Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland / Institute of Pharmacology, University of Bern, Switzerland.
Division of Clinical Pharmacology and Toxicology, University Hospital and University of Basel, Switzerland.
Swiss Med Wkly. 2019 Jul 24;149:w20056. doi: 10.4414/smw.2019.20056. eCollection 2019 Jul 15.
To analyse emergency department (ED) presentations related to acute medical problems after recreational use of prescription/over-the-counter (OTC) drugs in two major Swiss hospitals in order to identify the prevalence of specific drugs, vulnerable groups, time trends and local differences which could have major public health implications.
Retrospective analysis of cases presenting with signs/symptoms consistent with acute toxicity due to recreational use of prescription/OTC drugs from May 2012 to August 2017 at the ED of the University Hospital of Bern and from October 2013 to July 2017 at the ED of the University Hospital Basel. We investigated time trends, sex differences, patient characteristics and consumption patterns within three age groups (≥16 to <36 years; ≥36 to <56 years; ≥56 years).
During the study period, 344 cases were included out of 1715 ED attendances due to acute drug toxicity and a total of 412,557 ED presentations. The use of prescription drugs in conjunction with illegal drugs was reported in nearly half the cases. The most frequently reported prescription drugs were benzodiazepines (64%, n = 220) and methadone (13%, n = 45). Forty-eight percent (n = 166) of all presentations occurred within the youngest age group. The analysis of time trends showed a significant increase in presentations in the youngest and the oldest groups in Basel (both p <0.05), while the trend remained stable over time in Bern for all age groups. While the number of presentations remained constant over time for men and women in Bern, a significant increase was found for the female cohort in Basel (p <0.05). Patients in all age groups presented with toxicities of predominantly minor severity.
The prescription/OTC drugs most frequently leading to ED presentations after recreational use were sedative substances. A large proportion of the patients belonged to the youngest age group. A significant increase in presentations was seen in the youngest and oldest age groups and within women in Basel. This information can be used to inform health care providers so that they can adapt their prevention and treatment strategies in their communities.
分析在瑞士两家大医院的急诊科（ED）因娱乐性使用处方/非处方（OTC）药物而出现的急性医学问题就诊情况，以确定特定药物的流行率、弱势群体、时间趋势和当地差异，这些因素可能具有重大公共卫生意义。
对 2012 年 5 月至 2017 年 8 月在伯尔尼大学医院 ED 和 2013 年 10 月至 2017 年 7 月在巴塞尔大学医院 ED 因娱乐性使用处方/OTC 药物而出现与急性中毒一致的体征/症状的病例进行回顾性分析。我们调查了时间趋势、性别差异、患者特征和三个年龄组（≥16 至 <36 岁；≥36 至 <56 岁；≥56 岁）内的消费模式。
在研究期间，在 1715 例因急性药物毒性就诊的 ED 患者中，共有 344 例被纳入研究，共有 412557 例 ED 就诊。近一半的病例报告同时使用了处方药物和非法药物。报告的最常见处方药物是苯二氮䓬类（64%，n=220）和美沙酮（13%，n=45）。所有就诊中，48%（n=166）发生在年龄最小的组。时间趋势分析显示，巴塞尔最年轻和最年长组的就诊人数显著增加（均 p <0.05），而伯尔尼所有年龄组的趋势在研究期间保持稳定。在伯尔尼，男性和女性的就诊人数随时间保持不变，但在巴塞尔，女性就诊人数显著增加（p <0.05）。所有年龄组的患者均表现出毒性程度主要为轻度。
娱乐性使用后导致 ED 就诊的处方/OTC 药物主要为镇静药物。大多数患者属于最年轻的年龄组。巴塞尔最年轻和最年长年龄组以及女性组的就诊人数显著增加。这些信息可以用于告知医疗保健提供者，以便他们能够调整其在社区中的预防和治疗策略。
