title: Pattern and characteristics of ecstasy and related drug (ERD) presentations at two hospital emergency departments, Melbourne, Australia, 2008-2010.
abstract: OBJECTIVE
  To describe patterns and characteristics of emergency department (ED) presentations related to the use of ecstasy and related drugs (ERDs) in Melbourne, Australia.
  
  
  METHODS
  Retrospective audit of ERD-related presentations from 1 January 2008 to 31 December 2010 at two tertiary hospital EDs. Variation in presentations across years was tested using a two-tailed test for proportions. Univariate and multivariate logistic regressions were used to compare sociodemographic and clinical characteristics across groups.
  
  
  RESULTS
  Most of the 1347 presentations occurred on weekends, 24:00-06:00. Most patients arrived by ambulance (69%) from public places (42%), private residences (26%) and licensed venues (21%). Ecstasy-related presentations decreased from 26% of presentations in 2008 to 14% in 2009 (p<0.05); γ-hydroxybutyrate (GHB) presentations were most common overall. GHB presentations were commonly related to altered conscious state (89%); other presentations were due to psychological concerns or nausea/vomiting. Compared with GHB presentations, patients in ecstasy-related presentations were significantly less likely to require intubation (OR 0.04, 95% CI 0.01 to 0.18), but more likely to result in hospital admission (OR 1.77, 95% CI 1.08 to 2.91). Patients in amphetamine-related cases were older than those in GHB-related cases (median 28.4 years vs 23.9 years; p<0.05), and more likely to have a history of substance use (OR 4.85, 95% CI 3.50 to 6.74) or psychiatric illness (OR 6.64, 95% CI 4.47 to 9.87). Overall, the median length of stay was 3.0 h (IQR 1.8-4.8), with most (81%) patients discharged directly home.
  
  
  CONCLUSIONS
  Although the majority of ERD-related presentations were effectively treated, with discharge within a short time frame, the number and timing of presentations places a significant burden on EDs. ERD harm reduction and improved management of minor harms at licensed venues could reduce this burden.
authors: Centre for Population Health, Burnet Institute, , Melbourne, Victoria, Australia.
authors: Danielle
authors: D
authors: Horyniak
authors: Louisa
authors: L
authors: Degenhardt
authors: De Villiers
authors: de V
authors: Smit
authors: Venita
authors: V
authors: Munir
authors: Jennifer
authors: J
authors: Johnston
authors: Craig
authors: C
authors: Fry
authors: Paul
authors: P
authors: Dietze
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000453:epidemiology*; D054869:Clinical Audit; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006213:Hallucinogens / Q000009:adverse effects; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects; D012044:Regression Analysis; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013021:South Australia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006213:Hallucinogens; D018817:N-Methyl-3,4-methylenedioxyamphetamine
keywords: drug abuse; emergency department; epidemiology