Summary

Amphetamine and methamphetamine poisonings attended in hospital emergency departments: clinical features and the usefulness of laboratory confirmation

Roset Ferrer C, Gomila Muñiz I, Elorza Guerrero MA, Puiguriguer Ferrado J, Leciñena Estean MA, Tuero León G, Sahuquillo Frías L, Ripoll Vera T, Socias Crespi L, Sanchís Cortés P, Barceló Martín B

Affiliation of the authors

Servicio de Psiquiatría, Hospital Universitari Son Espases, Palma de Mallorca, Spain. Servicio de Análisis Clínicos, Hospital Universitari Son Llàtzer, Palma de Mallorca, Spain. Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, Spain. Servicio de Análisis Clínicos, Unidad de Toxicología Clínica, Hospital Universitari Son Espases, Palma de Mallorca, Spain. Servicio de Urgencias, Unidad de Toxicología Clínica, Hospital Universitari Son Espases, Palma de Mallorca, Spain. Servicio de Urgencias, Hospital Can Misses, Ibiza, Spain. Servicio de Medicina Intensiva, Hospital Can Misses, Ibiza, Spain. Servicio de Análisis Clínicos, Hospital Can Misses, Ibiza, Spain. Servicio de Cardiología, Hospital Universitari Son Llàtzer, Palma de Mallorca, Spain. Servicio de Medicina Intensiva, Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain. Departamento de Química, Universidad de las Islas Baleares, Palma de Mallorca, Spain.

DOI

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Roset Ferrer C, Gomila Muñiz I, Elorza Guerrero MA, Puiguriguer Ferrado J, Leciñena Estean MA, Tuero León G, et al. Amphetamine and methamphetamine poisonings attended in hospital emergency departments: clinical features and the usefulness of laboratory confirmation. Emergencias. 2020;32:26-32

Summary

Objective.

To determine whether clinical and toxicologic findings differed between cases of amphetamine (AMP) and methamphetamine (mAMP) poisoning attended in 2 Balearic Island hospital emergency departments.

Methods.

Retrospective observational study of AMP and mAMP cases with laboratory confirmation between 2013 and 2018. We compared clinical and toxicologic variables as well as clinical management between groups.

Results.

1) A total of 120 cases were found: 86 (71.7%) with AMP poisoning and 34 (28.3%) with mAMP poisoning. 2) Drug poisoning was confirmed by gas chromatography associated with mass spectrometry (GC–MS) in 787 urine samples found to be positive during screening. One hundred fifty-four (19.6%) were confirmed by GC–MS. Thirtyfour of them did not meet the inclusion criteria. 3) Significant differences between AMP and mAMP cases were found for age (32.3 vs 28.4 y, respectively); sex (72.1% vs 94.1% men); and Spanish nationality (64.0% vs 29.4%). Reasons for admission and clinical features also differed: the reasons were aberrant behavior (15.1% in the AMP group vs 0% in the mAMP group) and palpitations (1.2% vs 20.6%); agitation was observed in 27.9% and 8.8%, respectively. Clinical management was similar in the 2 groups. Multiple drug poisoning was detected in 76.6% patients and was more common in patients in the AMP group (82.6% vs 61.8%). The additional drugs in these cases were mainly cocaine (63.0%), cannabis (48.9%), 3,4-methylenedioxy-N-methamphetamine (MDMA) (38.0%), and alcohol (35.9%). Cannabis was detected in a significantly higher proportion in the AMP group (45.3%) than in the mAMP group (17.6%). False positives were found in 78.7% of the samples. The culprit drug was most often MDMA (71.2%).

Conclusions.

AMP poisonings were associated with age over 30 years, Spanish nationality, aberrant behavior, agitation, multiple drug findings, and the use of cannabis. Poisonings caused by mAMP abuse were associated with age under 30 years, non-Spanish nationality, palpitations, and single-drug use.

 

More articles by the authors

Barceló Martín B, Elorza Guerrero MA, Gomila Muñiz I, Leciñena Estean MA, Puiguriguer Ferrado J, Ripoll Vera T, Roset Ferrer C, Sahuquillo Frías L, Sanchís Cortés P, Socias Crespi L, Tuero León G

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