Legal highs toxicity--symptomatology and clinical diagnosis in case series.

Legal highs offered by online shops and smart shops are blends of natural substances and synthetic additives which have an actual or perceived psychoactive effect which stimulates central nervous system, are supposed to improve mood and alter the perception of reality. Advertisements of these substances tempt potential buyers with a promise of a legal narcotic high, because these substances are not included on the lists of controlled substances. Easy access and the sense of safety make these products the reason of acute toxicity. This article presents the symptomatology of acute legal high toxicity based on the symptoms observed in patients hospitalized at the Department of Toxicology and Internal Diseases in Poznań. Most of the symptoms concerned the central nervous system (mental confusion, hallucinations, agitation, anxiety, phobias, logorrhea, weakness, dizziness and somnolence) and the circulatory system (hypertension, tachycardia, chest pain) and dilated pupils. This article also points out to diagnostic difficulties in cases of acute legal highs toxicity. In none of the cases described was it possible to prove the toxicity by the positive results of toxicological tests, because the methods used in regular clinical practice to test the presence of psychoactive substances do not detect legal highs.