Ontario's emergency departments are seeing a dramatic rise in visits related to the use of unregulated amphetamines and their street equivalent: crystal meth.
In a new paper published in the Canadian Journal of Psychiatry, researchers found that individuals accessing the emergency department (ED) for amphetamine- and methamphetamine-related concerns grew from 233 in 2003 to 4,146 individuals annually by 2020.
"That's a nearly 15-fold increase – pretty dramatic. If we consider ED visits as a crude proxy for how prevalent unregulated amphetamine use is, then the observed trend is highly concerning," said the paper's lead author, Dr. James Crispo, a postdoctoral researcher at the University of British Columbia and adjunct scientist at ICES.
"This is information that we didn't have before. While there's been concern that amphetamine use is trending upwards, this is probably the first time that we have actual numbers to fill a major gap in our local knowledge," said Dr. Crispo.
Amphetamines are highly addictive stimulants. People who repeatedly use them may experience permanent damage to the heart and brain, high blood pressure and other disorders.
Repeat ED visits linked to primary care access
The researchers also found that over a two-year period, individuals who had access to a family doctor were 33 per cent less likely to return to the ED within six months.
"Having a family doctor was linked to fewer repeat ED visits. And yet, a very small number – just around seven per cent – of the population we studied were registered with a family physician," said senior author Dr. Jacquelyn Cragg, an assistant professor in the faculty of pharmaceutical sciences at UBC.
"This is very concerning given what we know of the benefits of primary care. Particularly for people who use amphetamines and other substances, there would be a very clear benefit to having access to a family physician and other medical specialties," she noted.
Better treatment and prevention needed
These findings represent only one aspect of the many consequences of rising methamphetamine use in Canada, said co-author Dr. Paxton Bach. He added that treatment and prevention strategies for methamphetamine use disorder require significant investment.
"Given the rising consequences and dearth of evidence-based treatments for methamphetamine use disorder, these findings are troubling and highlight the need for further research in this critical area," said Dr. Bach, an addiction medicine physician and clinical assistant professor in the department of medicine at UBC.
The study was funded by the Canadian Institutes of Health Research and supported by ICES, an independent, non-profit research institute that collects and analyzes healthcare and demographic data in Ontario. Researchers from the BC Centre on Substance Use, the University of Calgary, and NOSM University also contributed to the study.
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