Tuesday, August 04, 2009

14% Rise in Meth-Related
ER Visits in SF

The latest monthly STD report from the city is out and shows a 14% overall increase in meth-related visits to the ER at SF General Hospital.

Let's go to the stats, as presented in Table 4:
Half Year 2008 v. 2009

All visits
225 / 262
14% increase

Male visits
183 / 204
11% increase

Female visits
42 / 58
28% increase
The stats are compiled for the federal Substance Abuse and Mental Health Services Administration, and I asked SF DPH public info officer Eileen Shields to address several questions. Her reply and that of a clinician at the ER shed valuable light on the stats and a snapshot of meth use in the city.

From SF DPH:
The data listed in the STD monthly report on SFGH meth-related ED [emergency department] visits is collected through DAWN (Drug abuse warning network). Here is the link to the national program which describes how the data is collected
( https://dawninfo.samhsa.gov/default.asp ). SFGH provides the STD unit with access to their DAWN data and we put that in the report.

Your questions regarding what is behind the numbers is best posed to those at SFGH ED. I have forwarded your inquiry.
Here's the response from the SF DPH ED clinician, explaining lots more about what are the elements behind the stats on Table 4:
[MP question] (1) Are more meth users injuring themselves and seeking treatment?

This is difficult to determine based on the DAWN data available. While I am not very familiar with DAWN’s data collection and analysis, in looking into their website they use “broad case criteria” and they state that “to be a DAWN case, the relation between the ED visit and the drug need not be causal.” They assign each case into one of eight categories:

(1) Suicide attempt, (2) Seeking detoxification, (3) Alcohol only in patients under age 21, (4) Adverse reaction, (5) Overmedication, (6) Malicious poisoning, (7) Accidental ingestion, and (8) Other.

As an example then, a case in which a patient presented to the emergency department seeking detox for methamphetamine would be counted as a methamphetamine related visit. The table provides no information on this classification scheme.

It might be useful to speak to someone directly form DAWN about their methods, data interpretation, and whether they can further classify the cases in the table.

[MP question] (2) Do meth users show up at the ER with mental problems and not physical ones?

Yes…they show up with both psychiatric and physical problem, and as stated above, both would be considered meth related visits and would be counted in the numbers.

[MP question] (3) Are more meth users injuring themselves and seeking treatment?

Possible, although anecdotally I have not detected a particular increase in the number of methamphetamine related injuries over the usual amount.

[MP question] (4) Maybe there is more meth on the streets or perhaps more potent forms of it are being used?

Again, a possibility, although I don’t think you can draw that conclusion definitively from this data.
And the struggle to combat meth-addiction and its associated health care problems in San Francisco continues ...

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