Using poisons information service data to assess the acute harms associated with novel psychoactive substances

• Published in: Drug testing and analysis Vol. 6; no. 7-8; pp. 850 - 860
• Main Authors: Wood, D. M., Hill, S. L., Thomas, S. H. L., Dargan, P. I.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-07-2014; Wiley Subscription Services, Inc
• Subjects: acute toxicity; Adverse Drug Reaction Reporting Systems; Cannabinoid Receptor Agonists - poisoning; Cannabinoid Receptor Agonists - toxicity; data triangulation; Humans; Internet; Methamphetamine - analogs & derivatives; Methamphetamine - poisoning; Methamphetamine - toxicity; novel psychoactive substances; poisons information service; Psychotropic Drugs - poisoning; Psychotropic Drugs - toxicity; recreational drugs; Street Drugs - poisoning; Street Drugs - toxicity; recreational drugs; novel psychoactive substances; data triangulation; acute toxicity; poisons information service
• ISSN: 1942-7603; 1942-7611
• DOI: 10.1002/dta.1671

Novel psychoactive substances (NPS) can cause significant acute toxicity but usually little is known about their toxicity when they enter the recreational drug scene. Current data sources include online user forums, user questionnaires, case reports/series, and deaths; however, these are limited by their focus on sub‐populations and generally include severe cases and specific geographical areas. Approximately 54% of countries have at least one poisons information service (in 2012 there were 274 worldwide) providing advice to healthcare professionals and/or the public on poisoning. They provide advice on recreational drug and NPS toxicity. In 2012, 2.5% of telephone enquiries to the UK National Poisons Information Service and 2.4% of enquiries to US poisons centres related to recreational drugs. Data are collected at population level and can be used to complement other data sources with clinical details on acute NPS toxicity and geographical/time patterns of toxicity. Like other acute NPS toxicity data, poisons centre data should be interpreted within their limitations, notably the absence of analytical confirmation and reliance on secondary reporting of clinical features. This manuscript demonstrates the breadth and depth of poisons information service data in the literature with a focus on mephedrone and synthetic cannabinoid‐receptor agonists. In our opinion it would be possible to develop a more robust and systematic reporting system using a network of poisons information services both within and across countries that would be complimentary to other datasets on acute NPS toxicity and allow more accurate data triangulation. Copyright © 2014 John Wiley & Sons, Ltd.
Novel psychoactive substances (NPS) can be associated with significant acute harms (toxicity). We discuss in this paper how data from poisons information services, collected as part of their core activities, can be used to complement and build on other available data sources on NPS toxicity. This can include information on the clinical pattern of acute NPS toxicity and also data on geographical and time‐patterns of toxicity on NPS.