Amphetamine-Related Emergency Department Visits in Ontario, Canada, 2003-2020.
James A G Crispo, Lisa Liu, Paxton Bach, Dominique R Ansell, Branavan Sivapathasundaram, Francis Nguyen, Paul Kurdyak, Dallas P Seitz, Michael Conlon, Jacquelyn J Cragg
Author Information
James A G Crispo: Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada. ORCID
Lisa Liu: Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Paxton Bach: Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Dominique R Ansell: Emergency Department, Health Sciences North, Sudbury, Ontario, Canada.
Francis Nguyen: ICES McMaster, Hamilton, Ontario, Canada.
Paul Kurdyak: ICES, University of Toronto, Toronto, Ontario, Canada. ORCID
Dallas P Seitz: Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Michael Conlon: Health Sciences North Research Institute, Sudbury, Ontario, Canada.
Jacquelyn J Cragg: Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
OBJECTIVES: Despite unregulated amphetamine use increasing, there are limited data on related emergency department (ED) visits in Canada. Our primary objective was to examine trends in amphetamine-related ED visits over time in Ontario, including by age and sex. Secondary objectives were to examine whether patient characteristics were associated with ED revisit within 6 months. METHODS: Using administrative claims and census data, we calculated annual patient- and encounter-based rates of amphetamine-related ED visits from 2003 to 2020 among individuals 18+ years of age. We also performed a retrospective cohort study of individuals with amphetamine-related ED visits between 2019 and 2020 to determine whether select factors were associated with ED revisit within 6 months. Multivariable logistic regression modelling was used to measure associations. RESULTS: The population-based rate of amphetamine-related ED visits increased nearly 15-fold between 2003 (1.9/100,000 Ontarians) and 2020 (27.9/100,000 Ontarians). Seventy-five percent of individuals returned to the ED for any reason within 6 months. Psychosis and use of other substances were both independently associated with ED revisit for any reason within 6 months (psychosis: AOR = 1.54, 95% CI = 1.30-1.83; other substances: AOR = 1.84, 95% CI = 1.57-2.15), whereas having a primary care physician was negatively associated with ED revisit (AOR = 0.77, 95% CI = 0.60-0.98). CONCLUSIONS: Increasing rates of amphetamine-related ED visits in Ontario are cause for concern. Diagnoses of psychosis and the use of other substances may serve to identify individuals who are most likely to benefit from both primary and substance-specific care.
