Wilkes Rachael, Roberts Darren M, Liknaitzky Paul, Brett Jonathan
Emergency Department, St. Vincent's Hospital, Sydney, Australia.
Edith Collins Centre, Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia.
Clin Toxicol (Phila). 2024 Apr;62(4):242-247. doi: 10.1080/15563650.2024.2346612. Epub 2024 May 16.
The global use of certain classical psychedelics has increased in recent years, but little is known about their spectrum of toxicity within Australia. We aim to describe calls to New South Wales Poisons Information Centre relating to exposures to classical psychedelics including lysergic acid diethylamide, psilocybin, N,N-dimethyltryptamine, ayahuasca, mescaline and ibogaine.
This is a retrospective observational study of calls to New South Wales Poisons Information Centre between January 2014 and December 2022. We identified exposures to classical psychedelics within New South Wales Poisons Information Centre database and measured the annual number of exposures, source of call (hospital, health care worker, member of the public), co-ingested substances, clinical features and advice given.
There were 737 calls related to relevant psychedelic exposures; 352 (47.8 per cent) to lysergic acid diethylamide, 347 (47.0 per cent) to psilocybin, 28 (3.8 per cent) to N,N-dimethyltryptamine, 4 (0.5 per cent) to ayahuasca, 4 (0.5 per cent) to mescaline and 2 (0.3 per cent) to ibogaine. Cases were predominantly male (77.2 per cent) and aged between 20 and 74 years (65.6 per cent). Psychedelic calls more than doubled from 45 in 2014 to 105 in 2022 and 625 (85 per cent) of all calls were either from or referred to hospital. Co-ingestion of psychedelics with another substance occurred in 249 (33.8 per cent) of calls and the most frequent clinical features related to single substance psychedelic exposures were hallucinations (27.6 per cent), gastrointestinal symptoms (21.7 per cent) and tachycardia (18.1 per cent). Seizures occurred in 2.9 per cent of single substance psychedelic exposures.
Increasing incidence of psychedelic exposure calls, including those reporting significant toxicity, likely reflects increasing community use. This may in part be driven by increasing interest in psychedelic assisted psychotherapy trials subsequently increasing public awareness.
Relatively high poisoning severity contrasts with safety within clinical trials of psychedelic assisted psychotherapy that may relate to the uncontrolled nature of community use which is mitigated within clinical trial environments. Education about safe use may be useful.
近年来，某些经典迷幻剂在全球的使用有所增加，但在澳大利亚，人们对其毒性范围知之甚少。我们旨在描述新南威尔士州毒物信息中心接到的与接触经典迷幻剂相关的电话，这些迷幻剂包括麦角酸二乙酰胺、裸盖菇素、N,N-二甲基色胺、死藤水、三甲氧苯乙胺和伊博格碱。
这是一项对2014年1月至2022年12月期间新南威尔士州毒物信息中心接到的电话进行的回顾性观察研究。我们在新南威尔士州毒物信息中心数据库中识别出接触经典迷幻剂的情况，并统计了每年的接触次数、来电来源（医院、医护人员、公众）、同时摄入的物质、临床特征以及给出的建议。
共有737个与相关迷幻剂接触有关的电话；352个（47.8%）与麦角酸二乙酰胺有关，347个（47.0%）与裸盖菇素有关，28个（3.8%）与N,N-二甲基色胺有关，4个（0.5%）与死藤水有关，4个（0.5%）与三甲氧苯乙胺有关，2个（0.3%）与伊博格碱有关。病例主要为男性（77.2%），年龄在20至74岁之间（65.6%）。与迷幻剂相关的来电从2014年的45个增加到2022年的105个，增加了一倍多，所有来电中有625个（85%）要么来自医院，要么被转介到医院。249个（33.8%）来电中迷幻剂与另一种物质同时摄入，单一物质迷幻剂接触最常见的临床特征是幻觉（27.6%）、胃肠道症状（21.7%）和心动过速（18.1%）。单一物质迷幻剂接触中有2.9%发生了癫痫发作。
包括报告有显著毒性的来电在内，迷幻剂接触来电的发生率不断上升，这可能反映出社区使用的增加。这可能部分是由于对迷幻剂辅助心理治疗试验的兴趣增加，随后公众意识也有所提高。
相对较高的中毒严重程度与迷幻剂辅助心理治疗试验中的安全性形成对比，这可能与社区使用的不受控制性质有关，而在临床试验环境中这种情况会得到缓解。关于安全使用的教育可能会有所帮助。
