Study on Psychiatric Hospitalizations and Substance Use

A new study, out now in Drug and Alcohol Dependence, details trends among psychiatric hospitalizations between 2015-2019. It finds that while most hospitalizations did not involve any substances, methamphetamine-related hospitalizations have increased while the overall number of psychiatric hospitalizations remained stable.

Additionally, researchers detail that psychiatric hospitalizations caused by methamphetamine use were highest in the Mountain West region but were also shifting geographically. “Rates of methamphetamine-involved psychiatric hospitalizations were by far the highest in the Mountain West. As expected, this mirrors rates of self-reported methamphetamine use and methamphetamine-related overdose deaths in the Mountain West,” says Susan Calcaterra, MD, MPH, professor at the University of Colorado Anschutz Medical Campus and study lead author. “Psychiatric hospitalizations involving methamphetamine use is really taking off in the Midwest and Northeast, in particular.”

While rates of methamphetamine-related psychiatric hospitalizations increased 68% over the study period, opioid-related hospitalizations decreased by 22%. Methamphetamine rate increases may be attributed to methamphetamine's ubiquitousness and affordability, as well as the lack of resources available to manage methamphetamine use. Why opioid-involved psychiatric hospitalizations declined is less clear but may be related to the lethality of fentanyl.

“An important takeaway from this study is the need for resources to address the mental and physical treatment of methamphetamine use,” says Calcaterra.

“While the vast majority of psychiatric hospitalizations in this timeframe did not involve substance use, the significant increase in methamphetamine use means we have to better consider harm reduction in clinical settings. Evidence-based interventions such as:

• Contingency management which involves offering incentives for abstinence
• Harm reduction education
• Provision of naloxone for overdose reversal
• Access to expanded mental health treatments

are proven to help mitigate dangerous effects from methamphetamine use, especially when contaminated with fentanyl much like the campaigns aimed at public awareness around opioid use.”

Reference

Susan L. Calcaterra, Kristina Yamkovoy, Pallavi Aytha Swathi, Daniel Ciccarone, Brandon del Pozo, Honora Englander, Jianing Wang, Joshua A. Barocas, U.S. trends in methamphetamine-involved psychiatric hospitalizations in the United States, 2015–2019, Drug and Alcohol Dependence, https://doi.org/10.1016/j.drugalcdep.2024.111409.