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Emergency Department Strain As Ice Problems Grows

use seems to have a higher risk of psychotic symptoms requiring hospital treatment and represents a risk for more users in all age groups." Registrar in Emergency Medicine at Royal Perth Hospital (RPH), Dr Suzanne Gray, and colleagues studied all amphetamine-related presentations to RPH's emergency department (ED) over a three-month period in 2005.

They found that 1.2 per cent of all ED presentations were related to amphetamine use, including the drugs known as ice, ecstasy, and speed. Serious amphetamine-related presentations resulted in prolonged length of stay in the ED and consumed considerable resources.

"A third of patients required sedation, which correlates with a high pre-hospital, nursing, medical and security load to manage these patients safely," says Dr Gray.

"Further contributing to the impact are the high rates of repeat attendance and the large proportion of patients with underlying psychiatric illness and a history of drug dependence.

"With increasing availability and use of amphetamines, the burden on emergency services will continue to grow."

About half of all patients admitted for amphetamine use were aged between 20 and 29 years, the majority of them single white men.

Amphetamine use is associated with violence, antisocial behaviour and risk-taking, Dr Gray and colleagues said - 20 per cent of all amphetamine-related presentations to the RPH ED involved the police at some stage.

"Also of great concern is emerging evidence of serious long-term effects, including depression, anxiety, psychosis and memory disturbance," she says. In an accompanying editorial, Dr Gordian Fulde and Dr Alex Wodak of St Vincent's Hospital, Sydney, support the view that amphetamine-related presentations are a great burden on the health care system and believe there is a pressing need to increase health and social resources to cope with the growing problem of amphetamine use.


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