Department of Emergency Medicine, Oregon Health and Science University, Portland, USA.
Acad Emerg Med. 2010 Nov;17(11):1216-22. doi: 10.1111/j.1553-2712.2010.00911.x.
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.
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).
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.
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.
甲基苯丙胺是一种滥用药物，它是由去充血伪麻黄碱经化学转化制成的。2006 年 7 月，俄勒冈州颁布了一项州法律，将伪麻黄碱列为附表 III 类药物，并规定只能凭处方购买。本研究旨在确定该立法是否改变了与甲基苯丙胺使用有关的急诊室（ED）就诊人数。
这是一项针对前瞻性研究数据库的回顾性分析，该研究旨在确定甲基苯丙胺对 ED 就诊的影响。该前瞻性研究持续了 1 年，要求 ED 临床医生确定患者就诊是否与甲基苯丙胺有关，以及患者是否确认使用了甲基苯丙胺。在研究期间，临床医生接受了关于甲基苯丙胺的初始和持续教育和培训。在研究期间的每次 ED 就诊时都会提出这些问题，并与患者的处置情况电子链接，无法回避。研究期间分为立法前（2006 年 2 月 5 日至 6 月 30 日）和立法后（2006 年 7 月 1 日至 2007 年 2 月 5 日）两个时期。
在为期 1 年的研究期间，共纳入 37625 名患者，1.90%（n=714）的患者有与甲基苯丙胺相关的 ED 就诊（MREDV），1.65%（n=620）的患者有确认的甲基苯丙胺使用。与非 MREDV 患者相比，MREDV 患者更有可能是白人且没有保险。从立法前到立法后，每周 MREDV 的数量和比例显著下降（平均每周就诊次数，18.0 次比 11.3 次，p=0.001；平均每周就诊比例，2.3%比 1.6%，p=0.003）。在研究期间，每周确认使用甲基苯丙胺的人数和比例也显著下降（平均每周使用者人数，14.6 次比 10.3 次，p=0.004；平均每周使用者比例，1.9%比 1.4%，p=0.017）。立法前后 MREDV 的诊断无显著差异。
本研究发现，限制伪麻黄碱供应的立法的颁布与研究 ED 中 MREDV 和确认使用甲基苯丙胺的人数减少之间存在关联。
