TY  - JOUR
PY  - 2019//
TI  - Characteristics and circumstances of death related to new psychoactive stimulants and hallucinogens in Australia
JO  - Drug and alcohol dependence
A1  - Darke, Shane
A1  - Duflou, Johan
A1  - Peacock, Amy
A1  - Farrell, Michael
A1  - Lappin, Julia
SP  - e107556
EP  - e107556
VL  - 204
IS  - 
N2  - BACKGROUND: New psychoactive stimulants and hallucinogens comprise a range of "designer drugs" that have risen to prominence in the 21<sup>st</sup> century. The study aimed to: 1. Determine the characteristics, and circumstances of death, of all recorded cases of new psychoactive stimulant and hallucinogen-related death in Australia; 2. Determine the toxicology of such deaths; and 3. Determine the major organ pathology of cases. <br><br>METHODS: All cases in which new psychoactive stimulants were a mechanism contributory to death were retrieved from the National Coronial Information System (2000-2017). Information was collected on cause of death, demographics, drug use history, circumstances of death, toxicology and major organ pathology. <br><br>RESULTS: 82 cases were identified. The mean age was 30.7yrs and 86.6% were male. Circumstances of death were: accidental drug toxicity (59.8%), traumatic accident (15.9%), suicide (12.2%) and natural disease (2.4%). The most common clinical presentation observed proximal to death was delirium (26.8%). Delirium was mostly frequently observed after phenethylamine consumption (72.2%). The most common cardiovascular diagnosis at autopsy was replacement fibrosis, indicative of previous ischemia (10.5%). New psychoactive stimulants and hallucinogens detected in toxicology were: cathinones (75.7%), phenethylamines (22.0%) and piperazines (6.1%). Other substances were present in 83.5% of cases, most commonly established controlled psychostimulants (58.2%). <br><br>CONCLUSIONS: Acute toxicity was the most common cause of death, but more than a third of deaths were due to trauma. Cathinones were the most commonly detected of the new psychoactive stimulants and hallucinogens. Delirium was the most frequently reported clinical sign proximal to death and was strongly associated with the phenethylamines.<br><br>Copyright © 2019 Elsevier B.V. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0376-8716
UR  - http://dx.doi.org/10.1016/j.drugalcdep.2019.107556
ID  - ref1
ER  -