Max Nakamoto, Jane Onoye, Miki Kiyokawa, Junji Takeshita, Brett Lu
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引用次数: 0
Abstract
Objectives: Addressing the methamphetamine epidemic will require a more complete understanding of its effect on healthcare systems and of the populations at risk. The objective of the study was to assess the impact of methamphetamine use on psychiatric emergency services outcomes and on Asian American (AA) and Pacific Islander (PI) populations, a historically overlooked population in substance use research.
Methods: A retrospective chart review was performed for all visits to a large level I trauma center in urban Hawaii from 2007 to 2019 that required psychiatric emergency services and in which urine drug screening was completed (N = 44,658). Demographic characteristics and emergency room courses were compared between amphetamine-positive and amphetamine-negative visits.
Results: The proportion of amphetamine-positive visits approximately doubled from 13.3% in 2007 to 25.5% in 2019. Amphetamine-positive visits were more likely to involve arrival by law enforcement (38.3% vs 27.2.%, P < 0.001), require intramuscular psychotropic medications (17.3% vs 12.3%, P < 0.001), and have longer emergency department lengths of stay (median, 420 vs 372 minutes, P < 0.001). Visits by Native Hawaiian and Hispanic/Latino patients had the highest rate of amphetamine positivity, while visits by Chinese and Korean patients had the lowest.
Conclusions: The findings reveal a concerning rise in amphetamine positivity that is associated with increased resource utilization. There was also significant variability in the rate of amphetamine positivity within the AA and PI population, a group of ethnicities often analyzed as a single entity in previous studies. Culturally sensitive interventions may curb the methamphetamine epidemic's effect on healthcare systems and vulnerable populations.
目标:应对甲基苯丙胺的流行需要更全面地了解其对医疗保健系统和高危人群的影响。本研究的目的是评估甲基苯丙胺的使用对精神科急诊服务结果的影响,以及对亚裔美国人(AA)和太平洋岛民(PI)人群的影响,亚裔美国人和太平洋岛民是药物使用研究中历来被忽视的人群:方法:对 2007 年至 2019 年期间夏威夷市区一家大型一级创伤中心所有需要精神科急诊服务并完成尿液药物筛查的就诊病例(N = 44658)进行了回顾性病历审查。对苯丙胺阳性和苯丙胺阴性就诊者的人口统计学特征和急诊过程进行了比较:苯丙胺阳性就诊者的比例从2007年的13.3%上升到2019年的25.5%,增加了约一倍。苯丙胺呈阳性的就诊者更有可能需要执法人员到场(38.3% vs 27.2.%,P <0.001),需要肌肉注射精神药物(17.3% vs 12.3%,P <0.001),急诊科住院时间更长(中位数为 420 分钟 vs 372 分钟,P <0.001)。夏威夷原住民和西班牙/拉美裔患者的安非他明阳性率最高,而华裔和韩裔患者的阳性率最低:研究结果表明,苯丙胺阳性率的上升令人担忧,这与资源利用率的增加有关。在 AA 和 PI 人口中,苯丙胺阳性率也存在很大差异,而在以往的研究中,这两个种族往往被作为一个整体进行分析。对文化敏感的干预措施可能会抑制甲基苯丙胺流行病对医疗系统和弱势群体的影响。
期刊介绍:
The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty.
Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including:
•addiction and substance use in pregnancy
•adolescent addiction and at-risk use
•the drug-exposed neonate
•pharmacology
•all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances
•diagnosis
•neuroimaging techniques
•treatment of special populations
•treatment, early intervention and prevention of alcohol and drug use disorders
•methodological issues in addiction research
•pain and addiction, prescription drug use disorder
•co-occurring addiction, medical and psychiatric disorders
•pathological gambling disorder, sexual and other behavioral addictions
•pathophysiology of addiction
•behavioral and pharmacological treatments
•issues in graduate medical education
•recovery
•health services delivery
•ethical, legal and liability issues in addiction medicine practice
•drug testing
•self- and mutual-help.