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Acute recreational drug toxicity: Comparison of self-reports and results of immunoassay and additional analytical methods in a multicenter European case series.

Abstract The aim of the study was to compare self-reported and analytically confirmed substance use in cases of acute recreational drug toxicity.We performed a retrospective analysis of emergency department presentations of acute recreational drug toxicity over 2 years (October 2013 to September 2015) within the European Drug Emergencies Network Plus project.Among the 10,956 cases of acute recreational drug toxicity during the study period, 831 could be included. Between the self-reported substance use and the toxicological results, the highest agreement was found for heroin (86.1%) and cocaine (74.1%), whereas inhalants, poppers, and magic mushrooms were self-reported but not analytically detected. Cathinones and other new psychoactive substances (NPS) could be detected using additional analytical methods. Among cases with both immunoassay (IA) and confirmation with mass spectrometry (MS), the results were consistent for methadone (100%) and cocaine (95.5%) and less consistent for amphetamines (81.8%). In cases with a positive IA for amphetamines (nā€Š=ā€Š54), MS confirmed the presence of 3,4-methylenedioxymethamphetamine (MDMA), amphetamine, methamphetamine, and NPS in 37, 20, 10, and 6 cases, respectively, also revealing use of more than 1 substance in some cases. MS yielded positive results in 21 cases with a negative IA for amphetamines, including amphetamine, MDMA, methamphetamine, and NPS, in 14, 7, 2, and 2 cases, respectively.In conclusion, the highest agreement was found between self-reports and analytical findings for heroin and cocaine. The diagnosis of NPS use was mainly based on self-report. The IAs accurately identified methadone and cocaine, and MS had advantages for the detection of NPS and amphetamine derivatives.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29384873
OWN - NLM
STAT- MEDLINE
DCOM- 20180209
LR  - 20180209
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 5
DP  - 2018 Feb
TI  - Acute recreational drug toxicity: Comparison of self-reports and results of
      immunoassay and additional analytical methods in a multicenter European case
      series.
PG  - e9784
LID - 10.1097/MD.0000000000009784 [doi]
AB  - The aim of the study was to compare self-reported and analytically confirmed
      substance use in cases of acute recreational drug toxicity.We performed a
      retrospective analysis of emergency department presentations of acute
      recreational drug toxicity over 2 years (October 2013 to September 2015) within
      the European Drug Emergencies Network Plus project.Among the 10,956 cases of
      acute recreational drug toxicity during the study period, 831 could be included. 
      Between the self-reported substance use and the toxicological results, the
      highest agreement was found for heroin (86.1%) and cocaine (74.1%), whereas
      inhalants, poppers, and magic mushrooms were self-reported but not analytically
      detected. Cathinones and other new psychoactive substances (NPS) could be
      detected using additional analytical methods. Among cases with both immunoassay
      (IA) and confirmation with mass spectrometry (MS), the results were consistent
      for methadone (100%) and cocaine (95.5%) and less consistent for amphetamines
      (81.8%). In cases with a positive IA for amphetamines (n = 54), MS confirmed the 
      presence of 3,4-methylenedioxymethamphetamine (MDMA), amphetamine,
      methamphetamine, and NPS in 37, 20, 10, and 6 cases, respectively, also revealing
      use of more than 1 substance in some cases. MS yielded positive results in 21
      cases with a negative IA for amphetamines, including amphetamine, MDMA,
      methamphetamine, and NPS, in 14, 7, 2, and 2 cases, respectively.In conclusion,
      the highest agreement was found between self-reports and analytical findings for 
      heroin and cocaine. The diagnosis of NPS use was mainly based on self-report. The
      IAs accurately identified methadone and cocaine, and MS had advantages for the
      detection of NPS and amphetamine derivatives.
FAU - Liakoni, Evangelia
AU  - Liakoni E
AD  - Division of Clinical Pharmacology and Toxicology, Basel University Hospital and
      University of Basel, Basel, Switzerland.
AD  - Clinical Pharmacology and Toxicology, Department of General Internal Medicine,
      Inselspital, Bern University Hospital, University of Bern, Bern.
FAU - Yates, Christopher
AU  - Yates C
AD  - Clinical Toxicology Unit, Emergency Department, Hospital Universitari Son
      Espases, Research Institute of Health Sciences (IdISBa), Palma de Mallorca,
      Spain.
FAU - Dines, Alison M
AU  - Dines AM
AD  - Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health 
      Partners.
FAU - Dargan, Paul I
AU  - Dargan PI
AD  - Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health 
      Partners.
AD  - Clinical Toxicology, Faculty of Life Sciences and Medicine, King's College
      London, London, UK.
FAU - Heyerdahl, Fridtjof
AU  - Heyerdahl F
AD  - The Norwegian CBRNe Centre of Medicine, Department of Acute Medicine, Oslo
      University Hospital, Oslo, Norway.
FAU - Hovda, Knut Erik
AU  - Hovda KE
AD  - The Norwegian CBRNe Centre of Medicine, Department of Acute Medicine, Oslo
      University Hospital, Oslo, Norway.
FAU - Wood, David M
AU  - Wood DM
AD  - Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health 
      Partners.
AD  - Clinical Toxicology, Faculty of Life Sciences and Medicine, King's College
      London, London, UK.
FAU - Eyer, Florian
AU  - Eyer F
AD  - Department of Clinical Toxicology, Klinikum Rechts der Isar, Technical University
      of Munich, Munich, Germany.
FAU - Liechti, Matthias E
AU  - Liechti ME
AD  - Division of Clinical Pharmacology and Toxicology, Basel University Hospital and
      University of Basel, Basel, Switzerland.
CN  - Euro-DEN Plus Research Group
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Street Drugs)
SB  - AIM
SB  - IM
MH  - Acute Disease
MH  - Emergency Service, Hospital
MH  - Europe
MH  - Humans
MH  - Immunoassay
MH  - Mass Spectrometry
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Self Report
MH  - Street Drugs/*poisoning
MH  - Substance-Related Disorders/*complications/*diagnosis/psychology
IR  - Anand JS
FIR - Anand, Jacek Sein
IR  - Kabata PM
FIR - Kabata, Piotr Maciej
IR  - Barcelo B
FIR - Barcelo, Barcelo
IR  - Chevillard L
FIR - Chevillard, Lucie
IR  - Megarbane B
FIR - Megarbane, Bruno
IR  - Galicia M
FIR - Galicia, Miguel
IR  - Giraudon I
FIR - Giraudon, Isabelle
IR  - Jurgens G
FIR - Jurgens, Gesche
IR  - Moughty A
FIR - Moughty, Adrian
IR  - O'Connor N
FIR - O'Connor, Niall
IR  - O'Donohoe P
FIR - O'Donohoe, Patrick
IR  - Paasma R
FIR - Paasma, Raido
IR  - Pedersen CB
FIR - Pedersen, Carsten Boe
IR  - Persett PS
FIR - Persett, Per Sverre
IR  - Pold K
FIR - Pold, Kristiina
IR  - Puiguriguer J
FIR - Puiguriguer, Jordi
IR  - Rabe C
FIR - Rabe, Christian
IR  - Vallersnes OM
FIR - Vallersnes, Odd Martin
IR  - Waring WS
FIR - Waring, W. Stephen
EDAT- 2018/02/01 06:00
MHDA- 2018/02/10 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/10 06:00 [medline]
AID - 10.1097/MD.0000000000009784 [doi]
AID - 00005792-201802020-00035 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Feb;97(5):e9784. doi: 10.1097/MD.0000000000009784.