The following is a summary of “Trends in amphetamine prescriptions given at discharge in emergency departments: A national analysis (2012–2019),” published in the April 2023 issue of Emergency Medicine by Ramdin, et al.

An increase in amphetamine usage, health issues, and fatalities have occurred concurrently with the opioid pandemic. Increased prescription drug use was the initial cause of the opioid epidemic, which later included heroin and, more recently, fentanyl analogs. However, less was known about current patterns in prescriptions for amphetamines. Therefore, for a study, researchers sought to determine whether current trends in amphetamine prescriptions written at discharge in emergency departments (EDs) in the United States had changed.

From 2012 to 2019, they looked at data from the National Hospital Ambulatory Medical Care Survey (NHAMCS). First, they tallied the total number of visits for which prescriptions for amphetamine salts, methylphenidate derivatives, and dexmethylphenidate were written at the time of discharge for each year. Next, they calculated the overall number and percentage of visits (of all ED visits) where prescriptions for both amphetamines and opioids were written upon discharge across time. As necessary, they employed descriptive statistics like mean to explain the data distribution and the Shapiro-Wilke test to determine data normality. Depending on the situation, they employed Pearson’s correlation (PC) or Spearman’s rho (SR) to describe data trends. All P-values were one-tailed and provided a 0.05 threshold of significance. Version 28 of IBM SPSS was used for all analyses.

An estimated 817,895 ED visits between 2012 and 2019 resulted in the dispensing of an amphetamine prescription, a rate that increased significantly overall over time (SR = 0.71, P = 0.02). There were 83,503 visits (0.06%) at the start of the study period in 2012, and there were 186,539 visits (0.12%) in 2019 (a 123% increase in absolute numbers). There were 102,237 (SD: 52,725) visits with discharge prescriptions for amphetamines every year on average. The number of visits with a discharge prescription for amphetamine salt increased significantly and linearly (PC = 0.92, P = 0.001). A total of 23,676 visits were made in 2012, compared to 124,773 visits in 2019 (an increase of 427%). In visits where both an amphetamine and an opioid were prescribed, there was no trend (PC: 0.61, P = 0.06).

Over time, the number of amphetamine discharge prescriptions in the ED increased. Amphetamine salt medications played a significant role in this. In the context of increased amphetamine usage, future research endeavors should continue to track this development as well as in prescriptions and accompanying abuse.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723000463