Patterns of Polydrug Use in Patients Presenting at the Emergency Department with Acute Intoxication

Abstract

Studies analyzing the prevalence of associated substance use are limited. Currently, the World Health Organization (WHO) defines polydrug use as the concurrent (simultaneous use) or sequential (use of one drug followed by another) abuse of more than one drug or type of drug, with dependence on at least one. Associated drug consumption can exacerbate the adverse effects and complicate the clinical management of patients. This study aimed to investigate the prevalence of polydrug use, excluding tobacco, in patients presenting with acute intoxication in the Emergency Department (ED) of the Clinical University Hospital Virgen de la Arrixaca (Murcia, Spain) in the year 2023. To this end, a retrospective analysis of 2562 patients was conducted, examining demographic variables, substance use patterns, reasons for presenting to the ED, and the substances consumed by each patient. The study reveals an average patient age of 41 ± 0.5 (SD = 11.96) composed of predominantly male patients (74.4%). A high prevalence of benzodiazepines and cocaine use, often in combination, was observed. The main reasons for attendance included symptoms such as palpitations, dyspnea, vomiting, diarrhea, behavioral disturbances, and self-harm. Only 25.5% of patients admitted to consuming all substances detected in their analyses. Polydrug use is frequent in our environment, which can lead to added complexity in diagnosis and treatment. Consumption patterns show a profile strongly related to the age of the subject. Among the youngest subjects, tetrahydrocannabinol (THC) and benzodiazepines predominate, whilst among older subjects, alcohol and benzodiazepines, and sometimes cocaine, predominate. This study highlights the need to design specific intervention and prevention strategies to address patterns of substance abuse, the importance of family and community support, and the need to tackle challenges in identifying and treating cases of polysubstance abuse. Moreover, cooperation between the healthcare system and law enforcement is also important to obtain up-to-date knowledge of new drugs and their consumption patterns in an emergency context.