Acute cocaine-related health problems in patients presenting to an urban emergency department in Switzerland: a case series

BMC Research Notes

Matthias E Liechti¹  Marcel Bruggisser¹  Evangelia Liakoni¹  Florian Enzler¹  Michael Bodmer² 

[1] Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland;Department of Internal Medicine, University Hospital Bern, Bern, Switzerland

关键词: Intoxication;    Drug abuse;    Cocaine;   

Others  :  1134173
DOI  :  10.1186/1756-0500-7-173

 received in 2013-12-18, accepted in 2014-03-20,  发布年份 2014

【 摘 要 】

Background

Emergency departments may be a useful information source to describe the demographics and clinical characteristics of patients with acute cocaine-related medical problems. We therefore conducted a retrospective analysis of 165 acute, laboratory-confirmed cocaine intoxications admitted to an urban emergency department in Switzerland between January 2007 and March 2011.

Results

A total of 165 patients with a mean age of 32 years were included. Most patients were male (73%) and unemployed (65%). Only a minority (16%) had abused cocaine alone while 84% of the patients had used at least one additional substance, most commonly ethanol (41%), opioids (38%), or cannabis (36%) as confirmed by their detection in blood samples. The most frequently reported symptoms were chest pain (21%), palpitations (19%), anxiety (36%) and restlessness (36%). Psychiatric symptoms were present in 64%. Hypertension and tachycardia were observed in 53% and 44% of the patients, respectively. Severe poisonings only occurred in patients with multiple substance intoxication (15%). Severe intoxications were non-significantly more frequent with injected drug use compared to nasal, oral, or inhalational drug use. Severe complications included acute myocardial infarction (2 cases), stroke (one case), and seizures (3 cases). Most patients (75%) were discharged home within 24 h after admission. A psychiatric evaluation in the ED was performed in 24% of the patients and 19% were referred to a psychiatric clinic.

Conclusions

Patients with acute cocaine intoxication often used cocaine together with ethanol and opioids and presented with sympathomimetic toxicity and/or psychiatric disorders. Severe acute toxicity was more frequent with multiple substance use. Toxicity was typically short-lasting but psychiatric evaluation and referral was often needed.

【 授权许可】

   
2014 Bodmer et al.; licensee BioMed Central Ltd.

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