The Psychoactive Surveillance Consortium and Analysis Network (PSCAN): the first year

Area of Science:

• Emergency medicine
• Clinical toxicology
• Pharmacology

Background:

• The Psychoactive Surveillance Consortium and Analysis Network (PSCAN) is a national network of academic emergency departments (EDs) and specialists.
• PSCAN collects clinical data and biological samples to identify and improve treatments for conditions arising from new psychoactive substance (NPS) use.
• This study focused on data from PSCAN's first year of operation (2016-17).

Purpose of the Study:

• To gather clinical data and drug identification from emergency department patients who used NPS.
• To analyze the clinical presentations and outcomes associated with NPS use.
• To inform treatment strategies for NPS-related medical emergencies.

Main Methods:

• An observational study design was employed, utilizing patient records and biological samples.
• Data were collected from 127 emergency department patients aged over 8 years with suspected NPS use across seven US academic medical centers.
• Clinical data were abstracted from health records, and biological samples (urine, serum, whole blood) were tested for drugs and metabolites using LC-QTOF/MS.

Main Results:

• Synthetic cannabinoids (SC) were the most frequently identified NPS (n=27).
• Patients with detected synthetic opioids (n=9) exhibited higher rates of intubation, impaired mental status, and respiratory acidosis compared to the cohort (P < 0.05).
• Lower median diastolic blood pressure was observed in patients with SC use (70.5 mmHg vs. 77 mmHg, P=0.046). Benzodiazepines were effective in 84% of single-drug ingestions where administered.

Conclusions:

• The PSCAN network successfully collected valuable clinical and biological data on NPS use across a large geographical area in its first year.
• Synthetic cannabinoids were the most prevalent NPS identified.
• Synthetic opioids were significantly associated with severe outcomes, including intubation and respiratory acidosis, highlighting the need for targeted interventions.