A risk-based approach to community illicit drug toxicosurveillance: operationalisation of the Emerging Drugs Network of Australia – Victoria (EDNAV) project

Syrjanen, Rebekka; Schumann, Jennifer L.; Lyons, Tom; McKinnon, Ginny; Hodgson, Sarah E.; Abouchedid, Rachelle; Gerostamoulos, Dimitri; Koutsogiannis, Zeff; Fitzgerald, John; Greene, Shaun L.

doi:10.1016/j.drugpo.2023.104251

Cited by 4 publications

(1 citation statement)

References 38 publications

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“…Several articles have also been recently published based on results from the EDNA – Victoria (EDNAV), which is a state-based EDNA network for local monitoring that reports back to the national EDNA registry. Syrjanen et al [11 ▪▪ ] described the overarching framework and approach of the EDNAV for toxicosurveillance and present examples of risk assessments carried out over the first two years of the EDNAV project, including how signals of emerging drugs of concern are identified and reported through public health alerts. Another recent study showed how the EDNAV cohort could be used to characterize patterns and the time course of benzodiazepine-type NPS detections [12 ▪ ].…”

Section: Data From Emergency Departmentsmentioning

confidence: 99%

Public health surveillance of new psychoactive substances: recent developments

Fitzgerald,

Cottler,

Palamar

2024

Current Opinion in Psychiatry

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Purpose of review New psychoactive substances (NPS) continue to emerge globally and present a threat to public health. This article summarizes the most recent literature on approaches for monitoring NPS use and adverse events related to use. Recent findings A variety of approaches have recently been employed for surveillance of NPS use and associated harms, including the use of toxicology testing of patients in emergency departments, surveys of sentinel populations, drug checking and syringe services programs, wastewater-based epidemiology, and retrospective analyses of clinical samples and toxicology reports. These studies cover a range of time periods and NPS examined across numerous countries. Summary Areas of particular interest for future research include the use of data from drug checking services to inform surveillance efforts of the illicit drug supply and the development of methods for wastewater-based monitoring of NPS. Studies that combine self-report data with toxicology testing in particular are important for capturing unintentional or unknown exposure to NPS including fentanyls and drugs like xylazine. Given the limitations associated with individual indicators of drug use and associated harms, the harmonization of multiple data sources can help present a more complete picture of both trends involving NPS to better inform public health responses.

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Section: Data From Emergency Departmentsmentioning

confidence: 99%

Public health surveillance of new psychoactive substances: recent developments

Fitzgerald,

Cottler,

Palamar

2024

Current Opinion in Psychiatry

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Detection of the synthetic cathinone N,N-dimethylpentylone in seized samples from prisons

Norman,

Schwelm,

Semenova

et al. 2024

Forensic Science International

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Identification of clobromazolam in Australian emergency department intoxications using data-independent high-resolution mass spectrometry and the HighResNPS.com database

Castle,

Syrjanen,

Di Rago

et al. 2024

Journal of Analytical Toxicology

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The proliferation of novel psychoactive substances (NPSs) continues to challenge toxicology laboratories. In particular, the United Nations Office on Drugs and Crime considers designer benzodiazepines to be a current primary threat among all NPSs. Herein, we report detection of a new emerging designer benzodiazepine, clobromazolam, using high-resolution mass spectrometry and untargeted data acquisition in combination with a “suspect screening” method built from the crowd-sourced HighResNPS.com database. Our laboratory first detected clobromazolam in emergency department presenting intoxications included within the Emerging Drugs Network of Australia—Victoria project in the state of Victoria, Australia, from April 2022 to March 2023. Clobromazolam was the most frequent designer benzodiazepine detected in this cohort (100/993 cases, 10%). No patients reported intentional administration of clobromazolam, although over half reported exposure to alprazolam, which was detected in only 7% of cases. Polydrug use was prevalent (98%), with phenazepam (45%), methylamphetamine (71%) and other benzodiazepines (60%) most frequently co-detected. This is the first case series published in the literature concerning clobromazolam in clinical patients. The identification of clobromazolam in patients presenting to emergency departments in Victoria demonstrates how high-resolution mass spectrometry coupled with the HighResNPS.com database can be a valuable tool to assist toxicology laboratories in keeping abreast of emerging psychoactive drug use.

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A risk-based approach to community illicit drug toxicosurveillance: operationalisation of the Emerging Drugs Network of Australia – Victoria (EDNAV) project

Cited by 4 publications

References 38 publications

Public health surveillance of new psychoactive substances: recent developments

Public health surveillance of new psychoactive substances: recent developments

Detection of the synthetic cathinone N,N-dimethylpentylone in seized samples from prisons

Identification of clobromazolam in Australian emergency department intoxications using data-independent high-resolution mass spectrometry and the HighResNPS.com database

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