NEWS: The Australian - 02/04/07 'Hospitals snowed under by an ice storm'

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Hospitals snowed under by an ice storm
Cath Hart
April 02, 2007

HOSPITAL emergency departments are struggling to cope with the growing number of people requiring medical treatment after using the drug ice, according to two studies published in the latest edition of the Medical Journal of Australia.

The results have prompted doctors working in drug-addiction treatment to call for more resources to deal with the growing scourge.

Ice, or crystalline methamphetamine, is a potent stimulant that can cause violent rages and erratic behaviour. It has led to an increase in the number of patients requiring treatment in emergency departments for heart problems and psychosis.

A study by Associate Professor Louisa Degenhardt from the University of NSW National Drug and Alcohol Research Centre found the number of drug-induced psychosis cases in hospitals had increased four-fold over the 10 years to 2004.

The study found that amphetamines such as ice were the main drivers of the rise in drug-induced psychoses, overtaking marijuana.

Another study, by Royal Perth Hospital's registrar in Emergency Medicine Suzanne Gray found that 20 per cent of all amphetamine-related presentations at the hospital had required police assistance. The patients were often aggressive, required long emergency department admission and consumed considerable resources.

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

"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.

Alex Wodak, director of the alcohol and drug service at Sydney St Vincent's Hospital, and Gordian Fulde, who runs the hospital's emergency department, said studies showed that approaching ice from a health perspective was more effective than attacking it with law enforcement . Associate Professor Fulde said the ice epidemic was not confined to Sydney and had spread throughout the country.

"The fact that Perth Hospital is having the same problem that we are in the east underscores that it really is a problem Australia-wide," he said.

The Australian

 

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Some links to related reading from the Medical Journal of Australia;

Amphetamine-related presentations to an inner-city tertiary emergency department: a prospective evaluation

Hospital separations for cannabis- and methamphetamine-related psychotic episodes in Australia

 

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Drug violence in our wards
JILL PENGELLEY, HEALTH REPORTER
April 02, 2007 02:15am

EMERGENCY departments are dealing with four times as many cases of drug-induced psychosis as they were a decade ago, research shows.

A National Drug and Alcohol Research Centre study of Australia's public hospitals found a "notable increase" in the number of people treated for drug-induced psychosis. In 1994, there were 55.5 cases per million people, rising to 253 per million by 2004 says the report, published in the Medical Journal of Australia.

The greatest increase had been among amphetamine users, while episodes of cannabis-induced psychosis having stabilised since 1999. A Royal Perth Hospital study also published in the journal found more than one in every 100 emergency department patients was being treated for a problem related to amphetamine use, which included ice, ecstasy and speed.

This had a "major impact" on the functioning of the department. "Patients with acute amphetamine intoxication are often agitated and aggressive, require extensive resources such as sedation and frequently re-attend," the report says.

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

Royal Adelaide Hospital emergency department doctor David Caldicott said 85 per cent of drug strategy funding went to policing, rather than health.

"The police are maxed out on trying to reduce the supply and almost no effort is going into trying to reduce the demands," he said. "The reason why these drugs are illegal is because they're dangerous to your health."

Dr Caldicott said more money should be directed to prevention and treatment programs.

A Royal Adelaide Hospital study found 22 per cent of intoxicated patients had taken amphetamines. The average age was 27.8 years but 6 per cent of users treated in the emergency department were under 18.

AdelaideNow

 

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Ice abuse leads to rise in psychotic episodes
Christian Catalano
April 2, 2007

CRYSTAL amphetamine or "ice" addicts are more likely to suffer psychotic symptoms than cannabis users, a study has shown.

Researchers from the National Drug and Alcohol Research Centre in NSW believe harder amphetamines are responsible for a fourfold increase in the number of drug-induced psychotic episodes dealt with by Australian hospitals in the 10 years to 2004.

Though there is a well-established link between cannabis abuse and mental illnesses such as schizophrenia, the study showed that amphetamine abuse was now responsible for at least 55 per cent of acute mental illness related to drugs.

"We found relatively stable numbers for cannabis-induced psychosis," the study said. "In contrast, hospital separations for amphetamine-induced psychosis had increased, particularly among those aged 20 years and older."

The study, published today in The Medical Journal of Australia, showed that the number of hospital stays for drug-related psychosis had risen from 55.5 per million hospital-stays to 253.1 per million.

The biggest increases came among older users of amphetamine, with an eight-fold increase in patients aged between 30 and 39 and a six-fold increase in those aged between 40 and 49.

"This may be due to the higher rates of injecting and of crystal methamphetamine (ice) use among these age groups," co-author Professor Louisa Denghart said.

The research coincides with the release of a handbook by the Victorian Government to help health workers deal with amphetamine-affected patients.

The guidebook said users of drugs like ice and speed may not be getting appropriate medical attention because paramedics and hospital staff were uninformed about the best treatment.

The Age

 

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Sharp rise in psychosis
Jane Metlikovec
April 02, 2007 12:00am

ICE and other amphetamines are being blamed for a drastic rise in the number of people attending emergency departments with drug-induced psychosis.

More than four times as many Australians were treated in a major city hospital suffering from drug-related psychosis in 2004 compared with 1994.

New research published in the Medical Journal of Australia has estimated that synthetic drugs are responsible for more than one in every 100 emergency presentations.

Doctors are calling for increased intervention services to help ease the strain on emergency departments bearing the brunt of the drug's increasing popularity and availability.

The stimulant effect of amphetamines causes users to often become aggressive, and doctors warn the burden placed on hospitals is set to increase.

A study by the National Drug and Alcohol Research Centre found drug-induced psychotic episodes accounted for 55.5 per million people in 1994.

But by 2004 this had escalated to 253 per million -- a more than fourfold increase according to figures from the national hospital database.

Doctors at the Royal Perth Hospital found 1.2 per cent of emergency department presentations in the 10 years to 2004 related to amphetamine use.

Users were most commonly single white males aged in their 20s.

Most had injected themselves with an amphetamine, and the majority had used the drug while alone.

Royal Perth Hospital emergency doctor and study author Suzanne Gray said serious amphetamine presentations were resulting in longer stays and draining hospital resources.

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

"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 of amphetamines, the burden on emergency services will continue to grow."

An Australian National Council on Drugs report released in February revealed more than 114,000 Victorians take amphetamines including ice and speed, but less than a third of addicts got treatment.

Victoria has stepped up its war on ice. Premier Steve Bracks recently announced a new taskforce to crack down on dealers and has committed $14 million to treating amphetamine addicts.

Two specialist clinics for amphetamine addicts will also open in St Kilda and Fitzroy in three months.

Herald Sun