- Narcotics and Psychostimulants in Acute Overdose-Suspected Patients in Emergency Departments in Korea: Analysis of Toxicological Laboratory Data
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Yoonsoo Kim, Jiwon Lee, Suncheun Kim, Arum Lee, Misuk Kim, Yun Hee Kim, Jung-In Ko, Bum-Jin Oh
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Received November 11, 2024 Accepted January 18, 2025 Published online May 2, 2025
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DOI: https://doi.org/10.22537/jksct.2024.00007
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 Abstract
- Purpose: Narcotic use and associated overdose deaths pose a serious public health threat worldwide. The use of psychostimulants, amphetamines and their derivatives, methamphetamine, ecstasy, or 3,4-methylenedioxy-methamphetamine (MDMA) is a significant challenge to the emergency department (ED). Although cases of illicit psychostimulant use have been reported in Korea, no reports with confirmative laboratory analyses have been reported. The objective of this study was to present data on ED patients who have used psychostimulants.
Methods
We used the 2019–2022 toxicological laboratory database of the National Medical Center, which includes data from six nationwide toxicological laboratories that support suspected acute poisoning patients in the ED. We analyzed demographics (age and sex), presenting mental status, and ethanol co-ingestion. The psychostimulant group was compared with the narcotic group, which contained patients who consumed narcotic drugs but not psychostimulants.
Results
Among 4,366 patients, narcotic drugs were detected in 2,239 patients (51.3%): 2,176 in the narcotic group, one who used cannabis, and 60 in the psychostimulant group. Psychostimulant cases were reported from 2019 to 2022 (13, 11, 25, and 11 each year). The psychostimulant group was younger (39.3±14.3 vs. 55.3±21.5 years), contained more female patients (45.0% vs. 21.1%), and had poorer mental status than the narcotic group (p<0.01). The cases of psychostimulant use were treated in 26 hospitals throughout Korea.
Conclusion
This is the first study reporting results from confirmative analyses of narcotic drug use in ED patients. Psychostimulant-related ED visits were observed throughout Korea.
- Characteristics of Acute Toxic Alcohol Poisoning Patients in the Emergency Department: A Toxicological Laboratory Analysis of Ethylene Glycol and Methanol
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Min Kyung Park, 응급취약지 지역협력팀, Arum Lee, Misuk Kim, Yun Hee Kim, Jung-in Ko, Bum Jin Oh
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Received November 11, 2024 Accepted January 18, 2025 Published online June 2, 2025
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DOI: https://doi.org/10.22537/jksct.2024.00006
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Abstract
- Purpose: Toxic alcohol exposures are rare but represent an ongoing and potentially lethal poisoning issue in Korea. Few studies have characterized the epidemiological features of acutely intoxicated patients and their blood substance levels at emergency departments (EDs). The objective of this study was to characterize intoxicated patients for whom toxicological analyses were requested.
Methods
We reviewed demographic and analytical data collected from a toxicological laboratory operated by the National Medical Center (NMC) between 2018 and 2022. A total of 1,244 cases from 35 emergency departments (EDs) were included.
Results
Among the 1,244 cases analyzed, 107 cases (63 patients) tested positive for toxic alcohols, including methanol (MeOH), ethylene glycol (EG), and isopropyl alcohol. We analyzed 60 patients with a single toxic alcohol detected, consisting of MeOH (n=17) and EG (n=43). Clinical characteristics were as follows: median age was 42 years; 63.3% were male; 100% had acute exposure events; 66.7% were suicide attempts; ethanol co-ingestion occurred in 50.0%; median ingestion amount was 255 mL (MeOH) versus 365 mL (EG). Significant differences between the MeOH and EG groups included unknown substance ingestion (41.2% vs. 69.8%, p=0.04), initial blood pH (7.33 vs. 7.20, p<0.01), and multiple substance ingestion (52.9% vs. 81.4%, p=0.03). Median blood concentrations were 255 mg/dL in the MeOH group and 12 mg/dL in the EG group. Follow-up analyses were performed 15 times in nine patients (52.9%) from the MeOH group and 30 times in 15 patients (34.9%) from the EG group.
Conclusion
This study provides the first confirmatory analytic data on toxic alcohol poisoning among ED patients in Korea. Between 2018 and 2022, cases of acute toxic alcohol poisoning continued to be identified around Seoul. Approximately half of the toxic alcohol poisoning patients underwent follow-up toxicological analyses.
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KSCT
Korean Society of Clinical Toxicology