Evidence map›Paper›PMID 39829384›Full record

Observational studyAddiction (Abingdon, England)2025

Is methamphetamine blood concentration in emergency department patients associated with the clinical picture?

David McCutcheon, Jessamine Soderstrom, Mohan Raghavan, Francois Oosthuizen, Bianca Douglas, Sally Burrows, Jennifer L Smith, Daniel Fatovich

Abstract readObservational Study
In one paragraph

Observational study in Addiction (Abingdon, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

David McCutcheonCentre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, Australia.ORCID https://orcid.org/0000-0001-8034-7749
Jessamine SoderstromCentre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, Australia.ORCID https://orcid.org/0009-0008-1548-1464
Mohan RaghavanEmergency Department, Royal Perth Hospital, Perth, Australia.ORCID https://orcid.org/0009-0007-3136-0702
Francois OosthuizenChemCentre WA, Perth, Australia.
Bianca DouglasChemCentre WA, Perth, Australia.
Sally BurrowsSchool of Medicine, University of Western Australia, Perth, Australia.ORCID https://orcid.org/0000-0002-8499-4537
Jennifer L SmithCentre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, Australia.ORCID https://orcid.org/0000-0002-0398-2121
Daniel FatovichCentre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, Australia.ORCID https://orcid.org/0000-0001-9414-6905

Funding

Australasian College for Emergency Medicine Al Spilman Early Career Researcher AwardRoyal Perth Hospital Research Foundation Springboard Grant ID MRF2018/16
6 · The paper itself

Abstract

aimsThis study aimed to describe clinical features and outcomes of patients presenting to the emergency department with analytically confirmed methamphetamine intoxication, to determine the blood concentration of methamphetamine and to test its association with clinical findings.

designThe Western Australian Illicit Substance Evaluation (WISE) study is a prospective observational cohort study.

settingRoyal Perth Hospital Emergency Department, Perth, Australia, between 2016 and 2018.

participantsPatients suspected to be intoxicated with a stimulant, hallucinogenic or cannabinoid substance and who required intravenous access or blood tests as part of standard care. Those predominantly alcohol intoxicated, behaviourally disturbed or opioid intoxicated were excluded. The 431 participants with detectable methamphetamine (> 0.001 mg/l) included in this analysis had a mean age of 33.2 (9.4) years and 286/431 (66.4%) were male. MEASUREMENTS: Concentration was reported for methamphetamine and other illicit drugs detected. Univariate associations of symptoms and signs, and physiological and laboratory parameters with methamphetamine concentration were determined and used to develop a multivariable model.

findingsThe median concentration of methamphetamine was 0.12 mg/L [Q1,Q3: 0.05, 0.27]. Psychotic symptoms were seen in 265/431 (61.5%) patients and intravenous or intramuscular sedation was required in 280/431 (65.0%). Mean heart rate was elevated at 105.9 (21.5) beats per minute, but other mean or median physiological parameters were within normal limits. A multivariable model showed that methamphetamine concentration was 27% lower in males (P = 0.026), 60% higher in those with palpitations (P = 0.013), 62% higher in those with choreoathetoid movements (P = 0.002) and increased by 1% for each unit (μg/L) increment in creatinine (P = 0.001).

conclusionsIn a cohort of emergency department patients with methamphetamine exposure, a multivariable model inferred a significant association between higher methamphetamine concentration and female sex, the presence of palpitations and choreoathetoid movements and creatinine concentration. The model showed no significant association with agitation, psychotic symptoms or other physiological or clinical parameters.

Indexed as

Amphetamine-Related DisordersCentral Nervous System StimulantsEmergency Service, HospitalMethamphetamineAdultArrhythmias, CardiacFemaleHumansMaleMiddle AgedProspective StudiesWestern AustraliaYoung AdultCentral Nervous System StimulantsMethamphetamineamphetaminesemergency medical servicesillicit drugsmethamphetaminepsychosissubstance‐related disorderssynthetic drugs

Identifiers

PMID39829384
PMCPMC11986284

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.