The Emerging Drugs Network of Australia – Victoria Clinical Registry: A state‐wide illicit substance surveillance and alert network

Abstract

Objectives With an increasingly dynamic global illicit drug market, including the emergence of novel psychoactive substances, many jurisdictions have moved to establish toxicosurveillance systems to enable timely detection of harmful substances in the community. This paper describes the methodology for the Emerging Drugs Network of Australia – Victoria (EDNAV) project, a clinical registry focused on the collection of high‐quality clinical and analytical data from ED presentations involving illicit drug intoxications. Drug intelligence collected from the project is utilised by local health authorities with the aim to identify patterns of drug use and emerging drugs of concern. Methods The project involves 10 public hospital EDs in Victoria, Australia. Patients 16 years and over, presenting to a network ED with a suspected illicit drug‐related toxicity and a requirement for venepuncture are eligible for inclusion in the study under a waiver of consent. Clinical and demographic parameters are documented by site‐based clinicians and comprehensive toxicological analysis is conducted on patient blood samples via specialised forensic services. All data are then deidentified and compiled in a project specific database. Results Cases are discussed in weekly multidisciplinary team meetings, with a view to identify potentially harmful substances circulating in the community. High‐risk signals are escalated to key stakeholders to produce timely and proportionate public health alerts with a focus on harm minimisation. Conclusions The EDNAV project represents the first centralised system providing near real‐time monitoring of community drug use in Victoria and is fundamental in facilitating evidence‐based public health intervention.

From signal to alert: A cluster of exposures to counterfeit alprazolam tablets containing five novel benzodiazepines

“…Cases were captured as part of a Human-Research-Ethics-Committeeapproved project with waiver of patient consent for inclusion of deidentified clinical and analytical data obtained from adult ED illicit drug presentations within a secure on-line (HREC/66506/ Austin-2020). 3 Blood samples underwent comprehensive toxicology analysis using a liquid chromatography-tandem mass spectrometry screen targeting five pharmaceutical, illicit and novel substances at the Victorian Institute of Forensic Medicine. 3…”

“…3 Blood samples underwent comprehensive toxicology analysis using a liquid chromatography-tandem mass spectrometry screen targeting five pharmaceutical, illicit and novel substances at the Victorian Institute of Forensic Medicine. 3…”

“…Cases were captured as part of a Human‐Research‐Ethics‐Committee‐approved project with waiver of patient consent for inclusion of de‐identified clinical and analytical data obtained from adult ED illicit drug presentations within a secure on‐line clinical registry (HREC/66506/Austin‐2020) 3 …”

Moving beyond the dose makes the poison

“…10 NPS are compounds, often structurally modified, to mimic conventional recreational drugs with poorly described pharmacological and toxicological characteristics. 11,12 NPS manufacturing and use is proliferating at an unprecedented rate worldwide and multiple deaths in Australia have been attributed to NPS consumption. 11,13 Prehospital data spanning drug-related ambulance attendances in Victoria show almost a threefold increase in attendances in the past decade with long term trends increasing for all categories of drugs illustrating the presentations not captured by hospitalisation data.…”

“…11,12 NPS manufacturing and use is proliferating at an unprecedented rate worldwide and multiple deaths in Australia have been attributed to NPS consumption. 11,13 Prehospital data spanning drug-related ambulance attendances in Victoria show almost a threefold increase in attendances in the past decade with long term trends increasing for all categories of drugs illustrating the presentations not captured by hospitalisation data. 14 Toxicovigilance trend data is gathered through police seizures and drug testing, surveys, internet fora, customs, sewage monitoring and coronial investigation.…”