D amphetamine salt combo 20 plus#

Conversely, reverse causation (ie, self-medication with ATS for symptoms associated with self-harm) is also plausible. 30–34 It is likely that the relationship between ATS use and self-harm is complex however, it is likely that depression, anxiety, trauma and stressful life events may act as mediators.

D amphetamine salt combo 20 plus#

22–26 Both ATS use and self-harm also occur at higher rates in marginalised groups who have experienced high rates of trauma such as those who have contact with the justice system, people who experience homelessness, 27–29 and lesbian, gay, bisexual, transgender, queer, intersex plus (LGBTQIA+) groups. 12–15 ATS use and self-harm share a number of underlying risk factors such as depression and anxiety, 16–21 and life stressors and traumatic events such as such as physical, sexual and psychological abuse. Self-harm is defined as ‘intentional self-poisoning or self-injury, irrespective of type of motive or the extent of suicidal intent’ 11 and is a major public health issue internationally. 8 9 Accordingly, there is emerging evidence of increasing ATS-related hospitalisations and health service use in many parts of the world, 8 10 placing excess strain on already overburdened services sectors. These include poor mental health (including depression, psychosis and suicidal behaviour), 3–5 hypertension and cardiovascular problems, 6 violence perpetration, 7 and contact with the criminal justice system. Multiple health and social problems are associated with ATS use. 2 It is clear from the evidence that ATS use is a growing issue in many parts of the world. Evidence from the Association of Southeast Asian Nations shows a 93% increase in treatment admissions for ATS-related treatment between 20, and an 81% increase in the number of people committing ATS-related offences during the same period. 1 However, wastewater analysis suggests an increase of 37% in consumption of methamphetamine between 20 1 likely indicating increasingly heavy use among those who are using. 1 In Australia, there has been a reduction of methamphetamine use among people aged 14 and older since 2001. 1 Additionally, wastewater analysis across 140 European cities suggests an upward trend since 2011 in the quantity of amphetamines being consumed. 1 Since 2016, countries such as the USA, UK, Germany, The Netherlands, Norway and New Zealand have seen increases in the prevalence of illicit amphetamine use. Estimates suggest that approximately 27 million people globally used ATS in 2018.

The use of amphetamine type stimulants (ATS) is a major public health concern internationally. The Methodological Standard for Epidemiological Research scale will be used to assess study quality, and Egger’s test and I 2 values will be used to assess publication bias and heterogeneity, respectively. If sufficient data are available, we will perform multiple meta-analyses to produce pooled measures of effect for each measure of ATS exposure, as well as different population sub-groups. Data will be extracted using a predesigned template, and pooled prevalence and pooled measures of effect for the association between ATS use and self-harm. We place no restriction on the population that studies investigate, our exposure of interest is both prescription and illicit ATS use, comparators will be those not currently using ATS, and our primary outcome of interest is the prevalence of self-harm.

All studies will be independently screened by two reviewers, first on title and abstract, and then on full-text to determine inclusion in the review. The initial search was conducted on 5 February 2021, with a final search expected on 1 February 2022.

We will search the Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and Scopus databases for relevant observational studies published in peer-reviewed journals.