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Introduction: Our goal in this study was to identify stimulant abuser patients who are at specifically high risk of suicide attempt (SAT), in order to prioritize them in preventive and risk mitigation programs. Methods: We used the California State Emergency Department Database (SEDD) to obtain discharge information for 2011. The SEDD contains discharge information on all outpatient ED encounters, including uninsured patients and those covered by Medicare, Medicaid, and private insurance. We identified SAT and stimulant abuse by using the relevant International Classification of Diseases, Ninth Revision, codes. Results: The study included 10,124,598 outpatient ED visits. Stimulant abuse was observed in 0.97% of ED visits. Stimulant abuse was more common among young and middle-aged males and people with low median household income. Moreover, it was more common among Native American (1.8%) and Black (1.8%), followed by non-Hispanic White (1.1%) patients. The prevalence of SAT was 2.0% (n = 2000) for ED visits by patients with a history of stimulant abuse, and 0.3% (N = 28,606) for ED visits without a history of stimulant abuse (odds ratio 7.29, 95% confidence interval, 6.97-7.64). The SATs were directly associated with stimulant abuse, younger age (age groups >10), and non-Hispanic White and Native American race. Association of SAT with stimulant abuse was stronger in female patients. Conclusion: Stimulant abuse was the only modifiable risk factor for suicide attempt in our study. Reaching out to populations with higher prevalence of stimulant abuse (young and middle-aged individuals who are Native American or Black, with lower household income) to control the stimulant abuse problem, may reduce the risk of SAT. In this regard, people who are at higher risk of SAT due to non-modifiable risk factors (younger age, and Native American or White race) should be prioritized. Moreover, controlling stimulant abuse among women may be specifically effective in SAT prevention. [ABSTRACT FROM AUTHOR]

Introduction: Toxicologic exposures (TE) are a major preventable public health issue, with most cases due to unintentional causes. Although these cases are well documented and reported via the National Poison Data System, there is little information regarding toxicologic exposure cases in the emergency department (ED). The aim of this study was to identify demographic groups at risk for potential poisoning. Methods: This was a cross-sectional study. We used data from the California State Emergency Department Database (SEDD) 2011 for statistical analysis. Results: The study included 10,124,598 ED visits in California in 2011. The prevalence of TE was 383.4 (379.6-387.3) per 100,000 visits. Toxicologic exposures were most common among patients aged <10 years (555.4, 95% confidence interval [CI]: 544.5-566.5 per 100,000 visits). Overall, TE was more common among males. White patients showed the highest prevalence of TE compared to other racial groups (P <0.001). Subpopulation analysis showed Native American female patients ages 10-19 had a noticeably higher prevalence of TE (1,464.4, 95% CI: 802.9-2444.9 per 100,000). The prevalence of TE was higher in households of higher median income (P <0.001). Prevalence of TE among those with a history of substance use was also elevated. Conclusion: Toxicologic exposure cases in the ED are elevated in particular age and race/ethnicity groups, as well as among those with a diagnosis of substance use disorder. The strength of association between these factors and TE in the general population may be different because we examined ED visits only. Further preventive and education strategies are necessary and should target the demographic groups identified in this epidemiological study. [ABSTRACT FROM AUTHOR]