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

• DOI: 10.1111/add.14808
• Publication Date: 2019-11-26T02:19:01Z
• Authors: Andrew A. Monte; Andrew Hopkinson; Jessica Saben; Shelby K. Shelton; Stephen Thornton; Aaron Schneir; Adam Pomerleau; Robert G. Hendric...; Ann M. Arens; Jon B. Cole; James Chenoweth; Spencer Martin; Axel Adams; Samuel D. Banister; Roy R. Gerona
• Keywords: Adult; Male; 610; Emergency Care; Medical and Health Sciences; Clinical and health psychology; Specimen Handling; Substance Misuse; Hospital; 03 medical and health sciences; psychoactive; 0302 clinical medicine; Clinical Research; Health Services and Systems; Health Sciences; Humans; Emergency Service; Public health; Academic Medical Centers; Psychotropic Drugs; novel; Cannabinoids; Data Collection; Psychology and Cognitive Sciences; Substance Abuse; opioids; United States; 3. Good health; Substance Abuse Detection; Good Health and Well Being; synthetic; stimulants; Female; Generic health relevance; Drug Abuse (NIDA only); Emergency Service, Hospital; Sentinel Surveillance

Background and aimsThe Psychoactive Surveillance Consortium and Analysis Network (PSCAN) is a national network of academic emergency departments (ED), analytical toxicologists and pharmacologists that collects clinical data paired with biological samples to identify and improve treatments of medical conditions arising from use of new psychoactive substances (NPS). The aim of this study was to gather clinical data with paired drug identification from NPS users who presented to EDs within PSCAN during its first year (2016–17).DesignObservational study involving patient records and biological samples.SettingSeven academic emergency medical centers across the United States.ParticipantsED patients (n = 127) > 8 years of age with possible NPS use who were identified and enrolled in PSCAN by clinical providers or research personnel.MeasurementsClinical signs, symptoms and treatments were abstracted from the patients' health records. Biological samples were collected from leftover urine, serum and whole blood. Biological and drug samples, when available, were tested for drugs and drug metabolites via liquid chromatography–quadrupole time‐of‐flight mass spectrometry (LC‐QTOF/MS).FindingsPatients in whom synthetic opioids were detected (n = 9) showed higher rates of intubation (four of nine), impaired mental status (four of nine) and respiratory acidosis (five of nine) compared with the rest of the cohort (nine of 118, P‐value < 0.05). Patients in whom synthetic cannabinoid (SC) were found (n = 27) had lower median diastolic blood pressures (70.5 versus 77 mmHg, P = 0.046) compared with the rest of the cohort. In 64 cases of single drug ingestion, benzodiazepines were administered in 25 cases and considered effective by the treating physician in 21 (84%) cases.ConclusionsDuring its first year of operation, the Psychoactive Surveillance Consortium and Analysis Network captured clinical data on new classes of drugs paired with biological samples over a large geographical area in the United States. Synthetic cannabinoids were the most common new psychoactive drug identified. Synthetic opioids were associated with a high rate of intubation and respiratory acidosis.