Comparison of Laboratory Confirmed Drugs in Acute Recreational Drug Toxicity Presentations to an Urban Hospital in London, UK, 2016/17 versus 2019/20

• Published in: Journal of medical toxicology 2024-12
• Main Authors: Wolfe, Caitlin E, Sund, Lachlan J, Archer, John Rh, Rowe, Ashley, Hudson, Simon, Wood, David M, Dargan, Paul I
• Format: Article
• Language: English
• ISSN: 1937-6995; 1937-6995
• DOI: 10.1007/s13181-024-01051-8

Novel Psychoactive Substance (NPS) use is increasingly prevalent and is often associated with severe acute recreational drug toxicity (ARDT). 258 UK deaths were attributed to NPS use in 2021. Confirmatory testing which identifies NPS is limited by expense and timeliness. We aimed to identify NPS and other recreational drugs in a sample of 1000 ARDT presentations to a central London hospital in 2019/20 and to compare these drugs to those identified from a previous cohort in 2016/2017. We prospectively enrolled 1000 serum samples from ARDT presentations to St Thomas' Hospital between February 2019 and February 2020. Serum samples were deidentified and underwent qualitative analysis via mass spectrometry. Results were returned at the conclusion of testing and statistical analysis performed using 'R' (R Foundation for Statistical Computing). Twenty-eight unique NPS were detected in 2019/20, compared to 31 in 2016/17. Eight new NPS were detected in 2019/20: four benzodiazepines, two synthetic cannabinoid receptor agonists, one cathinone and one ketamine-analogue. No NPS opioids were detected in either cohort. Cannabis (16%,11% p = 0.02), ketamine (12%,7% p