Trends in a decade of drug abuse presentation to an inner city ED

Temporal factors on the periodic presentations has been described for many diseased states tie, asthma, seizures, coronary attacks). We now report an analysis of factors that could affect the periodic character regarding emer gency department (ED) presentation of drugs of abuse. All drugs presentatio ns consistent with the Drug Abuse Warning Network (DAWN) reporting program from January 1988 through December 1997 were categorized. Data collection w as based on daily chart review of ED medical records from Rush Presbyterian St. Luke's Hospital (Chicago, IL). Data were computer analyzed using SPSS and Pharmfit programs and analyzed for time, age, disposition, sex, and rea sons for presentation and taking the drugs. During the above period, the Ru sh ED saw 369,770 patients of which 2,561 (0.7%) presented with a drug-rela ted problem. The average age of men was 33.7 + 0.29 and women 30.5 + 0.37 y ears. One hundred thirty nine patients (5.4%) were under 17 years of age wh ereas only 72 patients (2.8%) were over 55 years of age. Cocaine was the mo st common drug presentation with a total of 859 visits. Seven hundred sixty one (29.7%) presented with an unexpected reaction, 754 (29.4%) experienced an over dosage, 135 (5.3%) had a drug withdrawal, 546 (21.3%) experienced chronic effects, 1,380 (53.9%) were drug dependent, 218 (8.5%) were suicide attempts, and the remaining 2.7% were unknown. There were 1,078 (42.2%) pa tients who were treated and released, 1,394 (54.6%) who were admitted into the hospital, 74 (2.9%) left against medical advice whereas 9 patients (0.4 %) died. Peak time for presentation was 5:03 PM (P =.00002). Suicide intent presentations were more likely to be women (P <.0001), older (P <.001), an d present at a later time that of recreational drug use (acrophase 18:49 ve rsus 16:39; P =.00011). Almost 90% of patients presenting to our urban ED o ver past 10 years with drug related problems arrive because of drug abuse o r dependency issues. ED staff should be most prepared to deal with these is sues in the late afternoon. (Am J Emerg Med 2001;19:37-39. Copyright (C) 20 01 by W.B. Saunders Company).