Association between Methamphetamine Use and Psychiatric Hospitalization, Chemical Restraint, and Emergency Department Length of Stay

Introduction Methamphetamine intoxication is an increasing cause of emergency department (ED) visits in the United States, particularly in the west . In San Francisco, CA 47% of patients visiting psychiatric emergency services are intoxicated with methamphetamine. Such patients often visit the ED due to acute psychiatric symptoms, yet-ED based research investigating the outcomes and resource utilization of these visits is limited. Methods We examined a retrospective cohort of ED patients requiring ED-based psychiatric consultation from June 2017-July 2018. We evaluated the association between methamphetamine visits and need for chemical restraint, psychiatric hospitalization, and LOS. Results We identified 2,087 ED visits with psychiatric consults. Based on urine toxicology results and discharge diagnosis, 403 visits involved methamphetamine with or without other drugs, 480 involved other drugs without methamphetamine, and 1204 had no evidence of drug use. Methamphetamine visits were associated with increased odds of chemical restraint compared to visits without drug use, adjusted OR 3.2 (2.1-5.2, p