A risk-based approach to community illicit drug toxicosurveillance : operationalisation of the Emerging Drugs Network of Australia - Victoria (EDNAV) project
Copyright © 2023. Published by Elsevier B.V..
INTRODUCTION: The Emerging Drugs Network of Australia - Victoria (EDNAV) project is a newly established toxicosurveillance network that collates clinical and toxicological data from patients presenting to emergency departments with illicit drug related toxicity in a centralised clinical registry. Data are obtained from a network of sixteen public hospital emergency departments across Victoria, Australia (13 metropolitan and three regional). Comprehensive toxicological analysis of a purposive sample of 22 patients is conducted each week, with reporting of results to key alcohol and other drug stakeholders. This paper describes the overarching framework and risk-based approach developed within Victoria to assess drug intelligence from EDNAV toxicosurveillance.
METHODS: Risk management principles from other spheres of public health surveillance and healthcare clinical governance have been adapted to the EDNAV framework with the aim of facilitating a consistent and evidence-based approach to assessing weekly drug intelligence. The EDNAV Risk Register was reviewed over the first two years of EDNAV project operation (September 2020 - August 2022), with examples of eight risk assessments detailed to demonstrate the process from signal detection to public health intervention.
RESULTS: A total of 1112 patient presentations were documented in the EDNAV Clinical Registry, with 95 signals of concern entered into the EDNAV Risk Register over the two-year study period. The eight examples examined in further detail included suspected drug adulteration (novel opioid adulterated heroin, para-methoxymethamphetamine adulterated 3,4-methylenedioxymethamphetamine (MDMA)), drug substitution (25B-NBOH sold as lysergic acid diethylamide, five benzodiazepine-type new psychoactive substances in a single tablet, protonitazene sold as ketamine), new drug detection (N,N-dimethylpentylone), contamination (unreported acetylfentanyl) and a fatality subsequent to MDMA use. A total of four public Drug Alerts were issued over this period.
CONCLUSIONS: Continued toxicosurveillance efforts are paramount to characterising the changing landscape of illicit drug use. This work demonstrates a functional model for risk assessment of illicit drug toxicosurveillance, underpinned by analytical confirmation and evidence-based decision-making.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:122 |
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| Enthalten in: |
The International journal on drug policy - 122(2023) vom: 15. Dez., Seite 104251 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Syrjanen, Rebekka [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 16.12.2023 Date Revised 16.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.drugpo.2023.104251 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM364439750 |
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| 100 | 1 | |a Syrjanen, Rebekka |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A risk-based approach to community illicit drug toxicosurveillance |b operationalisation of the Emerging Drugs Network of Australia - Victoria (EDNAV) project |
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| 500 | |a Date Revised 16.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023. Published by Elsevier B.V. | ||
| 520 | |a INTRODUCTION: The Emerging Drugs Network of Australia - Victoria (EDNAV) project is a newly established toxicosurveillance network that collates clinical and toxicological data from patients presenting to emergency departments with illicit drug related toxicity in a centralised clinical registry. Data are obtained from a network of sixteen public hospital emergency departments across Victoria, Australia (13 metropolitan and three regional). Comprehensive toxicological analysis of a purposive sample of 22 patients is conducted each week, with reporting of results to key alcohol and other drug stakeholders. This paper describes the overarching framework and risk-based approach developed within Victoria to assess drug intelligence from EDNAV toxicosurveillance | ||
| 520 | |a METHODS: Risk management principles from other spheres of public health surveillance and healthcare clinical governance have been adapted to the EDNAV framework with the aim of facilitating a consistent and evidence-based approach to assessing weekly drug intelligence. The EDNAV Risk Register was reviewed over the first two years of EDNAV project operation (September 2020 - August 2022), with examples of eight risk assessments detailed to demonstrate the process from signal detection to public health intervention | ||
| 520 | |a RESULTS: A total of 1112 patient presentations were documented in the EDNAV Clinical Registry, with 95 signals of concern entered into the EDNAV Risk Register over the two-year study period. The eight examples examined in further detail included suspected drug adulteration (novel opioid adulterated heroin, para-methoxymethamphetamine adulterated 3,4-methylenedioxymethamphetamine (MDMA)), drug substitution (25B-NBOH sold as lysergic acid diethylamide, five benzodiazepine-type new psychoactive substances in a single tablet, protonitazene sold as ketamine), new drug detection (N,N-dimethylpentylone), contamination (unreported acetylfentanyl) and a fatality subsequent to MDMA use. A total of four public Drug Alerts were issued over this period | ||
| 520 | |a CONCLUSIONS: Continued toxicosurveillance efforts are paramount to characterising the changing landscape of illicit drug use. This work demonstrates a functional model for risk assessment of illicit drug toxicosurveillance, underpinned by analytical confirmation and evidence-based decision-making | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Early warning system | |
| 650 | 4 | |a Harm reduction | |
| 650 | 4 | |a Illicit drug | |
| 650 | 4 | |a Multi-disciplinary | |
| 650 | 4 | |a Public health | |
| 650 | 4 | |a Surveillance | |
| 650 | 4 | |a Toxicology | |
| 650 | 4 | |a Toxicosurveillance | |
| 650 | 7 | |a Illicit Drugs |2 NLM | |
| 650 | 7 | |a N-Methyl-3,4-methylenedioxyamphetamine |2 NLM | |
| 650 | 7 | |a KE1SEN21RM |2 NLM | |
| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 700 | 1 | |a Schumann, Jennifer L |e verfasserin |4 aut | |
| 700 | 1 | |a Lyons, Tom |e verfasserin |4 aut | |
| 700 | 1 | |a McKinnon, Ginny |e verfasserin |4 aut | |
| 700 | 1 | |a Hodgson, Sarah E |e verfasserin |4 aut | |
| 700 | 1 | |a Abouchedid, Rachelle |e verfasserin |4 aut | |
| 700 | 1 | |a Gerostamoulos, Dimitri |e verfasserin |4 aut | |
| 700 | 1 | |a Koutsogiannis, Zeff |e verfasserin |4 aut | |
| 700 | 1 | |a Fitzgerald, John |e verfasserin |4 aut | |
| 700 | 1 | |a Greene, Shaun L |e verfasserin |4 aut | |
| 700 | 0 | |a EDNAV project research group |e verfasserin |4 aut | |
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