Under the Microscope with Daniel Fatovich

February, 2009

Amphetamines have a dramatic effect on the brain, and there have been reports of structural abnormalities of the brain associated with methamphetamine use, according to a speaker at the 25th annual scientific meeting of the Australasian College for Emergency Medicine.

In 2005, Associate Professor Daniel Fatovich and his colleagues found during a prospective observational study at Royal Perth Hospital Emergency Department that 1.2% of all ED attendances were causally related to amphetamine use.

Most (71%) were men, whose average age was 28 years. About a third arrived by ambulance and 16% via the police. They spent between half an hour and 24 hours in the ED, with a third requiring sedation, 40% requiring admission, and 37% requiring psychiatric evaluation.

"We concluded that amphetaminerelated presentations comprise 1.2% of all ED attendances and have a major impact on hospital EDs. Patients are often agitated and aggressive, require extensive resources, and frequently re-attend."

Professor Fatovich said the burden of amphetamine-related illnesses on EDs is likely to continue.

Since 2005 he and his colleagues have conducted more research on the issue. As part of a chlamydia screening project, they surveyed 823 attendees aged 18-25 years on their drug use. 62% reported having used illicit drugs. These included 81% cannabis, 40% ecstasy, 25% "ice", and 13% cocaine.

The relationship between these drugs and the prevalence of asymptomatic chlamydia of 5.4% will be discussed. There is a significant relationship between drug use and sexual activity.

Professor Fatovich is now conducting a prospective study of patients who attend the emergency department at Royal Perth Hospital with amphetamine intoxication. These patients are offered a screening MRI brain scan to detect unsuspected cerebral abnormalities.

For more information please contact:
Joanne Hill
Royal Perth Hospital Public Relations
Office: (08) 9224 2209