Han Benjamin H, Brennan Jesse J, Kepner Wayne E, Chen Steven, Lin Sidney, Carley Joseph A, Larson Julia, Castillo Edward M
Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego School of Medicine, United States; Jennifer Moreno Department of Veterans Affairs Medical Center, United States.
Department of Emergency Medicine, University of California San Diego School of Medicine, United States.
Am J Emerg Med. 2025 Jul;93:94-98. doi: 10.1016/j.ajem.2025.03.051. Epub 2025 Mar 23.
Stimulants are becoming increasingly prevalent among overdoses, yet little is understood about how stimulant use impacts emergency department (ED) utilization.
Using data from California's Department of Healthcare Access and Information, we conducted a five-year trend analysis of stimulant-related ED visits from acute care hospitals in California from 2017 to 2021. For each year, we determined the stimulant-related ED visit rate per 100,000 ED visits for adults aged ≥18 utilizing ICD-10 diagnosis codes. We estimated the percent changes in overall stimulant-related visit rates during the study period and by subgroup, including by demographic characteristics, Charlson comorbidity index score (CCIS), and cardiovascular (CV) diagnoses. We used chi-squared analyses to examine changes in trends over time.
The rate of stimulant-related ED visits increased from 2064.4 per 100,000 ED visits in 2017 to 2586.1 per 100,000 ED visits in 2021, a 25.3 % increase (P < 0.001). By race/ethnicity, people identified as Native American/Alaska Natives had the highest ED visit rate in 2021 (4713.5 per 100,000 ED visits) and the largest increase of 60.8 % (P < 0.001). The proportion of stimulant-related ED visits with CV disease diagnoses increased from 13.8 % in 2017 to 18.0 % in 2021, a relative increase of 30.8 % (P < 0.001).
Stimulant-related ED visits are increasing among adults in California, especially among non-white populations and those with higher comorbidity. This sharp rise highlights the critical need for targeted interventions and harm reduction strategies that consider the unique effects of stimulant use on ED rates and CV outcomes.
