title: The impact of amphetamine-type stimulants on emergency services.
abstract: OBJECTIVE
  Amphetamine-type stimulants now rank second worldwide in the table of most widely used recreational drugs. Many countries report increased availability and increased purity of the drugs.Surprisingly, while many authors in the last decade have described clinical issues and demographic patterns associated with amphetamine use, there is little published research quantifying the specifics of the impact of 'ICE' use on health resources.It is, therefore, timely to review the available literature on the impact of this group of drugs on emergency medical systems.
  
  
  RESULTS
  Recent research has focused on the increase in production and availability of metamphetamines. Clinical findings at acute presentation and long-term sequelae have been studied and in particular, the impact of the drugs on mental health and development of long-term neurological problems. Work has also been done unsuccessfully to develop therapeutic agents for the acute management of patients who present under the influence of amphetamines.
  
  
  CONCLUSIONS
  It is clear that the use of metamphetamine-type substances places an increasing burden on acute health services. There is a need for preventive and harm-minimization strategies.
authors.affiliation: aEmergency Departments, St Vincents and Sydney Hospitals, Sydney bRural Health & Rural Medical School, University of New South Wales, Sydney, Australia.
authors.forename: Gordian W O
authors.initials: GW
authors.lastname: Fulde
authors.forename: S Lesley
authors.initials: SL
authors.lastname: Forster
mesh_terms: D000208:Acute Disease; D000374:Aggression / Q000187:drug effects; D000661:Amphetamine / Q000008:administration & dosage / Q000009:adverse effects*; D019969:Amphetamine-Related Disorders / Q000523:psychology*; D001007:Anxiety / Q000139:chemically induced; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects*; D003702:Delusions / Q000139:chemically induced; D003863:Depression / Q000139:chemically induced; D062787:Drug Overdose / Q000453:epidemiology / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006212:Hallucinations / Q000139:chemically induced; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008694:Methamphetamine / Q000009:adverse effects; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects; D010259:Paranoid Disorders / Q000139:chemically induced; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced; D059020:Suicidal Ideation
chemical_list: D000697:Central Nervous System Stimulants; D013287:Illicit Drugs; D008694:Methamphetamine; D000661:Amphetamine; D018817:N-Methyl-3,4-methylenedioxyamphetamine