Oslo buy MDMA pills

__________________________

📍 Verified store!

📍 Guarantees! Quality! Reviews!

__________________________

▼▼ ▼▼ ▼▼ ▼▼ ▼▼ ▼▼ ▼▼

▲▲ ▲▲ ▲▲ ▲▲ ▲▲ ▲▲ ▲▲

Oslo buy MDMA pills

Analysis of one tablet identified a potent opioid a nitazene and no MDMA. If you use any drugs you should carry naloxone. Drugs sold as cocaine and MDMA have been found to contain opioids. You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Skip to content Contact us Emergency information. Last updated: 20 June Contact page owner: Centre for Alcohol and Other Drugs.

Poisoning with central stimulant drugs: an observational study from Oslo, Norway

Oslo buy MDMA pills

Metrics details. The use of central stimulant drugs causes significant morbidity. We describe poisonings with central stimulant drugs and compare the different central stimulants concerning combinations with other drugs, treatment, and clinical course. Patients presenting from 1 October to 31 March with poisoning related to the recreational use of central stimulant drugs were retrospectively included at a primary care emergency outpatient clinic and at a hospital emergency department in Oslo, Norway. Diagnosis of toxic agents was mainly based on the clinical assessment of the doctor treating the patient. Amphetamine and methamphetamine were co-categorized as amphetamine. Among the cases of acute poisoning with central stimulant drugs at the outpatient clinic, amphetamine was involved in Among the cases at the hospital, amphetamine was involved in Amphetamine was frequently combined with opioids Sedation was given in 5. In total, Among the hospital patients, Amphetamine was the most common central stimulant drug involved in acute poisoning in Oslo, often combined with opioids and benzodiazepines. Central stimulant use is a global problem \[ 1 \]. The use of amphetamines has increased in North America, to a last-year use prevalence of 3. Cocaine use is also widespread, with a last-year use prevalence of 2. The last-year use prevalence of central stimulants is markedly lower in Asia and Africa, in the range of 0. The central stimulant drugs cocaine, amphetamine, and methamphetamine are, after cannabis, the most frequently used illegal drugs in Norway \[ 1 , 3 , 4 \]. Cocaine use has a last-year prevalence in Norway of 0. Increasing amounts of cocaine are also found in wastewater analyses in Oslo \[ 4 \]. The last-year prevalence of the use of ecstasy in Norway is 0. During the last two decades, several hundred new drugs have appeared in Europe, often termed new psychoactive substances NPS or designer drugs, among them several hundred with stimulant effects \[ 5 , 6 \]. Police seizures confirm this trend also in Norway \[ 3 \]. The incidence of drug overdose death is high in Norway, The toxicity of central stimulants is related to their sympathomimetic effects, including agitation, tachycardia, arrhythmias, hypertension, acute coronary syndrome, stroke, hyperthermia, hallucinations, and psychosis \[ 6 , 8 , 9 \]. As the range of available drugs and the pattern of stimulant drug use change, updated studies are needed to keep track of trends and consequences for acute poisoning. We describe patients treated for acute poisoning with central stimulant drugs in Oslo, Norway. We compare cases involving amphetamines, cocaine, MDMA, and other stimulants concerning demographics, combinations with other drugs, clinical features, treatment, and clinical course. Oslo is the capital city of Norway and had a population of , as per 1 January \[ 10 \]. About one million live in the Oslo metropolitan area. There are about , consultations per year. The Norwegian emergency health care system is two-tiered with a gate-keeping function. Unless triaged for hospital care by the ambulance service, patients are seen in primary care and cannot present directly to a hospital emergency department ED. The OUH is one of four hospitals in Oslo, with both primary and tertiary referral functions. Data from the two centers were analyzed separately. Using the case definition developed by the European Drug Emergencies Network Euro-DEN \[ 12 \], we registered all patients with acute toxic effects related to recreational drug use presenting at the two centers. Cases involving only alcohol were not included, nor poisonings related to self-harm, suicide attempts, inflicted by others, or accidental exposures. Eligible cases were found by searching the patient registration lists in the electronic patient records. From this material, we extracted all cases involving at least one central stimulant drug. From the OUH total of cases, Classification of toxic agents was