A comparison of attendance for drug misuse to Dublin accident and emergency departments 1985-1993.

The figures available from the NDTRS in 1991-1992 indicate that the level of opiate misuse has increased after previous years of stabilisation. This study attempts to make a comparison between attenders at Accident & Emergency departments in 1993 and those who attended in 1985. The study also seeks to determine if the increase in opiate users seen in the drug treatment system is reflected in the numbers attending A & E departments. A questionnaire was administered by a trained A & E staff member to patients who presented in a four week period from 1 April 1993 to 28 April 1993 to the eight A & E department in the greater Dublin area. Individuals attending were judged by the attending doctor to have, in the past 6 months; experimented with drugs, abused drugs or be drug dependent. Information obtained included: socio-demographic details and the names of various misused drugs. The results for misused drugs were analysed using the Chi-squared Test. 68 drug misusers attending eight A & E departments were identified in the four week period. Physical problems associated with drug misuse were the most common cause for attendance, followed by drug over dose and deliberate self-harm. Drug use was intentional in 66.7% of the females and 50% of the males. Although the numbers attending were similar, the recent survey show the total number of drugs misused (260) compared with previous reports (140) is much higher. 38 subjects admitted to injecting a variety of drugs in this survey, compared to 43 subjects in 1983. Patients in 1993 have reported that they are using more drugs per person than in 1983. There is an increased misuse of prescribed drugs, and Benzodiazepines have become the major drug of misuse among males and females. Use of these minor tranquillisers can lead to behavioural dis-inhibition and memory impairment. There has also been an increase in the misuse of prescribed opiates such as methadone and morphine sulphate. The most noticeable trend emerging from this study is the rise in poly substance misuse and the increasing misuse of prescribed medication such as Benzodiazepines and methadone