Seizures as a complication of recreational drug use: Analysis of the Euro-DEN Plus data-set

Wolfe, Caitlin E.; Wood, David M.; Dines, Alison; Whatley, Benjamin P.; Yates, Christopher; Heyerdahl, Fridtjof; Hovda, Knut Erik; Giraudon, Isabelle; Dargan, Paul; Anseeuw, Kurt; Badaras, Robertas; Bonnici, Jeffrey; Brvar, Miran; Caganova, Blazena; Ceschi, Alessandro; Eyer, Florian; Galicia, Miguel; Geith, Stefanie; Gillebeert, Johan; Grenc, Damjan; Gorozia, Ketevan; Jaffal, Karim; Jurgens, Gesche; Kabata, Piotr Maciej; Kennedy, Iarlaith; Konstari, Jutta; Kutubidze, Soso; Laubner, Gabija; Liakoni, Evangelia; Liechti, Matthias E.; Lyphout, Cathelijne; Megarbane, Bruno; Miro, Oscar; Moughty, Adrian; Muller, Laura; O'Connor, Niall; Paasma, Raido; Perez, Juan Ortega; Perminas, Marius; Persett, Per Sverre; Pold, Kristiina; Puiguriguer, Jordi; Radenkova-Saeva, Julia; Rulisek, Jan; Schmid, Yasmin; Scholz, Irene; Sopirala, Radhika; Surkus, Jonas; Toth, Ibolya; Vallersnes, Odd Martin; Vigorita, Federico; Waldman, Wojciech; Waring, W. Stephen; Zacharov, Sergej     «

Wolfe, Caitlin E.; Wood, David M.; Dines, Alison; Whatley, Benjamin P.; Yates, Christopher; Heyerdahl, Fridtjof; Hovda, Knut Erik; Giraudon, Isabelle; Dargan, Paul; Anseeuw, Kurt; Badaras, Robertas; Bonnici, Jeffrey; Brvar, Miran; Caganova, Blazena; Ceschi, Alessandro; Eyer, Florian; Galicia, Miguel; Geith, Stefanie; Gillebeert, Johan; Grenc, Damjan; Gorozia, Ketevan; Jaffal, Karim; Jurgens, Gesche; Kabata, Piotr Maciej; Kennedy, Iarlaith; Konstari, Jutta; Kutubidze, Soso; Laubner, Gabija; Liako...     »

Seizures are a recognized and potentially serious complication of recreational drug use. This study examined a large international data set of presentations to Emergency Departments with acute recreational drug toxicity, the European Drug Emergencies Plus (Euro-DEN Plus) Network, to compare presentations with and without seizures and estimate incidence and associated drugs. Amongst 23,947 presentations between January 2014 and December 2017, there were 1013 (4.2%) with reported seizures. Clinical and demographic features were similar between individuals who had a seizure and those who did not, although rates of coma, cardiac arrest, intubation, intensive care admission, and death were significantly higher in those with seizures. There was a significant association between specific drugs and a higher seizure incidence, including fentanyl (odds ratio 2.63, 95% confidence interval 1.20-5.80), and synthetic cannabinoids (OR 2.90, 95% CI 2.19-3,84). Other drugs were associated with a lower seizure incidence, including heroin (OR 0.46, 95% CI 0.35-0.61), clonazepam (OR 0.22, 95% CI 0.06-0.91), and cannabis (OR 0.65, 95% CI 0.50-0.86). This substantiates observations that the synthetic cannabinoids as a group of novel psychoactive substances are clinically different in consequence of intoxication than cannabis, and that individuals who suffer a seizure in the context of recreational drug intoxication are likely to have worse outcomes overall. Utilising this information of what substances have a greater risk of seizures, could provide tailored harm reduction and education strategies to users to reduce the risk of seizures and their associated complications.     «

Seizures are a recognized and potentially serious complication of recreational drug use. This study examined a large international data set of presentations to Emergency Departments with acute recreational drug toxicity, the European Drug Emergencies Plus (Euro-DEN Plus) Network, to compare presentations with and without seizures and estimate incidence and associated drugs. Amongst 23,947 presentations between January 2014 and December 2017, there were 1013 (4.2%) with reported seizures. Clinica...     »