Acute Toxic Effects of the New Psychoactive Substance “Voodoo” among Patients presented to the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH), Egypt, during 2017

Abstract

Background Voodoo is a heterogeneous mixture of psychoactive substances that has recently grown in popularity among youth in Egypt. Patients can present with a variety of manifestations that may lead to death in some cases. This study assessed the acute toxic effects of voodoo among patients presented to the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH) during a one year period. Methods This is a retrospective study of all patients presented with voodoo intoxication at the PCC-ASUH from 1 January 2017 to 31 December 2017. Clinical data, routine laboratory findings, and ECG results as well as duration of hospitalization and outcome were compiled from hospital records. Results Seventy-one voodoo intoxication cases meeting the inclusion criteria were analyzed (mean age: 25.19 ± 9.54 years, range: 15–50 years, 97.2 % male). Pulse, blood pressure, and respiratory rate were normal in more than half of all patients. Neurological abnormalities including agitation, hallucinations, disturbance of consciousness were the most frequent manifestations. Respiratory acidosis was the most common laboratory finding (54.9 %), followed by increased serum urea (43.6 %), hypokalemia (33.8 %), hyperglycemia (28.1 %), and leukocytosis (26.7 %). The most common ECG finding was sinus tachycardia (31 %), followed by QT prolongation (15.4 %). More than half of the studied patients (53.5 %) co-administered other illicit substances, most frequently cannabis and tramadol. Most patients recovered fully and were discharged, but death occurred in two cases. Conclusions Voodoo toxicity can manifest with many presentations, hampering timely diagnosis. Clinicians should consider possible voodoo poisoning in patients presenting with a history of drug use with neurological symptoms, and they should conduct follow-up arterial blood gases, electrolytes and ECG as voodoo may contain potentially fatal psychoactive substances.

Substance use and substance use disorders in Africa: An epidemiological approach to the review of existing literature

“…In Northern Africa, the smoking of hashish and the chewing of Kath has become very rampant. Although there is little data from the region regarding the prevalence and patterns of use of novel psychoactive substances; reports from studies carried out in Egypt have suggested that the estimated prevalence of novel psychoactive substance use among adolescents in the country are largely underestimated[ 96 ]. However, tabloid reports have called attention to an increasing demand and use of novel psychoactive substances including “voodoo” and “strox” among adolescents and young adult in Egypt[ 97 , 98 ].…”

“…“Voodoo” is a heterogeneous mixture of several psychoactive substances, including synthetic cannabinoids, tramadol, amphetamine, methadone, benzodiazepines, penitrem A (a neurotoxin) and morphine derivatives. The concentrations of the chemical constituents and adulterants of voodoo also vary substantially among the different clandestine laboratories that produce it[ 96 , 99 ]. Another novel psychoactive substance that is gaining popularity in Egypt is “Strox”[ 100 ].…”

Pattern of novel psychoactive substance use among patients presented to the poison control centre of Ain Shams University Hospitals, Egypt: A cross-sectional study

“…Strox and Voodoo are considered two of the most popular blends of NPS in the Egyptian drug market. These NPSs are usually made in clandestine laboratories with substantial variation in the types and concentrations of chemical constituents and adulterants, further contributing to the variation in clinical presentation ( Hussien et al., 2021 ). They have also demonstrated that sample Voodoo NPS has a broad spectrum of various previously identified bioactive compounds, including quinazolines, morphinan alkaloid, cannabinoids, penitrem A and the well-known synthetic cannabinoid FUB-AMBcn ( Hussien et al., 2020 ).…”