Evidence map›Paper›PMID 39663285›Full record

ArticleJournal of medical toxicology : official journal of the American College of Medical Toxicology2025

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

Caitlin E Wolfe, Lachlan J Sund, John Rh Archer, Ashley Rowe, Simon Hudson, David M Wood, Paul I Dargan

Abstract readComparative Study
In one paragraph

Article in Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Caitlin E WolfeAtlantic Canada Poison Centre, Nova Scotia, Canada.
Lachlan J SundEmergency Medicine, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK. lachlan.sund@gstt.nhs.uk.ORCID 0000-0002-3042-1119
John Rh ArcherClinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.
Ashley RoweHealth Canada, Ottawa, Canada.
Simon HudsonSport and Specialised Analytical Services, LGC Assure Ltd, Fordham, UK.
David M WoodClinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.
Paul I DarganClinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNovel 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.

methodsWe 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).

resultsTwenty-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 < 0.01) and opioids (57%,24% p < 0.01) were detected significantly more frequently in 2019/20 than in 2016/17, while alcohol (22%,49% p < 0.01), cathinones (1%,15% p < 0.01), GHB (14%,20% p < 0.01) and MDMA (9%,18% p < 0.01) were detected less frequently.

conclusionsStudies that utilise confirmatory testing to detect NPS in presentations of ARDT provide important information for public health interventions. More NPS benzodiazepines and fewer NPS cathinones were detected in 2019/20, following temporal trends of forensic detection throughout Europe and reinforcing the importance of identifying emerging drugs.

Indexed as

Hospitals, UrbanIllicit DrugsPsychotropic DrugsSubstance Abuse DetectionAdultFemaleHumansLondonMaleMiddle AgedProspective StudiesRecreational Drug UseSubstance-Related DisordersYoung AdultIllicit DrugsPsychotropic DrugsLegal highsNovel psychoactive substancesNPSRecreational drugs

Identifiers

PMID39663285
PMCPMC11707132

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.