Narcotics and Psychostimulants in Acute Overdose-Suspected Patients in Emergency Departments in Korea: Analysis of Toxicological Laboratory Data

Purpose: Narcotic use and associated overdose deaths pose a serious public health threat worldwide. The use of psychostimulants, amphetamines and their derivatives, methamphetamine, ecstasy, or 3,4-methylenedioxy-methamphetamine (MDMA) is a significant challenge to the emergency department (ED). Although cases of illicit psychostimulant use have been reported in Korea, no reports with confirmative laboratory analyses have been reported. The objective of this study was to present data on ED patients who have used psychostimulants.Methods: We used the 2019–2022 toxicological laboratory database of the National Medical Center, which includes data from six nationwide toxicological laboratories that support suspected acute poisoning patients in the ED. We analyzed demographics (age and sex), presenting mental status, and ethanol co-ingestion. The psychostimulant group was compared with the narcotic group, which contained patients who consumed narcotic drugs but not psychostimulants.Results: Among 4,366 patients, narcotic drugs were detected in 2,239 patients (51.3%): 2,176 in the narcotic group, one who used cannabis, and 60 in the psychostimulant group. Psychostimulant cases were reported from 2019 to 2022 (13, 11, 25, and 11 each year). The psychostimulant group was younger (39.3±14.3 vs. 55.3±21.5 years), contained more female patients (45.0% vs. 21.1%), and had poorer mental status than the narcotic group (p<0.01). The cases of psychostimulant use were treated in 26 hospitals throughout Korea.Conclusion: This is the first study reporting results from confirmative analyses of narcotic drug use in ED patients. Psychostimulant-related ED visits were observed throughout Korea.