title: The association of controlling pseudoephedrine availability on methamphetamine-related emergency department visits.
abstract: OBJECTIVE
  Methamphetamine is a drug of abuse that has been manufactured locally by chemical conversion from the decongestant pseudoephedrine. In July 2006, an Oregon state law was enacted to establish pseudoephedrine as a schedule III drug and make it available by prescription only. This study sought to determine if this legislation altered the number of emergency department (ED) visits that are related to methamphetamine use.
  
  
  METHODS
  This was a retrospective analysis of a database created during a prospective study aimed at determining the effect of methamphetamine on ED visits. That prospective study was 1 year in duration and required ED clinicians to determine whether a patient's visit was related to methamphetamine and if the patient had confirmed use of methamphetamine. The clinicians received initial and continued education and training on methamphetamine during the study period. The questions were asked at every ED visit during the study period and were electronically linked to the patient's disposition and could not be circumvented. The study period was divided into prelegislation (February 5, 2006, to June 30, 2006) and postlegislation periods (July 1, 2006, to February 5, 2007).
  
  
  RESULTS
  Over the 1-year study period, 37,625 patients were enrolled, 1.90% (n = 714) of patients had methamphetamine-related ED visits (MREDVs), and 1.65% (n = 620) had confirmed methamphetamine use. Patients with MREDVs were more likely than patients with non-MREDVs to be white and uninsured. The number and proportion of weekly MREDVs significantly decreased from the prelegislation period to the postlegislation period (mean number of weekly visits, 18.0 vs. 11.3, p = 0.001; mean proportion of weekly visits, 2.3% vs. 1.6%, p = 0.003). The number and proportion of weekly confirmed users of methamphetamine also significantly decreased during the study period (mean number of weekly users, 14.6 vs. 10.3, p = 0.004; mean proportion of weekly users, 1.9% vs. 1.4%, p = 0.017). There were no significant differences in the diagnoses of MREDVS between the pre- and postlegislation periods.
  
  
  CONCLUSIONS
  This study found an association between the enactment of legislation that limits pseudoephedrine availability and a decrease in MREDVs and confirmed users of methamphetamine in the study ED.
authors.affiliation: Department of Emergency Medicine, Oregon Health and Science University, Portland, USA. hendriro@ohsu.edu
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hendrickson
authors.forename: Robert L
authors.initials: RL
authors.lastname: Cloutier
authors.forename: Rongwei
authors.initials: R
authors.lastname: Fu
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000453:epidemiology* / Q000628:therapy*; D015897:Comorbidity; D016208:Databases, Factual; D004345:Drug Industry / Q000331:legislation & jurisprudence; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000331:legislation & jurisprudence*; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects*; D008875:Middle Aged; D009922:Oregon / Q000453:epidemiology; D055553:Prescription Drugs; D054199:Pseudoephedrine / Q000009:adverse effects*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D055553:Prescription Drugs; D008694:Methamphetamine; D054199:Pseudoephedrine