A survey from the National Association of Counties paints a bleak picture of the toll that methamphetamine abuse is taking on the nation's emergency departments, at least in public and regional hospitals.
The survey of 200 emergency department officials in 39 states found that 73% of emergency departments saw increases in ED visits involving methamphetamine in the last five years, including 94% of hospitals in counties with a population ranging from 50,000 to 100,000. In Nebraska alone, 94% of EDs reported that up to 10% of their visits involve methamphetamine abuse.
Methamphetamine was also the top illicit drug seen in presentations of emergency department patients, according to 47% of respondents. Marijuana came in a distant second, at 16%, followed closely by cocaine at 15%. On the issue of what EDs recommended for these patients upon discharge, 58% of respondents said they referred them to private treatment programs, 53% referred to hospital treatment programs, and 39% said they referred to county treatment programs. Four percent said they made no referrals.
The survey also asked about the insurance status of methamphetamine abusers. Overall, 83% of respondents reported that during the last 3 years, patients presenting to the ED with meth-related conditions were often uninsured, and 81% said if they had insurance, they were often underinsured. As a result, the survey said, 56% of hospitals report that costs have increased at their facilities because of meth abuse.
A second survey released the same day involved substance abuse treatment facilities. Researchers interviewed 200 behavioral health directors in 26 states and the District of Columbia and found that 69% of respondents said the need for treatment programs has been increasing due to methamphetamine, including 90% of respondents in Texas and 86% of respondents in Maryland.
Some providers note, however, that although the methamphetamine problem clearly is widespread, the statistics in the hospital ED survey may not be representative of the nation as a whole. “My town is a heroin town,” said Dr. Jon Mark Hirshon, of the division of emergency medicine at the University of Maryland, in Baltimore, and chair of the American College of Emergency Physicians' public health committee. “That's what I see.”
But the National Association of Counties wasn't trying to be representative of all hospital EDs nationwide, according to Tom Goodman, public affairs director for the association. “We believe it's representative, but we're trying to show the effect of methamphetamine abuse on public hospitals, so it's representative of that,” he said. “The bigger factor people have to consider is that 83% of those [ED] officials said the people coming in needing treatment related to meth were uninsured. If that's the case, [public hospitals are] where they go, because private hospitals will probably turn them away.”
Mr. Goodman agreed that methamphetamine abuse is not a big problem on the East Coast. “It's possible it could grow, but it's not necessarily an urban problem at this point, although it is in the West and the Midwest.”
Whatever its shortcomings, the study does point up that the substance abuse problem is contributing to the continued overcrowding of emergency departments, Dr. Hirshon said.
Methamphetamine abuse is an emergency visit that is preventable, “and we need to address these problems in a better fashion. We need to give people resources, so they can get off of drugs and stay off. There needs to be increased public investment to deal with these problems,” he said.