Kamijo Yoshito, Takai Michiko, Fujita Yuji, Sakamoto Tetsuya
a Emergency Medical Center and Poison Center , Saitama Medical University Hospital , Moroyama, Iruma-gun , Saitama , Japan.
b Poisoning and Drug Laboratory Division, Critical Care and Emergency Center , Iwate Medical University Hospital , Morioka , Iwate , Japan.
Am J Drug Alcohol Abuse. 2016 Sep;42(5):513-519. doi: 10.1080/00952990.2016.1176177. Epub 2016 Jun 17.
In Japan, fatalities among patients who experienced an acute reaction following self-administration of novel psychoactive substances (NPS) have been more frequently reported since June 2014.
This survey aimed to document and analyze trends in NPS consumption in emergency patients.
We conducted a multicenter retrospective survey of patients who were transported to emergency facilities after consuming NPS-containing products between January 2013 and December 2014. Letters requesting participation were sent to 467 emergency facilities, and questionnaires were mailed to facilities that agreed to participate.
We surveyed 589 patients from 85 (18.2%) facilities. Most patients were male (89.6%) and young (median age, 30 years), and inhaled (88%) NPS contained in herbal products (80.5%). Harmful behavior was observed at the scene of acute reaction, including violence (6.9%), traffic accidents (4.9%), and self-injury or suicidal attempts (1.1%). Other than neuropsychiatric and physical symptoms, many patients also had physical complications such as rhabdomyolysis (17.5%), liver injury (12.4%), acute kidney injury (9%), and physical injury (1.9%). Of the 256 patients (43.5%) admitted to hospitals, 35 (5.9%) were hospitalized for seven or more days. Most patients (93.2%) completely recovered, although a few (1.4%) died. However, synthetic cannabinoids and synthetic cathinones were only detected in the blood of five patients.
Consumption of NPS-containing products have been associated with harmful behaviors such as violence and traffic accidents, physical complications (e.g., rhabdomyolysis, liver injury), death, or physical and neuropsychiatric symptoms. Compared to a previous survey (2006-2012), the present survey revealed more severe toxicity.
自2014年6月以来，日本因自行服用新型精神活性物质（NPS）后出现急性反应而导致患者死亡的报告更为频繁。
本调查旨在记录和分析急诊患者中NPS消费的趋势。
我们对2013年1月至2014年12月期间服用含NPS产品后被送往急诊设施的患者进行了多中心回顾性调查。向467家急诊设施发送了参与请求信，并向同意参与的设施邮寄了问卷。
我们调查了来自85家（18.2%）设施的589名患者。大多数患者为男性（89.6%）且年轻（中位年龄30岁），吸入（88%）草药产品中含有的NPS（80.5%）。在急性反应现场观察到有害行为，包括暴力行为（6.9%）、交通事故（4.9%）以及自我伤害或自杀企图（1.1%）。除神经精神和身体症状外，许多患者还出现了身体并发症，如横纹肌溶解（17.5%）、肝损伤（12.4%）、急性肾损伤（9%）和身体损伤（1.9%）。在256名（43.5%）入院患者中，35名（5.9%）住院7天或更长时间。大多数患者（93.2%）完全康复，尽管有少数（1.4%）死亡。然而，仅在5名患者的血液中检测到合成大麻素和合成卡西酮。
服用含NPS产品与暴力和交通事故等有害行为、身体并发症（如横纹肌溶解、肝损伤）、死亡或身体及神经精神症状有关。与之前的调查（2006 - 2012年）相比，本次调查显示毒性更为严重。
