Shane Darke1, Johan Duflou2, Amy Peacock3, Michael Farrell3, Julia Lappin4. 1. National Drug and Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia; School of Psychology, University of Wollongong, Northfields Ave Wollongong, NSW, 2522, Australia. Electronic address: s.darke@unsw.edu.au. 2. National Drug and Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia; Sydney Medical School, University of Sydney, NSW, 2006, Australia; School of Psychology, University of Wollongong, Northfields Ave Wollongong, NSW, 2522, Australia. 3. National Drug and Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia; School of Psychology, University of Wollongong, Northfields Ave Wollongong, NSW, 2522, Australia. 4. National Drug and Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia; School of Psychiatry, University of New South Wales, NSW, 2052, Australia; School of Psychology, University of Wollongong, Northfields Ave Wollongong, NSW, 2522, Australia.
Abstract
BACKGROUND: New psychoactive stimulants and hallucinogens comprise a range of "designer drugs" that have risen to prominence in the 21st century. The study aimed to: 1. Determine the characteristics, and circumstances of death, of all recorded cases of new psychoactive stimulant and hallucinogen-related death in Australia; 2. Determine the toxicology of such deaths; and 3. Determine the major organ pathology of cases. METHODS: All cases in which new psychoactive stimulants were a mechanism contributory to death were retrieved from the National Coronial Information System (2000-2017). Information was collected on cause of death, demographics, drug use history, circumstances of death, toxicology and major organ pathology. RESULTS: 82 cases were identified. The mean age was 30.7yrs and 86.6% were male. Circumstances of death were: accidental drug toxicity (59.8%), traumatic accident (15.9%), suicide (12.2%) and natural disease (2.4%). The most common clinical presentation observed proximal to death was delirium (26.8%). Delirium was mostly frequently observed after phenethylamine consumption (72.2%). The most common cardiovascular diagnosis at autopsy was replacement fibrosis, indicative of previous ischemia (10.5%). New psychoactive stimulants and hallucinogens detected in toxicology were: cathinones (75.7%), phenethylamines (22.0%) and piperazines (6.1%). Other substances were present in 83.5% of cases, most commonly established controlled psychostimulants (58.2%). CONCLUSIONS: Acute toxicity was the most common cause of death, but more than a third of deaths were due to trauma. Cathinones were the most commonly detected of the new psychoactive stimulants and hallucinogens. Delirium was the most frequently reported clinical sign proximal to death and was strongly associated with the phenethylamines.
BACKGROUND: New psychoactive stimulants and hallucinogens comprise a range of "designer drugs" that have risen to prominence in the 21st century. The study aimed to: 1. Determine the characteristics, and circumstances of death, of all recorded cases of new psychoactive stimulant and hallucinogen-related death in Australia; 2. Determine the toxicology of such deaths; and 3. Determine the major organ pathology of cases. METHODS: All cases in which new psychoactive stimulants were a mechanism contributory to death were retrieved from the National Coronial Information System (2000-2017). Information was collected on cause of death, demographics, drug use history, circumstances of death, toxicology and major organ pathology. RESULTS: 82 cases were identified. The mean age was 30.7yrs and 86.6% were male. Circumstances of death were: accidental drug toxicity (59.8%), traumatic accident (15.9%), suicide (12.2%) and natural disease (2.4%). The most common clinical presentation observed proximal to death was delirium (26.8%). Delirium was mostly frequently observed after phenethylamine consumption (72.2%). The most common cardiovascular diagnosis at autopsy was replacement fibrosis, indicative of previous ischemia (10.5%). New psychoactive stimulants and hallucinogens detected in toxicology were: cathinones (75.7%), phenethylamines (22.0%) and piperazines (6.1%). Other substances were present in 83.5% of cases, most commonly established controlled psychostimulants (58.2%). CONCLUSIONS: Acute toxicity was the most common cause of death, but more than a third of deaths were due to trauma. Cathinones were the most commonly detected of the new psychoactive stimulants and hallucinogens. Delirium was the most frequently reported clinical sign proximal to death and was strongly associated with the phenethylamines.
Authors: Sarah Konefal; Adam Sherk; Bridget Maloney-Hall; Matthew Young; Pam Kent; Emily Biggar Journal: BMC Public Health Date: 2022-02-10 Impact factor: 3.295
Authors: Ana Y Simão; Mónica Antunes; Emanuel Cabral; Patrik Oliveira; Luana M Rosendo; Ana Teresa Brinca; Estefânia Alves; Hernâni Marques; Tiago Rosado; Luís A Passarinha; Maristela Andraus; Mário Barroso; Eugenia Gallardo Journal: Int J Environ Res Public Health Date: 2022-04-17 Impact factor: 4.614