Drugs of abuse--an analysis based on cases from the Kraków Department of Clinical Toxicology of Jagiellonian University College of Medicine in 1997-2000.

The aim of the study was to present the frequency of acute drug overdosing by dependent patients in the years 1997, 1998, 1999 and 2000, and to compare the numbers of poisoned addicts suffering withdrawal syndrome and seeking detoxification. The analysis includes data for all drug addicts treated at the Kraków Department of Clinical Toxicology in years 1997, 1998, 1999 and 2000 because of drug overdosing and resultant acute intoxication, because of withdrawal syndrome and also the opiate dependent patients qualified to methadone maintenance programme. The patients dependent on ethanol were excluded. A progressive increase in number of poisonings with psychoactive substances was noted in analysed years, respectively 231, 298, 331 and 442 patients. Drugs of abuse, were the most frequent cause of admission. Also incidence rate of poisoning expressed per 10,000 of Kraków inhabitants was highest for the cases admitted because of overdosing or craving for narcotics. Opiate derivatives produced at home from poppy straw or from juice of poppy head (so called "kompot" or "Polish heroin") were the most common cause of admission in all the analysed years: increase in number of acutely poisoned, and also increase in number of opiate dependent patients who suffered withdrawal syndrome and sought detoxification was noted in 2000 as compared to years 1998 and 1999. Opiate derivatives followed by amphetamine, as the single toxic agent or in mixed combinations, were still the most common drugs of abuse detected in body fluids. The men were dominant in all the analysed years, but the increase in number of depended women was observed through the years under analysis.

[Diagnosis of ethanol dependence using the CAGE and SAAST questionnaire in selected therapeutic populations]. / Rozpoznawanie uzaleznienia alkoholowego przy pomocy kwestionariuszy CAGE i SAAST w wybranych populacjach terapeutycznych.

An diagnosing of ethanol dependence, despite of clear ICD 10 criteria, in patients treated particularly at the toxicological and detoxication wards, but also in other hospital wards is still a difficult task. Several questionnaires have been developed for easier detection of symptoms, the way of drinking and also for economic, family and medical effects of ethanol drinking in examined patients. A high sensitivity and specificity of CAGE and SAAST questionnaires allowing to identify problem drinkers or alcohol dependence in 192 patients of Kraków Department of Toxicology and 475 patients of Detoxification Unit was stated in the study. The CAGE questionnaire has allowed to identify the possibly ethanol dependence in group of 74 patients hospitalized at the Ward of Internal Diseases and Dialysis of Town Hospital in Sieradz, because of illness, that were not connected with alcohol drinking.

[Psychoactive agents: an analysis based on cases from the Department of Clinical Toxicology College of Medicine of the Jagiellonian University in Kraków in the years 1997-1999]. / Substancje uzalezniajace w materiale Kliniki Toksykologii Collegium Medicum Uniwersytetu Jagiellonskiego w Krakowie w latach 1997-1999.

The aim of the study was to evaluate the frequency of acute poisoning with psychoactive substances in adult abusers of Kraków population in 1997, 1998 and 1999 and to compare the number of poisoned patients suffering withdrawal syndrome as predominant. 27.2% (n = 945) of all 3472 acute poisonings treated in the Department of Clinical Toxicology in 1997, 36.9% (n = 1193) of all 3236 treated in 1998 and 47.9% (n = 1546) of all 3233 treated cases that were acute poisoning with psychoactive substances among the abusers of Kraków adult population. Ethanol followed by narcotics in 1998, and by drugs coingested with ethanol and by narcotics in 1997 and 1999 was predominant psychoactive agent in all the analysed years. Organic solvents and glue sniffing and drug dependency increased again in 1999. Opiate derivatives produced at home from poppy straw or juice of poppy head were still the most common narcotic detected in body fluids, but decrease in number of acute opiates poisoning was noted in 1999 as compared to previous analysed years. The most of ethanol abusers aged from 30-49 years. The highest incidence of narcotic and drug dependency was noted in age between 20-29 years.

[Self-poisoning with Datura stramonium]. / Samozatrucie Datura stramonium.