based on the clinical diagnosis made by the doctor treating the patient as entered in the patient records, in its turn based on all available information, i. At the OUH, the clinical diagnosis was supplemented by toxicological analyses in urine samples in We co-categorized amphetamine and methamphetamine as amphetamine. Z-drugs were categorized as benzodiazepines. Commonly used clinical thresholds were used when defining the categorical variables. For comparisons, we grouped the cases as follows: amphetamine, cocaine, MDMA, other stimulants all other specified or unspecified stimulants , and multiple stimulants all cases involving more than one stimulant drug. We described the data using proportions for categorical variables and medians and interquartile ranges for continuous variables. The chi-square test was used when comparing categorical variables. The Kruskal—Wallis test was used when comparing continuous variables. Hence, the need for approval by an ethics committee was waived by the Norwegian ethics committee regulations for quality improvement studies. The need for informed consent from the patients was also waived by the Norwegian ethics committee regulations for quality improvement studies. Data were registered anonymously from electronic medical records. The study was performed in accordance with guidelines and regulations. Among included cases at the outpatient clinic, Amphetamine was involved in Among included cases at the hospital, Combining opioids and benzodiazepines was also frequent among patients having taken multiple central stimulant drugs. Cocaine and MDMA were frequently combined with ethanol, both at the outpatient clinic and at the hospital Tables 1 and 2. Central stimulant drug poisoning per day of week in Oslo, Norway. No patients died at the outpatient clinic. Two patients died at the hospital. Both presented in cardiac arrest and died after 2 days in the intensive care unit. In both cases, amphetamine, cocaine, and opiates were identified in the laboratory analyses. Tachycardia, reduced GCS score, and agitation were the most common clinical features at the outpatient clinic Table 3. At the hospital, reduced GCS score, anxiety, and agitation were the most common Table 4. Palpitations and chest pain were most common in the cocaine group in both settings, as were arrhythmias at the hospital. Amphetamine was often combined with opioids and benzodiazepines. Cocaine and MDMA were mainly combined with ethanol and often occurred during weekends. Cardiotoxic effects were more frequently seen when cocaine was involved. Agitation and psychosis were particularly widespread among patients having taken unspecified stimulants. Amphetamine was frequently combined with opioids. This explains why naloxone frequently was given in the amphetamine group and likely signifies that an opioid toxidrome often dominated the clinical picture of the combination. Most of these patients were probably injecting drugs, as an estimated — people in Oslo regularly do \[ 13 \]. In our study, many patients combining amphetamine and opioids had also taken benzodiazepines, signifying dangerous polydrug use in this group of patients \[ 15 , 16 \]. Most drug-induced deaths in Oslo are polydrug poisonings \[ 17 \], and fatal overdoses from combined stimulant and opioid poisoning are on the rise in the USA \[ 2 \]. Patients taking cocaine and MDMA were significantly younger than those taking amphetamine, probably reflecting the position of these drugs as party drugs or club drugs \[ 18 , 19 \]. This is consistent with findings across Europe \[ 20 \]. Along the same lines, ethanol co-ingestion was most frequent among cocaine and MDMA patients, and they more frequently presented on weekends. GHB, often also viewed as a party drug \[ 18 , 21 \] and previously found to have a weekend presentation pattern in Oslo \[ 22 \], was surprisingly often combined with amphetamine. Taking multiple stimulants seemed to be a major risk factor for severe toxicity. The largest proportions needing intubation and sedation at the hospital were found in this group. However, the patients in the cocaine group stayed the longest in the hospital. Chest pain, tachycardia, and arrhythmias were mostly seen when cocaine was taken, in line with the established cardiotoxic effects of cocaine \[ 23 \]. Psychosis is a known risk of amphetamine use \[ 24 , 25 \]. Although most of the patients presenting with psychosis had taken amphetamine, the largest proportion with psychosis and agitation was seen among patients taking unspecified stimulants. The unspecified stimulants may hide undiagnosed stimulant NPS inducing psychosis \[ 26 , 27 \], though it is also possible that these stimulants were registered as unspecified as the patients were too psychotic to give any specific information on the drugs taken. Nearly all the hospital patients were admitted to intensive care. Hence, triage for hospital treatment seems to have been appropriately targeted by the ambulance service and the outpatient clinic. Concerning the related risk of under-triage, a previous study found that patients with substance use-related poisoning were safely managed in primary care by the procedure in use at the OAEOC \[ 11 \]. A similar trend is seen in the USA, where both fatal and non-fatal overdoses from stimulant poisoning are increasing \[ 2 \]. Surprisingly, no corresponding change in the seizure of cocaine has been seen during the last decade \[ 3 \]. In wastewater analyses, gradually increasing amounts have been found since for all three drugs: amphetamine, cocaine, and MDMA \[ 4 \]. Though we found an increasing number of cocaine poisonings, figures are still low compared to other ED settings in Europe \[ 28 \]. We included patients both at the OAEOC, where most substance use-related poisonings in Oslo are treated \[ 11 \], and at one of the four Oslo hospitals. By including the hospital level, where the more severe cases are treated, our results should be representative for the Oslo area. We did not include patients left on the scene after treatment by the ambulance service, but these poisonings mainly involve opioids and ethanol \[ 29 \]. The diagnosis of toxic agents was registered from the patient records and mainly based on the clinical assessment made by the doctor treating the patient, in turn mainly based on information from the patient and companions. This may also have led to an underreporting of infrequently occurring substances. However, a previous Oslo study with toxicological testing for a broad range of psychoactive substances found that patients usually had taken what they reported \[ 27 \]. As we did not gather any follow-up data, we do not know whether any patients died shortly after discharge. This is especially a concern at the outpatient clinic where the median length of stay was as short as three hours. However, in previous studies of acute poisoning in the same setting, death shortly after discharge was extremely rare \[ 11 , 29 , 30 \]. We co-categorized amphetamine and methamphetamine. Drug users in Norway rarely distinguish between them \[ 3 \]. Norwegian police and customs seizures of methamphetamine increased after and have been in the same range as amphetamine during the last decade \[ 3 \]. Amphetamine was the most common central stimulant drug involved in acute poisoning in Oslo, often combined with opioids and benzodiazepines among people injecting drugs, constituting severe polydrug poisonings in an at-risk population. Cocaine and MDMA were often combined with ethanol and were more frequently seen during weekends, reflecting party and club use. Cardiotoxicity was more frequent when cocaine was involved. The most severe toxicity was seen when multiple stimulant drugs had been taken in combination. The cases involving unspecified stimulants had more severe psychiatric symptoms. Future research should use toxicological laboratory testing to identify the specific stimulants involved. Data are currently not available for sharing. Several manuscripts based on the data set are in preparation. Requests concerning the data may be sent to the corresponding author. World drug report Vienna: United Nations Publications; Google Scholar. The rise in non-fatal and fatal overdoses involving stimulants with and without opioids in the United States. Article Google Scholar. Rusmidler i Norge \[Substances of abuse in Norway\]. Oslo: Folkehelseinstituttet; European drug report trends and developments. Novel psychoactive substances. Tidsskr Nor Legeforen. Liechti ME. Novel psychoactive substances designer drugs : overview and pharmacology of modulators of monoamine signalling. Swiss Med Wkly. PubMed Google Scholar. Narkotika i Norge \[Narcotics in Norway\]. Accessed 4 Apr Methamphetamine use: a comprehensive review of molecular, preclinical and clinical findings. Drug Alcohol Depend. Zimmerman JL. Cocaine intoxication. Crit Care Clin. Statistikkbanken \[Statbank\], Population. Accessed 11 Feb Outpatient treatment of acute poisoning by substances of abuse: a prospective observational cohort study. Clin Toxicol. Polydrug abuse: a review of opioid and benzodiazepine combination use. Drug Alcohol depend. Diversity in causes and characteristics of drug-induced deaths in an urban setting. Scand J Public Health. Typology