ArticleCJEM2026
Comprehensive toxicology testing and clinical outcomes of ED patients with unregulated drug poisoning.
Article in CJEM, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesUnregulated drugs place a significant burden on individuals and the healthcare system, yet relatively little is known about the mix of substances implicated in the current polydrug crisis and their clinical effects. The current study aims to describe the toxicology and clinical outcomes of unregulated drug poisoning.
methodsWe conducted a cross-sectional study at a tertiary hospital in Vancouver, British Columbia. Eligible patients were those presenting to the emergency department (ED) with suspected unregulated drug overdose and residual blood samples available for analysis. Chart review was performed to extract relevant clinical data, and liquid chromatography-tandem quadruple mass spectrometry was applied to blood samples to detect a broad panel of substances beyond routine ED toxicology screens.
resultsFrom 148 eligible patients, we randomly selected 69 for toxicology testing (mean age 43 years; 74% male). Amphetamines (94%), fentanyl or analogues (67%), and unregulated benzodiazepines (64%) were most prevalent. Polysubstance exposure was nearly universal, with 91% positive for three or more drug classes, 83% for four or more, and nearly half (49%) for six or more concurrently. Clinical interventions were frequent, with naloxone administered to 59% of patients, 25% requiring-assisted ventilation (including two who required intubation). Twenty-eight percent of patients were admitted to hospital, with 4% admitted to intensive care. Complications included loss of consciousness (55%), hypoxia (22%), seizures (9%), severe agitation (6%) and rhabdomyolysis (3%).
conclusionUnregulated drug poisoning in Vancouver, British Columbia was characterized by polysubstance exposure and frequent complications. Detailed toxicological analysis revealed high rates of unregulated benzodiazepines and stimulant co-detection with opioids, underscoring risks beyond opioid toxicity alone. Clinicians should be aware that unregulated drug poisoning involves multiple substances and may therefore have atypical presentations and/or incomplete response to standard therapy.
Indexed as
Identifiers
41913038What OpenQuestion holds
Registered trials
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.