UK trends in toxicity relating to drugs of misuse from National Poisons Information Service data

Objective: Toxicity relating to drugs of misuse is a common reason for presentation to hospital. Health professionals are likely to seek advice about management from a poisons centre, especially when they are unfamiliar with the agent involved or toxicity is severe. Poisons centre data may therefore be useful in tracking acute harms relating to drugs of misuse. This study was therefore performed to examine trends in NPIS enquiries for drugs of misuse and compare this with other sources. Methods: National study of telephone enquiries (2002–2009) and TOXBASE® accesses (2000–2009) relating to drugs of misuse. Since total TOXBASE® accesses have increased substantially and telephone enquiries have decreased for all products over the course of the study, data are presented as percentages of overall telephone or TOXBASE® activity for each year studied. Results: Ecstasy was the most common drug of misuse accessed on TOXBASE® or subject to a telephone enquiry during the study, but the proportion of activity relating to this drug declined for both telephone enquiries (2002 0.85%, 2008/9 0.38%) and TOXBASE® accesses (2000 1.36%, 2008/9 0.72%). In contrast, over the same time periods the proportion of telephone (0.37% to 0.59%) and TOXBASE® activity (0.28% to 0.71%) relating to cocaine has increased markedly. Cocaine is now the most common drug of misuse involved in telephone enquiries and the second most commonly accessed from TOXBASE®. Although less commonly encountered, increases in the proportion of telephone and TOXBASE® activity have also been observed for methamphetamine (telephone 0.002% to 0.025%; TOXBASE®, 0.008% to 0.025%) and benzylpiperazine (telephone 0% to 0.056%; TOXBASE®, 0.002% [for 2005/6, the first year that information was available for access] to 0.56% in 2008/9). Conclusion: Increases in the proportion of NPIS activity relating to cocaine are consistent with national statistics and other studies¹ reporting increased prevalence of use, arrests, drug seizures and deaths relating to the drug. NPIS data appear useful for following trends in toxicity relating to drugs of misuse. Reference: 1. Schifano F, Corkery J. Cocaine/crack cocaine consumption, treatment demand, seizures, related offences, prices, average purity levels and deaths in the UK 1990–2004. J Psychopharmacol 2008; 22:71–9.