Toxicological and Clinical Characteristics of Fatal Cases in the Emerging Drugs Network of Australia-Victoria (EDNAV) Clinical Registry 2020-2025
Abstract
Objective: The objective of this study is to characterise the analytical toxicology findings and clinical features of fatal cases recorded in the Emerging Drugs Network of Australia-Victoria (EDNAV) clinical registry.
Methods: EDNAV is a state-wide toxicosurveillance system capturing de-identified demographic, clinical and analytical data from ED presentations with illicit drug-related toxicity. Venous blood samples are screened for illicit, pharmaceutical and novel psychoactive substances (NPS) using liquid chromatography-quadrupole time-of-flight mass spectrometry. We conducted a retrospective observational case series of fatal registry cases recorded between September 2020 and December 2025.
Results: Forty-six fatal cases were identified (0.9% of 5026 EDNAV cases). Most patients were male (89%) with a median age of 33 years. Out-of-hospital cardiac arrest occurred in 67% of cases. Polysubstance exposure predominated (91%), with a median of three substances detected per case. Mixed stimulant-sedative patterns were most common (64%), followed by opioid-benzodiazepine (19%) and stimulant-only (7%). The most frequent individual detections were methamphetamine (54%), heroin (52%), diazepam (37%), cocaine (20%) and MDMA (17%). NPS accounted for 7.8% of detections, were never identified in isolation and were predominantly novel benzodiazepines (80%). Hypoxic brain injury was the most common terminal complication (72%).
Conclusion: Fatal cases were characterised by near-universal…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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