A Prospective Series of Poisonings in Brisbane, Australia 2014-2024: A Changing Pharmaceutical Landscape and the Rise...

Clinical toxicology units in Australia manage patients presenting to hospital with a range of poisonings. We aim to describe poisoning presentations over the first decade of a clinical toxicology service.

This is a prospective observational series of poisoned patients managed by a Queensland clinical toxicology unit between 15 May 2014 and 14 May 2024. All patient presentations were recorded in a relational database. Data extracted included demographic information, exposure details, clinical features, treatment, complications and outcome.

There were 20,609 presentations over the period involving 13,855 unique patients, with a median age of 32 years (Range: 0-98 years), males 7286 (52.6%). Most presentations (10,454, 50.7%) were for deliberate self-poisoning, followed by recreational intoxication (9107, 44.2%). Paracetamol was the most common pharmaceutical reported in overdose (2458, 11.9%), and methamphetamine was the most common recreational drug (5110, 24.8%). Methamphetamine exposures rose over the period from 158 presentations in 2014 to 717 presentations in 2024. Most patients (15,335, 74.4%) were managed through the Emergency Department Short Stay Treatment Area. The median length of stay was 13.1 h (IQR 7.2-19.8 h). Fifty-nine patients died with 24/59 (41%) deaths attributable to opioids.

Recreational intoxication increased over the study period, with methamphetamine intoxication overtaking paracetamol overdose to become the most common poisoning presentation in this series. Opioids account for the majority of overdose-related deaths.