Trends in stimulant-related emergency department visits among adults in California, 2017–2021

Abstract

Background

Stimulants are becoming increasingly prevalent among overdoses, yet little is understood about how stimulant use impacts emergency department (ED) utilization.

Methods

Using data from California's Department of Healthcare Access and Information, we conducted a five-year trend analysis of stimulant-related ED visits from acute care hospitals in California from 2017 to 2021. For each year, we determined the stimulant-related ED visit rate per 100,000 ED visits for adults aged ≥18 utilizing ICD-10 diagnosis codes. We estimated the percent changes in overall stimulant-related visit rates during the study period and by subgroup, including by demographic characteristics, Charlson comorbidity index score (CCIS), and cardiovascular (CV) diagnoses. We used chi-squared analyses to examine changes in trends over time.

Results

The rate of stimulant-related ED visits increased from 2064.4 per 100,000 ED visits in 2017 to 2586.1 per 100,000 ED visits in 2021, a 25.3 % increase (P < 0.001). By race/ethnicity, people identified as Native American/Alaska Natives had the highest ED visit rate in 2021 (4713.5 per 100,000 ED visits) and the largest increase of 60.8 % (P < 0.001). The proportion of stimulant-related ED visits with CV disease diagnoses increased from 13.8 % in 2017 to 18.0 % in 2021, a relative increase of 30.8 % (P < 0.001).

Conclusions

Stimulant-related ED visits are increasing among adults in California, especially among non-white populations and those with higher comorbidity. This sharp rise highlights the critical need for targeted interventions and harm reduction strategies that consider the unique effects of stimulant use on ED rates and CV outcomes.