of club drug use among young adults recruited using time-space sampling. Do novel psychoactive substances displace established club drugs, supplement them or act as drugs of initiation? The relationship between mephedrone, ecstasy and cocaine. Eur Addict Res. Epidemiology of recreational drug toxicity in a nightclub environment. Subst Use Misuse. Patients presenting with acute poisoning to an outpatient emergency clinic: a one-year observational study in Oslo. Treatment of cocaine cardiovascular toxicity: a systematic review. Amphetamine-induced psychosis: a separate diagnostic entity or primary psychosis triggered in the vulnerable? BMC Psychiatry. Treatment of toxicity from amphetamines, related derivatives, and analogues: a systematic clinical review. Synthetic cathinone and cannabinoid designer drugs pose a major risk for public health. Front Psychiatry. Underestimated impact of novel psychoactive substances: laboratory confirmation of recreational drug toxicity in Oslo. Norway Clin Toxicol. Epidemiology, clinical features and management of patients presenting to European emergency departments with acute cocaine toxicity: comparison between powder cocaine and crack cocaine cases. Pre-hospital treatment of acute poisonings in Oslo. BMC Emerg Med. Outpatient treatment of acute poisonings in Oslo: poisoning pattern, factors associated with hospitalization, and mortality. Download references. You can also search for this author in PubMed Google Scholar. EI and OMV drafted the manuscript. All the authors revised the manuscript. The authors have read and approved the final version of the manuscript. Correspondence to Odd Martin Vallersnes. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Reprints and permissions. Ingebrigtsen, E. Poisoning with central stimulant drugs: an observational study from Oslo, Norway. Int J Emerg Med 15 , 54 Download citation. Received : 11 May Accepted : 20 September Published : 29 September Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background The use of central stimulant drugs causes significant morbidity. Methods Patients presenting from 1 October to 31 March with poisoning related to the recreational use of central stimulant drugs were retrospectively included at a primary care emergency outpatient clinic and at a hospital emergency department in Oslo, Norway. Results Among the cases of acute poisoning with central stimulant drugs at the outpatient clinic, amphetamine was involved in Conclusion Amphetamine was the most common central stimulant drug involved in acute poisoning in Oslo, often combined with opioids and benzodiazepines. Background Central stimulant use is a global problem \[ 1 \]. Settings Oslo is the capital city of Norway and had a population of , as per 1 January \[ 10 \]. Participants Using the case definition developed by the European Drug Emergencies Network Euro-DEN \[ 12 \], we registered all patients with acute toxic effects related to recreational drug use presenting at the two centers. Data collection and classification We collected data from the electronic patient records at both centers and from paper observational charts at the OAEOC, using the Euro-DEN variable set \[ 12 \]. Results Among included cases at the outpatient clinic, Table 1 Central stimulant drug poisoning — outpatient clinic patients. Demographics, drugs combined, treatment, and disposition Full size table. Table 2 Central stimulant drug poisoning — hospital ED patients. Full size image. Table 3 Clinical features of poisoning involving central stimulant drugs — outpatient clinic patients Full size table. Table 4 Clinical features of poisoning involving central stimulant drugs — hospital ED patients Full size table. Comparisons between drugs Amphetamine was frequently combined with opioids. Strengths and limitations We included patients both at the OAEOC, where most substance use-related poisonings in Oslo are treated \[ 11 \], and at one of the four Oslo hospitals. Conclusions Amphetamine was the most common central stimulant drug involved in acute poisoning in Oslo, often combined with opioids and benzodiazepines among people injecting drugs, constituting severe polydrug poisonings in an at-risk population. Availability of data and materials Data are currently not available for sharing. Article Google Scholar Download references. Acknowledgements Not applicable. Funding The study received no funding. View author publications. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. About this article. Cite this article Ingebrigtsen, E. Copy to clipboard. Contact us General enquiries: journalsubmissions springernature.

Oslo buy MDMA pills