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
- 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. - 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
)