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Comparative Study
. 2016 Aug;109(8):527-9.
doi: 10.1093/qjmed/hcv208. Epub 2015 Nov 15.

Healthcare professionals are less confident in managing acute toxicity related to the use of new psychoactive substances (NPS) compared with classical recreational drugs

Affiliations
Comparative Study

Healthcare professionals are less confident in managing acute toxicity related to the use of new psychoactive substances (NPS) compared with classical recreational drugs

D M Wood et al. QJM. 2016 Aug.

Abstract

Background: The features of acute classical recreational drugs or new psychoactive substances (NPS) toxicity fall into three broad groups: (i) stimulant; (ii) hallucinogenic and (iii) depressant. Currently, there is no information available on healthcare professionals knowledge/confidence in managing the acute toxicity related to NPS use.

Aim: We have compared knowledge and confidence of managing acute toxicity related to use of NPS with that seen with the use of to classical recreational drugs.

Design and methods: Physicians/nurses completed a questionnaire survey to self-assess on a 5-point scale their knowledge (1-little knowledge; 5-very knowledgeable) and confidence (1-little confidence; 5-very confident) of managing acute toxicity related to the use of classical recreational drugs or NPS. Differences between knowledge and confidence for classical recreational drugs and NPS were assessed using paired Student's t-test; comparison between doctors, nurses and the frequency of managing acute classical recreational drug/NPS toxicity was assessed using unpaired Student's t-test.

Results: One hundred and eighty-eight (82 physicians, 106 nurses) completed the survey. Classical drug compared with NPS knowledge: nurses 2.9 ± 1.0 vs. 2.1 ± 1.0, P < 0.001; physicians 3.1 ± 0.8 vs. 2.1 ± 1.0, P < 0.001. There was no difference between nurses and physicians in classical drug (P = 0.11) or NPS (P = 0.89) knowledge. Confidence in managing classical drug toxicity compared with NPS confidence: nurses 3.0 ± 1.1 vs. 2.3 ± 1.1, P < 0.001; physicians 3.0 ± 0.9 vs. 2.1 ± 1.0, P < 0.001. There was no difference between nurses and physicians in classical drugs (P = 0.85) or NPS (P = 0.33) confidence.

Conclusions: Physicians/nurses are less confident in managing acute NPS toxicity. Management of toxicity is not dependent on knowing the drug/NPS, but should be on the basis of these clinical signs/symptoms. Training/education should focus on the concept of managing the pattern of toxicity that an individual presents with rather than the actual drug(s).

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References

    1. European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). European Drug Report 2015: Trends and Developments. Available from: http://www.emcdda.europa.eu/attachements.cfm/att_239505_EN_TDAT15001ENN.pdf (15 September 2015, date last accessed).
    1. Heyerdahl F, Hovda KE, Giraudon I, Yates C, Dines AM, Sedefov R, et al. Current European data collection on emergency department presentations with acute recreational drug toxicity: gaps and national variations. Clin Toxicol (Phila) 2014; 52:1005–12. - PubMed
    1. Wood DM, Heyerdahl F, Yates CB, Dines AM, Giraudon I, Hovda KE, et al. The European Drug Emergencies Network (Euro-DEN). Clin Toxicol (Phila) 2014; 52:239–41. - PubMed
    1. Wood DM, Dines AM, Heyerdahl F, Yates C, Giraudon I, Paasma R, et al. Review of European-Drug Emergencies Network (Euro-DEN) training package for non-specialist workers to assess acute recreational drug and new psychoactive toxicity in night-time economy environments. Drugs Educ Prev Pol 2015 doi: 10.3109/09687637.2015.1081379.
    1. Wood DM, Dines AM, Heyerdahl F, Yates C, Giraudon I, Paasma R, et al. Review of the European-Drug Emergencies Network (Euro-DEN) training package for non-specialist workers to assess acute recreational drug and novel psychoactive substance (NPS) toxicity in night-time economy environments. Clin Toxicol (Phila) 2015; 53:370.

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