Emergency department visits due to new psychoactive substances and other illicit drugs in Taiwan: preliminary results of the Taiwan Emergency Department Drug Abuse Surveillance (TEDAS) project

Figures & data

Table 1. Clinical features of 675 cases with positive LC-MS/MS results in their urine samples.

Clinical features	Number of cases (n)	Percentage (%)
Vital signs at triage
Systolic blood pressure (mmHg, n = 662)
Low (<90)	37	5.5
High (>140)	176	26.1
Body temperature (°C, n = 664)
Low (<35.0)	13	1.9
High (>38.0)	68	10.1
Heart rate (bpm, n = 660)
Bradycardia (<60)	23	3.4
Tachycardia (>100)	373	55.3
Respiration rate (/min, n = 645)
Bradypnea (<12)	19	2.8
Tachypnea (>20)	569	84.3
O2 Saturation (room air, n = 568)
Desaturation (≤94%)	81	12.0
Symptoms/signs
Cardiac complaints^a	385	57.0
General complaints^a	35	5.2
Abdominal complaints^a	27	4.0
Neurological symptoms/psychiatric symptoms	313	46.4
Depressed consciousness	212	31.4
Delirium	189	28.0
Acute psychosis	124	18.4
Agitation	84	12.4
Hallucination	42	6.2
Bizarre behavior	28	4.1
Injury-related events
Violence behavior	116	17.2
Self-injury	92	13.6
Traffic accidents	49	7.3
Trauma	29	4.3
Attacking others	26	3.9
Jumping from a high rise floor	19	2.8
Others
Sweating	129	19.1
Flushing	93	13.8
Tremor/myoclonus	62	9.2
Drug history
Self-reported illicit drug use	213	31.6
Self-reported non-illicit drug use	76	11.3
Drug used suspected by others	62	9.2
Ethanol use	44	6.5

^aGeneral complaints: dizziness/weakness; Cardiac complaints: chest pain (n = 25, 3.7%) and palpitation (n = 373, 55.3%); Abdominal complaints: nausea/vomiting/epigastralgia.

Figure 1. The distribution of age (year) and sex of cases with positive LC-MS/MS results in their urine samples. Because of one case with missing age and sex data, 674 cases are presented in the figure.

Figure 2. The Top 20 most commonly detected drugs. MDA: 3, 4-Methylenedioxyamphetamine; MDMA: 3,4-Methylenedioxymethamphetamine; 4-MEAPP: 4-Methyl-α-ethylaminopentiophenone; 4-Chloro-N-N-DMC: 4-chloro-N,N-dimethylcathinone; 5-MeO-MIPT: N-(2-(5-methoxy-1H-indol-3-yl)ethyl)-N-methylpropan-2-amine. The other less reported drugs (detected counts) were as following: Cathinones: 3, 4-Methylenedioxy-α-Pyrrolidinohexanophenone (7), N,N-Dimethylamphetamine (6), Pentylone (4), 4-Ethylmethylcathinone (3), Methedrone (3), Methylpentedrone (3), Benzedrone (2), 4-Bromoethcathinone (1), 3,4-Methylenedioxy-α-pyrrolidinobutyrophenone (1), Methylethcathinone (1), 4-Chloro-α-pyrrolidinovalerophenone (1), α-Ethylaminohexanophenone (1). Ketamine and ketamine analogs: Deschloro-N-ethyl-ketamine (1). Others: 11-nor-9-Carboxy-Δ9-THC (4), Phenazepam (3), 1-(benzo[d][1, 3]dioxol-5-yl)-N, N-dimethylpropan-2-amine (2), 2-(4-bromo-2, 5-dimethoxyphenyl)-N-(2-methoxybenzyl) ethan-1-amine (2), AB-PINACA (1), Etizolam (1), Cocaine (1).

Table 2. Common (more than 10 cases) drug combination patterns of different classes of drugs in 292 urine samples.

Drug combination pattern	Number of cases
Cathinones and ketamines^a	56
Methamphetamine and opioids	45
Different cathinones	44
Cathinones, ketamines^a, and methamphetamine	17
Ketamines^a and methamphetamine	16
Cathinones and methamphetamine	12
Ketamines^a and MDMA^b	10

^aKetamines: ketamine and its two analogs (deschloroketamine and deschloro-N-ethyl-ketamine).

^bMDMA: 3, 4-methylenedioxymethamphetamine.

Table 3. Results of univariable logistic regression comparing the NPS group and other illicit drug group.

	NPS group	Other illicit drug group	Odds ratio (95% CI)	p
	N = 340 (50.4%)	N = 335 (49.6%)
Demographic characteristics and vital signs
Age ≤39	260 (76.5%)	168 (50.1%)	3.3 (2.4–4.7)	<.0001
Female	112 (32.9%)	82 (24.5%)	1.5 (1.1–2.1)	.01
Glasgow coma scale score ≤ 8	45 (13.7%)	79 (24.5%)	0.5 (0.3–0.7)	.001
Systolic blood pressure > 140 mmHg	95 (28.6%)	81 (24.5%)	1.2 (0.9–1.7)	.24
Body temperature ≥ 38.0 °C	36 (10.7%)	32 (9.7%)	1.1 (0.7–1.8)	.66
Heart rate > 135 per min	61 (18.4%)	27 (8.2%)	2.6 (1.6–4.1)	.0002
Respiration rate > 20 per min	72 (21.9%)	62 (19.6%)	1.1 (0.8-1.7)	.50
Oxygen saturation ≤ 94%	26 (9.1%)	55 (19.5%)	0.4 (0.3–0.7)	.001
Chief complaint/history/symptoms/signs
Drug use suspected by others	33 (9.7%)	29 (8.7%)	1.1 (0.7–1.9)	.64
Self-reported illicit drug use	100 (29.4%)	113 (33.7%)	1.2 (0.9–1.7)	.23
Self-reported non-illicit drug use	34 (10.0%)	42 (12.5%)	0.8 (0.5–1.3)	.30
Ethanol alcohol use	23 (6.8%)	21 (6.3%)	0.9 (0.5–1.7)	.79
Dyspnea	16 (4.7%)	25 (7.5%)	0.6 (0.3–1.2)	.14
Nausea/vomiting	13 (3.8%)	11 (3.3%)	1.2 (0.5–2.7)	.71
Chest pain	18 (5.3%)	7 (2.1%)	2.6 (1.1–6.4)	.03
Palpitations	192 (56.5%)	181 (54%)	0.9 (0.7–1.2)	.52
Suicide attempt/non-suicidal self-harm	72 (21.2%)	43 (12.8%)	1.8 (1.2–2.8)	.004
Violence behavior	68 (20.0%)	48 (14.3%)	1.5 (1.0–2.2)	.05
Bizarre behavior/delirium/agitation	127 (37.4%)	101 (30.1%)	1.4 (1.0–1.9)	.048
Myoclonus	46 (13.5%)	37 (11.0%)	0.8 (0.5–1.3)	.33
Sweating	68 (20.9%)	61 (19.1%)	1.1 (0.8–1.6)	.57
Flushing	46 (14.2%)	47 (14.7%)	1.0 (0.7–1.6)	.86
Outcome
Intensive care unit admission or death	40 (42.6%)	54 (57.4%)	0.7 (0.4–1.1)	.10