OBJECTIVES: Methamphetamine (MA) use has beenassociated with health problems that commonly present in the emergencydepartment (ED). This study sought to determine whether frequent MAinjection was a risk factor for ED utilization among street-involvedyouth.

STUDY DESIGN: Prospective cohort study.

METHODS: Datawere derived from a street-involved youth cohort known as the 'At RiskYouth Study'. Behavioural data including MA use were linked to EDrecords at a major inner-city hospital. Kaplan-Meier and Coxproportional hazards methods were used to determine the risk factors forED utilization.

RESULTS: Between September 2005 andJanuary 2007, 427 eligible participants were enrolled, among whom themedian age was 21 (interquartile range 19-23) years and 154 (36.1%) werefemale. Within 1 year, 163 (38.2%) visited the ED, resulting in anincidence density of 53.7 per 100 person-years. ED utilization wassignificantly higher among frequent (i.e. ≥daily) MA injectors (log-rankP = 0.004). In multivariate analysis, frequent MA injection wasassociated with an increased hazard of ED utilization (adjusted hazardratio = 1.84, 95% confidence interval 1.04-3.25; P = 0.036).

CONCLUSIONS: Street-involvedyouth who frequently inject MA appear to be at increased risk of EDutilization. The integration of MA-specific addiction treatment serviceswithin emergency care settings for high-risk youth is recommended. (Authors)