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Acute health problems due to recreational drug use in patients presenting to an urban emergency department in Switzerland
Identifier
017418
Type of Spiritual Experience
Background
A description of the experience
Swiss Med Wkly. 2015 Jul 28;145:w14166. doi: 10.4414/smw.2015.14166. eCollection 2015.
Acute health problems due to recreational drug use in patients presenting to an urban emergency department in Switzerland.
Liakoni E1, Dolder PC2, Rentsch K3, Liechti ME1.
- 1Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Switzerland.
- 2Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Switzerland / Laboratory Medicine, University Hospital Basel and University of Basel, Switzerland.
- 3Laboratory Medicine, University Hospital Basel and University of Basel, Switzerland.
QUESTIONS UNDER STUDY: To describe acute toxicity of recreational drugs including novel psychoactive substances.
METHODS: We included all cases presenting at the emergency department (ED) of the University Hospital of Basel, Switzerland, between October 2013 and September 2014 with acute toxicity due to self-reported recreational drug use or with symptoms/signs consistent with acute toxicity. Isolated ethanol intoxications were excluded. Intoxications were confirmed with immunoassays and liquid chromatography coupled with mass spectrometry (LC-MS/MS), which also detected novel psychoactive substances.
RESULTS: Among the 47,767 attendances at the ED, 216 were directly related to acute toxicity of recreational drugs. The mean patient age was 31 years and 69% were male. Analytical drug confirmation was available in 180 cases. Most presentations were related to
- cocaine (36%),
- cannabis (31%),
- opioids (13%),
- 3,4-methylenedioxy-methamphetamine (MDMA, 9%),
- other amphetamines (7%),
- benzodiazepines (7%),
- and lysergic acid diethylamide (LSD, 5%).
The substances most commonly detected analytically were
- cannabis (37%),
- cocaine (33%),
- opioids (29%),
- benzodiazepines (21%), and
- amphetamines including MDMA (13%).
Notably, there were only two cases of novel psychoactive substances (2,5-dimethoxy-4-bromophenethylamine [2C-B] and pentylone). The most frequent symptoms were tachycardia (31%), anxiety (27%), nausea or vomiting (23%), and agitation (22%).
Severe complications included myocardial infarction (2), psychosis (10), seizures (10), and 1 fatality.
Most patients were discharged home (68%), 8% were admitted to intensive care and 9% were referred to psychiatric care.
CONCLUSION: Medical problems related to illicit drugs mostly concerned cocaine and cannabis and mainly involved sympathomimetic toxicity and/or psychiatric disorders. ED presentations associated with novel psychoactive substances appeared to be relatively rare.
PMID: 26218967
The source of the experience
PubMedConcepts, symbols and science items
Concepts
Symbols
Science Items
2C-BActivities and commonsteps
Activities
Overloads
Amphetamines and stimulantsAnalgesics - opioids [pharmaceuticals]
Benzodiazepines
Cocaine
LSD
MDMA