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Seizures as a complication of recreational drug use : analysis of the Euro-DEN Plus data-set
Wolfe, Caitlin E. ...
Seizures are a recognized and potentially serious complication of recreational drug use. This study examined alarge international data set of presentations to Emergency Departments with acute ...recreational drug toxicity, theEuropean Drug Emergencies Plus (Euro-DEN Plus) Network, to compare presentations with and without seizuresand estimate incidence and associated drugs. Amongst 23,947 presentations between January 2014 andDecember 2017, there were 1013 (4.2%) with reported seizures. Clinical and demographic features were similarbetween individuals who had a seizure and those who did not, although rates of coma, cardiac arrest, intubation,intensive care admission, and death were significantly higher in those with seizures. There was a significantassociation between specific drugs and a higher seizure incidence, including fentanyl (odds ratio 2.63, 95%confidence interval 1.20-5.80), and synthetic cannabinoids (OR 2.90, 95% CI 2.19-3.84). Other drugs wereassociated with a lower seizure incidence, including heroin (OR 0.46, 95% CI 0.35-0.61), clonazepam (OR 0.22,95% CI 0.06-0.91), and cannabis (OR 0.65, 95% CI 0.50-0.86). This substantiates observations that the syn-thetic cannabinoids as a group of novel psychoactive substances are clinically different in consequence of in-toxication than cannabis, and that individuals who suffer a seizure in the context of recreational drug in-toxication are likely to have worse outcomes overall. Utilising this information of what substances have a greaterrisk of seizures, could provide tailored harm reduction and education strategies to users to reduce the risk ofseizures and their associated complications.
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