Five-year trends in self-reported recreational drugs associated with presentation to a UK emergency department with suspected drug-related toxicity.

OBJECTIVE: User surveys show that there have been significant changes over the last decade in the recreational drugs that are available and being used. This study aims to determine whether there have been similar trends in the drug(s) used by individuals presenting to the emergency department (ED) with acute recreational drug toxicity.
METHODS: Data on all poisoned patients presenting to our large inner-city ED are recorded prospectively on a dedicated clinical toxicology database. Presentations relating to the use of classical recreational drugs and/or novel psychoactive substances were identified retrospectively between 1 January 2006 and 31 December 2010.
RESULTS: There was a significant increase between 2006 and 2010 in the number of individuals reporting the use of cocaine (119-222), γ-hydroxybutyrate/γ-butyrolactone (158-270), ketamine (58-81) and cannabis (18-68) and novel psychoactive substances (seven to 98). In particular, there was an increase in cathinones reported from none in 2006 to 82 in 2010. Only 3,4-methylenedioxymethamphetamine (MDMA) was associated with a downward trend in reported use from 140 in 2006 to 103 in 2010.
CONCLUSION: Data collection on the drug(s) used in individuals presenting to specialist clinical toxicology centres and/or sentinel EDs across Europe with acute recreational drug toxicity would help to determine the true pattern(s) of drug use and the acute harm associated with this use across Europe and trends over time.