Research Article Methamphetamine Use and Emergency Department Utilization: 20 Years Later John R. Richards, Sheiva Hamidi, Connor D. Grant, Colin G. Wang, Nabil Tabish, Samuel D. Turnipseed, and Robert W. Derlet Department of Emergency Medicine, University of California Davis Medical Center, Sacramento, CA, USA Correspondence should be addressed to John R. Richards; jrrichards@ucdavis.edu Received 8 May 2017; Accepted 19 July 2017; Published 17 August 2017 Academic Editor: Marlon P. Mundt Copyright © 2017 John R. Richards et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Methamphetamine (MAP) users present to the emergency department (ED) for myriad reasons, including trauma, chest pain, and psychosis. Te purpose of this study is to determine how their prevalence, demographics, and resource utilization have changed. Methods. Retrospective review of MAP patients over 3 months in 2016. Demographics, mode of arrival, presenting complaints, disposition, and concomitant cocaine/ethanol use were compared to a 1996 study at the same ED. Results. 638 MAP- positive patients, 3,013 toxicology screens, and 20,203 ED visits represented an increase in prevalence compared to 1996: 461 MAP- positive patients, 3,102 screens, and 32,156 visits. MAP patients were older compared to the past. Mode of arrival was most frequently by ambulance but at a lower proportion than 1996, as was the proportion of MAP patients with positive cocaine toxicology screens and ethanol coingestion. Admission rate was lower compared to the past, as was discharge to jail. Te proportion of MAP patients presenting with blunt trauma was lower compared to the past and higher for chest pain. Conclusion. A signifcant increase in the prevalence of MAP-positive patients was found. Diferences in presenting complaints and resource utilization may refect the shifing demographics of MAP users, as highlighted by an older patient population relative to the past. 1. Introduction At present, amphetamines may be legally prescribed for treatment of narcolepsy and attention defcit hyperactiv- ity disorders. Amphetamine and its derivatives, such as methamphetamine (MAP), were frst synthesized in the early 20th century and marketed as bronchodilators [1]. However, afer their introduction, these drugs were soon used for myriad unrelated conditions, such as for weight loss and to increase wakefulness. Legal availability of amphetamines led to widespread use until being designated as controlled Schedule II drugs in 1970. Afer this, MAP faded from popularity until the late 1980s, where it reappeared in the western United States and Hawaii [2]. In 1989, Derlet and coworkers published the frst study of patients with MAP toxicity in the emergency department (ED) and found that agitation, hallucinations, suicidal behavior, and chest pain were the most common presenting complaints [3]. During the 1990s, MAP use continued to grow in the Northwest and Southwest. By the millennium, MAP use had become entrenched in the Midwest as well and to a lesser degree in the South, Northeast, and Mid-Atlantic states [4]. During this period, authors of the National Survey on Drug Use and Health (NSDUH) estimated that MAP use increased from approximately 2% of the adult population in 1994 to 5% over the following decade [5]. Patients abusing MAP present to the ED for acute cardiovascular, psychiatric, toxicologic, neurologic, and traumatic disorders [6]. Richards and associates published the frst study of ED utilization by MAP users versus nonusers in 1996 and found signifcantly higher rates of arrival by ambulance and admission to the hospital [7]. Te United States Drug Abuse Warning Network (DAWN) began monitoring MAP-associated ED visits in 1995 and reported 11,002 visits in 1996 [8]. From the last published DAWN report in 2014, there were 102,961 MAP- associated ED visits in 2011 [9]. Methamphetamine use continues to be a signifcant problem domestically and worldwide. From the most recently Hindawi Journal of Addiction Volume 2017, Article ID 4050932, 8 pages https://doi.org/10.1155/2017/4050932