Recreational drug poisonings reported to six European poison centres from 2021 to 2024.

Abstract

<h4>Introduction</h4>Recreational drug poisonings pose a growing public health concern. European-level data remain limited, although poison centres are well placed to monitor related health incidents. This study analysed temporal trends in recreational drug poisonings reported to six European poison centres.<h4>Methods</h4>Aggregated retrospective data were collected over four years (2021-2024) from poison centres in Austria, Freiburg (Germany), the Netherlands, Sweden, Switzerland, and the United Kingdom. Cases involving 11 recreational drugs (amfetamine, cocaine, delta-9-tetrahydrocannabinol, gamma-hydr-oxybutyrate, heroin, ketamine, lysergic acid diethylamide, 3,4-methylenedioxymetamfetamine, metamfetamine, poppers, and psilocybin) were included. Annual rates of recreational drug exposures were calculated relative to all poisoned patients, and trends were analysed using linear regression.<h4>Results</h4>From 2021 to 2024, the six centres recorded 1,051,287 poisonings, of which 23,779 (2.3%) involved recreational drugs. The rate of recreational drug exposures increased from 1.8% (<i>n</i> = 4,581) in 2021 to 2.6% (<i>n</i> = 7,229) in 2024, mainly driven by the increases in Austria, Freiburg, and the United Kingdom. Rates ranged from 1.3% (Austria) to 2.8% (Netherlands) in 2021 and from 1.9% (Austria) to 3.6% (Freiburg) in 2024. Delta-9-tetrahydrocannabinol, cocaine, amfetamine, and 3,4-methylenedioxymetamfetamine were most frequently implicated. Increasing rates were observed for delta-9-tetrahydrocannabinol (Freiburg, Austria), cocaine (Freiburg, United Kingdom), amfetamine (Freiburg, Sweden), and ketamine (Austria, Freiburg, United Kingdom). In 2024, amfetamine poisonings peaked in Freiburg (0.63%) and Sweden (0.94%), cocaine in Freiburg (0.78%) and the United Kingdom (0.74%), and ketamine in the Netherlands (0.42%) and the United Kingdom (0.24%).<h4>Discussion</h4>Although recreational drug poisonings comprised a small proportion of poison centre calls (∼3%), a significant increase was observed between 2021 and 2024, underscoring their value in toxicovigilance and early identification of emerging drug trends.<h4>Conclusions</h4>Delta-9-tetrahydrocannabinol, cocaine, amfetamine, and 3,4-methylenedioxymetamfetamine were most frequently reported, with notable national differences. Coordinated European monitoring of recreational drug poisonings may support timely public health interventions and prevention strategies.

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