PNS27 Amphetamine-Related Hospitalizations in the United States, 2003-2014: Examining Trends and Factors Associated with Admission Outcomes

Abstract

Although methamphetamine use is a growing health problem in the United States (US), there are limited data on amphetamine-related hospitalizations. Our study objectives were (1) to examine trends in amphetamine-related hospitalizations in the US between 2003 and 2014 and (2) to determine whether sociodemographic, clinical, and hospital characteristics were associated with outcomes of amphetamine-related hospital admission, including mortality, prolonged length of stay, and leaving against medical advice. Using the 2003-2014 National Inpatient Sample, we estimated the number of amphetamine-related hospitalizations for each calendar year among individuals 18+ years of age. US Census Bureau data were used to report annual rates of amphetamine-related hospitalization. Rates were stratified by age and sex, and subgroup analyses examined hospitalizations due to amphetamine causes. Unconditional logistic regression modeling was used to estimate the adjusted odds of admission outcomes for sociodemographic, clinical, and hospital indicators. The rate of amphetamine-related hospitalization increased from 27 to 69 per 100,000 population between 2003 and 2014. Annual rates of amphetamine-related hospitalization were consistently greater among younger (18-44 years) individuals and men. The proportion of hospitalizations with amphetamine causes as the primary reason for admission ranged from 2.2% to 7.7%. Regional differences were observed across examined outcomes, with admission to western hospitals being associated with increased mortality (AOR: 5.07, 95% CI: 1.22–21.04) and shorter (0-2 days) lengths of stay (AOR: 0.70, 95% CI: 0.58–0.83) compared with northeast admissions. Male sex (AOR: 1.26, 95% CI: 1.15–1.38; compared with female) and self-pay (AOR: 2.30, 95% CI: 1.90–2.79; compared with private insurance) were associated with being discharged against medical advice. Increasing rates of amphetamine-related hospitalization risk being overshadowed by the opioid crisis. Regional methamphetamine interventions may offer the greatest population health benefits. Future studies should examine long-term outcomes among patients hospitalized for amphetamine causes.