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Clinical Toxicology Volume 60, 2022 - Issue 8
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Clinical Research

Comparison of clinical characteristics between meth/amphetamine and synthetic cathinone users presented to the emergency department

Te-I Wenga Department of Emergency Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan;b Forensic and Clinical Toxicology Center, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan;c Department of Forensic Medicine, College of Medicine, National Taiwan University, Taipei, TaiwanView further author information
,
Hsien-Yi Chend Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan;e College of Medicine, Chang Gung University, Taoyuan, TaiwanORCID Iconhttps://orcid.org/0000-0001-9353-026XView further author information
ORCID Icon,
Lengsu W. Chinf Department of Emergency Medicine, Da Chien General Hospital, Miaoli, TaiwanView further author information
,
Hsin-Hui Choug Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, TaiwanView further author information
,
Meng-Huan Wue College of Medicine, Chang Gung University, Taoyuan, Taiwan;h Department of Emergency Medicine, Chang Gung Memorial Hospital, Kaohsiung, TaiwanView further author information
,
Guan-yuan Chenb Forensic and Clinical Toxicology Center, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan;c Department of Forensic Medicine, College of Medicine, National Taiwan University, Taipei, TaiwanView further author information
,
Ju-Yu Chenb Forensic and Clinical Toxicology Center, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan;c Department of Forensic Medicine, College of Medicine, National Taiwan University, Taipei, TaiwanView further author information
,
Chia-Pang Shihi Department of Nursing, Yuanpei University of Medical Technology, Hsin-Chu, TaiwanView further author information
,
Chih-Chuan Lind Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan;e College of Medicine, Chang Gung University, Taoyuan, TaiwanCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-9613-115XView further author information
ORCID Icon &
Cheng-Chung Fanga Department of Emergency Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan;b Forensic and Clinical Toxicology Center, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, TaiwanCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-5386-6674View further author information
ORCID Icon show all
Pages 926-932 | Received 22 Jan 2022, Accepted 31 Mar 2022, Published online: 19 Apr 2022
 
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Abstract

Background

Synthetic cathinones (SC) are popular new psychoactive substances that produce sympathomimetic toxicity. Meth/amphetamine and SC have similar chemical structures and pharmacological effects. We aimed to compare the clinical characteristics between meth/amphetamine and SC users presenting to the emergency department (ED).

Methods

This retrospective observational cohort study included patients who presented to six EDs from May 2017 to April 2021 with symptoms that related to recreational drug use and whose urine toxicology tests were positive only for meth/amphetamine or SC through liquid chromatography-tandem mass spectrometry.

Results

There were 379 patients who tested positive only for meth/amphetamine (MA group), and 87 patients tested positive only for SC (SC groups). Patients in the MA group were older than those in the SC group (median (IQR); MA: 37.0 (30–43.7), SC: 25.0 (21.0–32.7), p < 0.001). There were no significant between-group differences in the sex distribution and initial chief complaints. Compared with the MA group, the SC group had more cases of tachycardia (≥ 135/min; MA: 29 (8.2%), SC:16 (19.0%), p = 0.0031) and hyperthermia (≥ 38 °C; MA: 31 (8.2%), SC:18 (20.7%), p = 0.001). Besides, the SC group had significantly higher levels of creatinine kinase (CK, IU/L; MA: 263 (115–601), SC: 497 (206–9216), p = 0.008) as well as a higher risk of rhabdomyolysis (CK > 1000; MA:32 (8.4%), SC: 16 (18.4%), p = 0.006) and severe rhabdomyolysis (CK > 10,000; MA:10 (2.6%), SC:10 (11.5%), p = 001). Multivariable logistic regression analyses indicated SC group in comparison with the MA group (adjusted odds ratio: 2.732, 95% confidence interval: 1. 250–5.972, p = 0.012) was an association with the risk of rhabdomyolysis.

Conclusion

Our findings demonstrate that tachycardia, hyperthermia, and rhabdomyolysis were more common among cathinone users than among meth/amphetamine users presented to EDs.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by research grants from National Taiwan University Hospital, Taiwan (NTUH:109-P08, and 110-S5144).

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