Journal of Research in Pharmacy Practice

Outcome of treatment in patients with methamphetamine poisoning in an Iranian tertiary care referral center

Authors

. Parva Paydar 1
. Ali Mohammad Sabzghabaee 2
. Hooman Paydar 3
. Nastaran Eizadi-Mood 2
. Ali Joumaa 1

1 Pharmacy Students’ Research Committee, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

2 Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Medical Students’ Research Center, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran

Abstract
Objective: Methamphetamine is the second most widely abused drug worldwide. We 
performed a study on the treatment outcome of acute methamphetamine intoxication in 
a referral tertiary care University hospital in Iran.
Methods: In this hospital‑based, retrospective study which was carried out from 2012 to 
2013, medical records of all patients aged 18 to 65 years who were admitted with a reliable 
history and clinical diagnosis of acute methamphetamine intoxication were abstracted 
and analyzed. Patients’ data included gender, age, type and route of poisoning, clinical 
manifestations, duration of hospitalization, and the treatment outcome. ANOVA, Chi‑square, 
and binary logistic regression statistical tests were used for data analysis.
Findings: A total of 129 patients with a mean age of 30.70 ± 0.93 (mean ± standard error), 
including 111 (86%) males, had been fully evaluated. Most of the patients had intentional 
poisoning (93.7%). In 42.6% of patients, inhalation was the main route of exposure. Most of the 
patients had complete improvement without any complication (89.1%). Age (odds ratio [OR], 
1.05; 95% confidence interval [95% CI] 1.006–1.099), suicide history (OR, 30.33; 95% CI 
3.11–295.24), route of poisoning ([ingestion: OR, 0.21; 95% CI 0.05–0.87], [inhalation: OR, 0.19; 
95% CI 0.04–0.78]), and pulmonary system manifestations (OR 1.84; 95% CI 1.15–2.93) 
were predictive in patients outcome (P < 0.05).
Conclusion: Methamphetamine poisoning was more common in males with intentional 
poisoning. Age, past history of suicide, route of poisoning, and pulmonary manifestations 
on admission could be considered as important predictive factors in patients’ outcome.
Keywords: Methamphetamine; poisoning; treatment outcome
  1. ChomchaiC, ChomchaiS. Global patterns of methamphetamine 
    use. Curr Opin Psychiatry 2015;28:269‑74.
    2. Tomás‑Rosselló J, Rawson RA, Zarza MJ, Bellows A, 
    Busse A, Saenz E, et al. United Nations office on drugs and 
    crime international network of drug dependence treatment 
    and rehabilitation resource centres: Treatnet. Subst Abus 
    2010;31:251‑63.
    3. McKetin R, Dunlop AJ, Holland RM, Sutherland RA, 
    Baker AL, Salmon AM, et al. Treatment outcomes for 
    methamphetamine users receiving outpatient counselling 
    from the stimulant treatment program in Australia. Drug 
    Alcohol Rev 2013;32:80‑7.
    4. Callaghan RC, Cunningham JK, Verdichevski M, Sykes J, 
    Jaffer SR, Kish SJ. All‑cause mortality among individuals 
    with disorders related to the use of methamphetamine: 
    A comparative cohort study. Drug Alcohol Depend 
    2012;125:290‑4.
    5. Degenhardt L, Baxter AJ, Lee YY, Hall W, Sara GE, Johns N, 
    et al. The global epidemiology and burden of psychostimulant 
    dependence: Findings from the global burden of disease study 
    2010. Drug Alcohol Depend 2014;137:36‑47.
    6. Kalin JR. Incidence of fetal drug exposure in Alabama: 
    2004‑2011. J Forensic Sci 2014;59:1029‑35.
    7. Ericsson E, Bradvik L, HakanssonA. Mortality, causes of death 
    and risk factors for death among primary amphetamine users 
    in the Swedish criminal justice system. Subst Use Misuse 
    2014;49:262‑9.
    8. PietschJ, PaulickT, SchulzK, Flössel U, EngelA, SchmitterS, et al.
    Escalation of methamphetamine‑related crime and fatalities in 
    the Dresden region, Germany, between 2005 and 2011. Forensic 
