Extrapolating from those figures, researchers from the University of the West of England estimated that up to one million ER visits annually in England might be drug-related. Illicit drug use also could be related to up to 400,000 hospital admissions, they estimated.

Interviews showed that 36 percent of ER patients were lifetime users of illicit drugs, with 16 percent having used within the past month; about 10 percent had used drugs in the previous 24 hours.

"A lot of the problems are related to overdoses from illegal drugs, infections, and even tetanus, which is being seen in heroin and crack cocaine users being cut with mud," said Martin Shalley, M.D., president of the British Association for Accident and Emergency Medicine. Shalley said ERs should have dedicated drug-intervention experts on staff.

"This is a bigger problem than people imagine," added St. Mary's Hospital consultant John Henry. "[ER] staff need more training in dealing with illegal drug users, rather than having to learn on the job."

The findings were reported in the Dec. 1, 2005 issue of the Emergency Medicine Journal.

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