The burden of crystalline methamphetamine ("ice" or "crystal") and other amphetamines on already stretched// public hospital resources is significant and set to grow, emergency physicians and drug specialists have warned in the latest Medical Journal of Australia (MJA), prompting an urgent call to beef up health and social drug intervention services.

Two new studies have found that a significant number of patients are presenting to hospital emergency departments with ice- and other amphetamine-related conditions, including heart problems and psychosis.

Australian hospitals faced a more than fourfold increase in the number of episodes of druginduced psychosis over the 10 years to 2004, say Associate Professor Louisa Degenhardt and her colleagues at the National Drug and Alcohol Research Centre of the University of New South Wales.

The group studied national hospital separations for cannabis- and amphetamine-related psychotic episodes among patients aged between 10 and 49 years. They found the number of separations where drug-induced psychosis was noted by the treating doctor as being the primary problem increased from 55.5 per million population in 1993-94, to 253.1 per million population in 2003-04.

Despite recent media attention on the relationship between cannabis use and psychosis, they found relatively stable numbers of hospital separations for cannabis-induced psychosis over the five years from 1999 to 2004.

"In contrast, hospital separations for amphetamine-induced psychosis had increased, particularly among those aged 20 years and older," says Assoc Prof Degenhardt.

Hospitalisations for amphetamine users were highest among the older age groups. "(This) may be due to the higher rates of injecting and of crystalline methamphetamine use reported among these groups," she says.

"Although concern about links between cannabis and psychotic symptoms is understandable, amphetamine
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