    Sci Int 2013;233:51‑4.
    9. RadfarSR, RawsonRA. Current research on methamphetamine: 
    Epidemiology, medical and psychiatric effects, treatment, and 
    harm reduction efforts. Addict Health 2014;6:146‑54.
    10. Baalachandran R, Hypes C, Natt B, Snyder L. Pipe dreams: 
    Concealed methamphetamine causing severe toxicity. Am J 
    Med Sci 2015;349:548‑9.
    11. Alam‑Mehrjerdi Z, Mokri A, Dolan K. Methamphetamine 
    use and treatment in Iran: A systematic review from the most 
    populated Persian Gulf country. Asian J Psychiatr 2015. pii: 
    S1876‑201800111‑2.
    12. Eizadi‑Mood N, Masoumi G, Gheshlagh F, Siadat Z, Setare M, 
    Yazdani‑Ardestani M. Demographic factors, duration of 
    hospitalization, costs of hospitalization, and cause of death in 
    patients intoxicated with amphetamines and opioids. J Isfahan 
    Med Sch 2011;29:890‑900.
    13. World Health Organization (WHO), International Statistical 
    Classification of Diseases and Related Health Problems 10th 
    Revision (2010). Available from: http://apps.who.int/classifications/
    icd10/browse/2010/en [Last accessed on 2010 Mar 12].
    14. Hoffman RS, Nelson LS, Goldfrank LR, Flomenbaum N, 
    Howland MA, Lewin NA, et al. Goldfrank’s Toxicologic 
    Emergencies. New York [etc.]: McGraw‑Hill Education; 2015.
    15. Dworkin RJ. Hidden bias in the use of archival data. Eval 
    Health Prof 1987;10:173‑85.
    16. Kaji AH, Schriger D, Green S. Looking through the 
    retrospectoscope: Reducing bias in emergency medicine chart 
    review studies. Ann Emerg Med 2014;64:292‑8.
    17. Burns MK. How to establish interrater reliability. Nursing 
    2014;44:56‑8.
    18. Thompson SK. Sampling. Hoboken, NJ: Wiley; 2013. p. 431.
    19. Masoumi G, Eizadi‑Mood N, Akabri M, Sohrabi A, 
    Khalili Y. Pattern of poisoning in Isfahan. J Isfahan Med Sch 
    2012;29:1317‑24.
    20. Vassar M, Holzmann M. The retrospective chart review: 
    Important methodological considerations. J Educ Eval Health 
    Prof 2013;10:12.
    21. Degenhardt L, Mathers B, Guarinieri M, Panda S, Phillips B, 
    Strathdee SA, et al. Meth/amphetamine use and associated 
    HIV: Implications for global policy and public health. Int J 
    Drug Policy 2010;21:347‑58.
    22. Fairbairn N, Wood E, Stoltz JA, Li K, Montaner J, Kerr T. 
    Crystal methamphetamine use associated with non‑fatal 
    overdose among a cohort of injection drug users in Vancouver. 
    Public Health 2008;122:70‑8.
    23. Pittman HJ. Methamphetamine overdose. Nursing 2005;35:88.
    24. Werb D, Kerr T, Buxton J, Shoveller J, Richardson C, 
    Montaner J, et al. Crystal methamphetamine and initiation of 
    injection drug use among street‑involved youth in a Canadian 
    setting. CMAJ 2013;185:1569‑75.
    25. Rawson RA. Current research on the epidemiology, medical 
    and psychiatric effects, and treatment of methamphetamine 
    use. J Food Drug Anal 2013;21:S77‑81.
    26. RawsonRA, ChudzynskiJ, GonzalesR, MooneyL, DickersonD, 
    AngA, et al. The impact of exercise on depression and anxiety 
    symptoms among abstinent methamphetamine‑dependent 
    individuals in a residential treatment setting. J Subst Abuse 
    Treat 2015. pii: S0740‑547200088‑4.
  2. 27. Chen CK, Lin SK, Chen YC, Huang MC, Chen TT, Ree SC, 
    et al. Persistence of psychotic symptoms as an indicator of 
    cognitive impairment in methamphetamine users. Drug 
    Alcohol Depend 2015;148:158‑64.
    28. Courtney KE, Ray LA. Methamphetamine: An update on 
    epidemiology, pharmacology, clinical phenomenology, and 
    treatment literature. Drug Alcohol Depend 2014;143:11‑21.
    29. ElkashefA, Vocci F, Hanson G, White J, Wickes W, Tiihonen J. 
    Pharmacotherapy of methamphetamine addiction: An update. 
    Subst Abus 2008;29:31‑49
Journal of Research in Pharmacy Practice
Volume 4, Issue 3
Summer 2015
Pages 167-172

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