Novel psychoactive substances in Australian emergency departments: implications for public health practice from multi-centre prospective toxicosurveillance across five states, 2022–2023

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-08-22 DOI:10.1016/j.drugpo.2025.104969

Jennifer L. Smith , Courtney C. Weber , Jennifer L. Schumann , Nadine Ezard , Daniel M. Fatovich , David McCutcheon , Katherine Z. Isoardi , Andrew H. Dawson , Rebekka Syrjanen , Keith Harris , Peter Stockham , Emma Partridge , Sam Alfred , Viet Tran , Ellie M. Kotkis , Paul Sakrajda , Melissa Trujillo , Shaun L. Greene , EDNA and EDNAV investigator teams

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引用次数: 0

Abstract

Background

Comprehensive toxicology testing of emergency department (ED) presentations has become a prominent data source on novel psychoactive substances (NPS) in Australia. We describe the type and frequency of analytically confirmed NPS across five Australian states and 28 EDs between 2022 and 2023.

Methods

This is a prospective series of ED presentations with at least one confirmed NPS detection identified by the Emerging Drugs Network of Australia (EDNA) and Emerging Drugs Network of Australia Victoria (EDNAV). De-identified demographic and toxicology data were extracted for analysis.

Results

At least one NPS was detected in 646 ED presentations. Total detections was 1044 across 59 different compounds. The median age was 26 years (range 16–90 years) and 464 (71.8 %) were male. Benzodiazepine-type NPS comprised over three-quarters of all NPS positive cases (526, 81.4 %), bromazolam being most frequent (290, 44.9 % total cases). Twenty-four different novel stimulants were detected across 88 (13.6 %) presentations, N,N-dimethylpentylone (52, 8.0 % total cases) the most common. Novel opioids, dissociatives and synthetic cannabinoid receptor agonists made up a small proportion of total NPS positive cases. These findings directly informed nine public health harm reduction communications by multiple state government authorities warning of high-risk NPS detections. Traditional illicit drug co-detections were common (520, 80.5 %), in particular methylamphetamine (404, 62.5 %).

Conclusion

Drug intelligence data generated in an acute harm setting such as the ED can provide early warning of drugs of concern circulating in the community, including NPS. This facilitates rapid community responses to reduce harm and inform subsequent public health responses.

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澳大利亚急诊科的新型精神活性物质：2022-2023年五个州多中心前瞻性毒物监测对公共卫生实践的影响

在澳大利亚，急诊科（ED）报告的综合毒理学测试已成为新型精神活性物质（NPS）的重要数据来源。我们描述了2022年至2023年间澳大利亚五个州和28个ed的分析确认NPS的类型和频率。方法：这是一个前瞻性ED系列报告，至少有一种NPS检测被澳大利亚新兴药物网络（EDNA）和澳大利亚维多利亚州新兴药物网络（EDNAV）确认。提取去识别的人口学和毒理学数据进行分析。结果646例ED中至少检出一种NPS。59种不同化合物的总检测值为1044。中位年龄为26岁（16-90岁），男性464例（71.8%）。苯二氮卓类NPS占所有NPS阳性病例的四分之三以上（526例，81.4%），溴唑仑最常见（290例，44.9%）。在88例（13.6%）病例中检测到24种不同的新型兴奋剂，其中N，N-二甲基戊酮（52.8%）最为常见。新型阿片类药物、解离剂和合成大麻素受体激动剂仅占NPS阳性病例总数的一小部分。这些发现直接通知了多个州政府当局就高风险NPS检测发出的9次减少公共卫生危害的通知。传统的非法药物共同检测很常见（520,80.5%），特别是甲基安非他明（404,62.5%）。结论在急诊科等急性危害环境中产生的药物情报数据可对包括NPS在内的社区流行的关注药物进行早期预警。这有助于社区迅速作出反应，以减少伤害，并为随后的公共卫生反应提供信息。

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来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.