Acute recreational drug and new psychoactive substance toxicity in Europe: 12 months data collection from the European Drug Emergencies Network (Euro-DEN)

Dines, Alison; Wood, David M.; Yates, Chris; Heyerdahl, Fridtjof; Hovda, Knut Erik; Giraudon, Isabelle; Sedefov, Roumen

doi:10.3109/15563650.2015.1088157

Cited by 114 publications

(117 citation statements)

References 12 publications

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“…As described in other large related cohorts [5,6,19,24], more than half of the admissions occurred during weekends, and clinical presentations as well as laboratory abnormalities were also equivalent to those previously outlined in other reports [5,6,16,18]. Our toxicology results are proportionate to formerly published data [5,6,13].…”

Section: Discussionsupporting

confidence: 90%

“…Our toxicology results are proportionate to formerly published data [5,6,13]. Including methadone, opiates was the most common substance detected in the urine toxicology screen of our subjects (30, 55%).…”

Section: Discussionsupporting

confidence: 83%

“…To our knowledge, this is the first study conducted in NYC addressing the utilization of ICU resources among patients with acute drug poisoning admitted to critical care units. The proportion of patients admitted to ICU in our study was substantially higher than previously reported in the literature [5,6,13–16,18–21], probably as a result of the hospital geographic location and our patients’ socio-demographic characteristics. Despite the fact that our data is exclusively limited to results obtained from admissions during the autumn and winter, other related publications also showed a peak of ICU admissions during these seasons [21–23].…”

Section: Discussioncontrasting

confidence: 75%

“…The unadjusted ICU mortality in our cohort was significantly higher than previously reported in other similar studies [5,6,13,16,18,20,24,26]. These patients were older, had higher SOFA scores on admission, and opiates were the most commonly detected substance in their toxicology screen.…”

Section: Discussioncontrasting

confidence: 59%

“…Despite the fact that our data is exclusively limited to results obtained from admissions during the autumn and winter, other related publications also showed a peak of ICU admissions during these seasons [21–23]. Although the majority of patients in this cohort were male, similarly to other related studies [5,6,24], our subjects were older when compared with other groups [5,6,16,18,19]. …”

Section: Discussionsupporting

confidence: 58%

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Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU

Orsini

Din

Elahi

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

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Background: Drug overdose continues to be the most common cause of acute poisoning worldwide. There has been a substantial increase in drug overdose incidence and prevalence over the past decade, probably as a result of the emergence of new synthetic designer drugs. The purpose of this study is to describe the clinical and epidemiological characteristics of patients with acute drug intoxication admitted to the Intensive Care Unit (ICU). Methods: A single center, prospective, observational study was conducted among all adult patients with clinical signs suggestive of acute drug intoxication admitted from the Emergency Department (ED) to ICU during a 6-month period (September to March). Results: Sixty-five patients were admitted. Their median age was 49 years (mean 48.2, range 20–72), and the majority were male (48, 74%). Median Sequential Organ Failure Assessment (SOFA) score on admission to ICU was 6 (mean 6, range 0–13). Fifty-five patients (85%) had a positive urine and/or serum toxicology screen. Most commonly detected substances were: opiates (18, 33%), cocaine (13, 24%), methadone (12, 22%), benzodiazepines (10, 18%), and marijuana (9, 16%). In 16 patients (29%), >1 substance was isolated. Twenty-three patients (35%) had negative urine toxicology screen. Ethyl alcohol was detected in the serum of 23 patients (35%). Five patients (8%) expired in ICU. Conclusion: Classic recreational drugs remain the most common substances involved in acute drug poisoning. More sensitive detection methods are warranted to identify new designer drugs of abuse such as synthetic cannabinoids.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 83%

Section: Discussioncontrasting

confidence: 75%

Section: Discussioncontrasting

confidence: 59%

Section: Discussionsupporting

confidence: 58%

See 3 more Smart Citations

Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU

Orsini

Din

Elahi

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

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The Emerging Role of Inhaled Heroin in the Opioid Epidemic

et al. 2018

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IMPORTANCE Opioid addiction affects approximately 2.4 million Americans. Nearly 1 million individuals, including a growing subset of 21 000 minors, abuse heroin. Its annual cost within the United States amounts to $51 billion. Inhaled heroin use represents a global phenomenon and is approaching epidemic levels east of the Mississippi River as well as among urban youth. Chasing the dragon (CTD) by heating heroin and inhaling its fumes is particularly concerning, because this method of heroin usage has greater availability, greater ease of administration, and impressive intensity of subjective experience (high) compared with sniffing or snorting, although it also has a safer infectious profile compared with heroin injection. This is relevant owing to peculiar and often catastrophic brain complications. Following the American Medical Association Opioid Task Force mandate, we contribute a description of the pharmacology, pathophysiology, clinical spectrum, neuroimaging, and neuropathology of CTD leukoencephalopathy, as distinct from other heroin abuse modalities.OBSERVATIONS The unique spectrum of CTD-associated health outcomes includes an aggressive toxic leukoencephalopathy with pathognomonic neuropathologic features, along with sporadic instances of movement disorders and hydrocephalus. Clinical CTD severity is predominantly moderate at admission, frequently unmodified at discharge, and largely improved in the long term. Mild cases survive with minor sequelae, while moderate to severe presentations might deteriorate and progress to death. Other methods of heroin use may complicate with stroke, seizure, obstructive hydrocephalus, and (uncharacteristically) leukoencephalopathy. CONCLUSIONS AND RELEVANCEThe distinct pharmacology of CTD correlates with its specific clinical and radiological features and prompts grave concern for potential morbidity and long-term disability costs. Proposed diagnostic criteria and standardized reporting would ameliorate the limitations of CTD literature and facilitate patient selection for a coenzyme Q10 therapeutic trial.

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Evaluation of UiO‐66 metal organic framework as an effective sorbent for Curcumin's overdose

Molavi

Zamani

Aghajanzadeh

et al. 2018

Applied Organom Chemis

101

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Metal organic frameworks (MOFs) UiO-66 (UiO stands for University of Oslo) and NH 2 -UiO-66 were prepared and characterized as sorbent (antidotal agents) for curcumin (CUR) adsorption. The structure of products were characterized by X-ray powder diffraction (XRD), Field emission scanning electron microscopy (FESEM), thermogravimetric analysis (TGA), Attenuated Total Reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), and N 2 adsorption-desorption measurements. FESEM showed NH 2 -UiO-66 displayed symmetrical crystals with triangular base pyramid morphology, with the particle size around 100 nm and uniform size distribution. Adsorption capacities of CUR/MOFs with different mass ratios in the feed were investigated in the present study, and this investigation revealed that when the CUR/MOFs with mass ratio was around 0.4, the absorption capacity of NH 2 -UiO-66 had tended to maximum. Although, functionalization reduced the specific surface area and free volume, introducing polar amine groups could improve the affinity of NH 2 -UiO-66 respect to CUR.Kinetic studies showed that the kinetic data are well fitted with the pseudo-second-order model. MTT assay revealed that MOFs at the concentration range of 0-560 μg/ml had no cytotoxic effect on the Human Foreskin Fibroblast normal cell line (HFF-2). These results suggest that these MOFs could be safe as sorbent for adsorb CUR from the body.

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Acute recreational drug and new psychoactive substance toxicity in Europe: 12 months data collection from the European Drug Emergencies Network (Euro-DEN)

Cited by 114 publications

References 12 publications

Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU

Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU

The Emerging Role of Inhaled Heroin in the Opioid Epidemic

Evaluation of UiO‐66 metal organic framework as an effective sorbent for Curcumin's overdose

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