During last 5 years only single cases of poisoning with plants containing psychoactive substances, especially Datura stramonium, were treated in the Department of Clinical Toxicology in Kraków. In autumn 1999, during 1 month, 7 patients, aged from 14 to 27 years (mean 18 years) poisoned with Datura stramonium were treated. On admission in all patients central and peripheral anticholinergic symptoms were stated. Four of them ingested seeds, three of them chewed seeds and leaves. Only one ingested Datura seeds in suicidal attempts. In the group, only one--20-years-old--previously abused amphetamine and smoked marihuana. For the remaining 5 boys (14-18 years-old), it was the first experience with psychoactive substances. All were successfully treated, in 5 patients physostigmine was used, in dose ranged from 2 to 6 mg, with no adverse effects. Seasonal accessibility of natural psychoactive products may be the first, easy, free step of addiction.

[Acute poisoning with psychoactive substances among adult abusers of the Krakow population]. / Ostre zatrucia srodkami psychoaktywnymi wsród uzaleznionych dorostych mieszkanców Krakowa.

The aim of the study was to evaluate a frequency and the course of acute poisonings with psychoactive substances in abusers, considering the kind of toxic substance. 25% of all acute poisonings treated in the Department of Clinical Toxicology in the year 1996 that were acute poisonings with psychoactive substances among the abusers of Kraków adult population. Alcohol followed by narcotics and drugs and by organic solvents was predominant cause of acute poisonings in that group. Opiates derivatives as the so called kompot produced at home from poppy straw or juice of poppy head were the most common narcotics. Pure amphetamine was detected only in 5.3%, while as combination with other narcotics (opioids, THC, LSD) was detected in 31.2% of narcomans and drug abusers. The combination of opioids, barbiturates and benzodiazepines was predominant cause of acute intoxications with mixed substances abuse. That was followed by combination of opiates and barbiturates in the group of patient identified positively as two or more substance abuse in the body fluids. Tramal and benzodiazepines were the most detected drugs responsible for acute intoxications between drug abusers. Acute intoxicated ethanol abusers aged from 30-49 years and were the oldest group compared to narcotics and drug abusers (20-29 years) and to organic solvent dependent patient (15-19 years).

[Essential, economic and social significance of the Poison Information Center for public health]. / Znaczenie merytoryczne, ekonomiczne i spoleczne Osrodka Informacji Toksykologicznej w ochronie zdrowia.

The role of toxicological information consisting of chemical substance toxicity, clinical signs and symptoms, treatment and diagnosis of poisonings is presented in the study. These data are collected in computer programmes TOKSY 5, TOKSY7 (MacroSoft Warazawa) which together with American CCIS data base (MICROMEDEX, Denver, Colorado) and IPCS INTOX Database are helpful instrument while giving the toxicological information or/and medical consulting. All cases are registered in IPCS (International Programme on Chemical Safety) INTOX SYSTEM data base that enables epidemiological analysis and also an evaluation of economical and social effects caused by poisonings.

Acute pesticides poisoning in the Kraków Department of Clinical Toxicology in 1986-1995.

The aim of the study was to evaluate the number and the course of acute pesticides poisoning treated in the Department of Clinical Toxicology in 1986-1995. During that period 264 cases (189 men and 75 women) of acute pesticides poisoning were treated. Suicidal oral ingestion followed by inhalation and dermal exposure was the most common cause of acute intoxication. Organophosphates and carbamates were the most common cause of acute intoxication. Poisonings with dipyridyls and sulfonylurea derivatives are relatively rare. The highest number of poisonings was noted in age group 30-39 years. In 37% of the total analysed cases the co-ingestion of ethanol was noted. As organophosphorous compounds were the most common cause of acute pesticides poisoning, the gastric lavage + intensive care treatment + specific and non-specific antidotes were the most common therapeutic management. Duration of hospitalisation was dependent on the kind of pesticide. The longest hospitalisation required the patients poisoned with organophosphates. A full recovery was noted in 57.6% of poisoned patients. 34.1% of patients suffered different organ injury mostly from respiratory and central nervous system. 22 (8.3%) the fatal cases were noted in analysed period.