A multicenter retrospective survey of poisoning after consumption of products containing novel psychoactive substances from 2013 to 2014 in Japan.
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.
a Emergency Medical Center and Poison Center , Saitama Medical University Hospital , Moroyama, Iruma-gun , Saitama , Japan.
Yoshito
Y
Kamijo
a Emergency Medical Center and Poison Center , Saitama Medical University Hospital , Moroyama, Iruma-gun , Saitama , Japan.
Michiko
M
Takai
b Poisoning and Drug Laboratory Division, Critical Care and Emergency Center , Iwate Medical University Hospital , Morioka , Iwate , Japan.
Yuji
Y
Fujita
c Department of Emergency Medicine, School of Medicine , Teikyo University , Itabashi-ku , Tokyo , Japan.
Tetsuya
T
Sakamoto
D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data / Q000639:trends; D000328:Adult; D004632:Emergency Medical Services / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning*; D007564:Japan / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D013406:Suicide, Attempted / Q000706:statistics & numerical data / Q000639:trends; D014754:Violence / Q000706:statistics & numerical data / Q000639:trends; D055815:Young Adult
D013287:Illicit Drugs
Acute kidney injury; liver injury; rhabdomyolysis; synthetic cannabinoid; synthetic cathinone