• Main Authors: Marshall, B.D.L, Grafstein, E, Buxton, J.A, Qi, J, Wood, E, Shoveller, J.A, Kerr, T
• Format: Article
• Language: English
• Subjects: Accident and emergency departments; Adolescent; Age; Amphetamine-Related Disorders - epidemiology; British Columbia - epidemiology; Cohort Studies; Emergency medicine; Emergency Service, Hospital - statistics & numerical data; Emergency Service, Hospital - utilization; Female; Hazards; Homeless Youth - statistics & numerical data; Humans; Incidence; Infectious Disease; Injection drug use; Injections; Integrated services; Internal Medicine; Male; Methamphetamine; Methamphetamine - administration & dosage; Prospective Studies; Risk Factors; Substance Abuse, Intravenous - epidemiology; Substance use; Surveys and Questionnaires; Young Adult; Young people
• ISSN: 0033-3506; 1476-5616
• DOI: 10.1016/j.puhe.2011.09.011

Summary Objectives Methamphetamine (MA) use has been associated with health problems that commonly present in the emergency department (ED). This study sought to determine whether frequent MA injection was a risk factor for ED utilization among street-involved youth. Study design Prospective cohort study. Methods Data were derived from a street-involved youth cohort known as the ‘At Risk Youth Study’. Behavioural data including MA use were linked to ED records at a major inner-city hospital. Kaplan-Meier and Cox proportional hazards methods were used to determine the risk factors for ED utilization. Results Between September 2005 and January 2007, 427 eligible participants were enrolled, among whom the median age was 21 (interquartile range 19–23) years and 154 (36.1%) were female. Within 1 year, 163 (38.2%) visited the ED, resulting in an incidence density of 53.7 per 100 person-years. ED utilization was significantly higher among frequent (i.e. ≥daily) MA injectors (log-rank P  = 0.004). In multivariate analysis, frequent MA injection was associated with an increased hazard of ED utilization (adjusted hazard ratio = 1.84, 95% confidence interval 1.04–3.25; P  = 0.036). Conclusions Street-involved youth who frequently inject MA appear to be at increased risk of ED utilization. The integration of MA-specific addiction treatment services within emergency care settings for high-risk youth is recommended.