A Prospective Series of Poisonings in Brisbane, Australia 2014–2024: A Changing Pharmaceutical Landscape and the Rise of Recreational Intoxication

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OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

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