Enhancing U.S. poison center surveillance with verbatim substance upload

Area of Science:

• Toxicology
• Public Health Surveillance
• Data Science

Background:

• The National Poison Data System® (NPDS) is vital for tracking drug and toxic exposure trends.
• Traditional NPDS surveillance relies heavily on coding, which may delay trend identification.
• Enhancements to the NPDS database are crucial for improving real-time surveillance capabilities.

Purpose of the Study:

• To evaluate the utility of verbatim substance data in identifying 7-hydroxymitragynine exposures within the NPDS.
• To compare the detection rates and timeliness of 7-hydroxymitragynine exposures identified by verbatim data versus product codes.

Main Methods:

• Queried the NPDS for kratom-related exposures between January 1, 2023, and July 31, 2025.
• Reviewed verbatim substance entries to identify 7-hydroxymitragynine exposures.
• Compared findings with exposures identified solely by product codes.

Main Results:

• A total of 186 exposures to 7-hydroxymitragynine were identified.
• Product codes identified 149 exposures, while verbatim data identified an additional 37.
• Verbatim data identified 7-hydroxymitragynine exposures in November 2024, predating product code implementation in February 2025.

Conclusions:

• Incorporating verbatim substance data enhances NPDS surveillance by capturing previously unidentified exposures.
• This method allowed for earlier detection of 7-hydroxymitragynine exposures, improving real-time trend analysis.
• Combining verbatim data with existing NPDS tools can significantly strengthen public health surveillance efforts.