The latest annual report from the National Poisons Information Service (NPIS) shows a marked increase in activity related to nitrous oxide and ketamine
The National Poisons Information Service (NPIS), an expert toxicology advice service commissioned by the UK Health Security Agency (UKHSA), has today released its annual report for 2022 to 2023. The report details how often and for what reasons the NPIS was consulted by clinicians. This year’s report shows a marked increase in NPIS activity related to nitrous oxide and ketamine.
The report shows an increase of approximately 175% in all forms of NPIS activity linked to nitrous oxide and an increase of approximately 25% in activity linked to ketamine since last year’s report. This data is consistent with other reports showing an increase in usage of these substances in the UK.
Poisoning is an important public health issue in the UK, accounting for over 380,000 hospital presentations in 2019 to 2020, in England alone, and many more consultations with primary care and NHS patient advice services such as NHS 111.
The majority of episodes of poisoning in adults are caused by drug overdose in the context of self-harm and drug misuse is also a significant cause of mortality. In children, accidental exposures are common, particularly involving substances found within the household. Most UK hospitals do not have specialist clinical toxicology services, therefore 24-hour access to expert advice concerning people with exposure to drugs and chemicals is essential for their safe and effective management.
NPIS provides clinical support to healthcare professionals to manage potential exposures to toxins and assist in providing appropriate clinical care and avoiding unnecessary referrals and hospital admissions. It provides a 24-hour telephone advice line, staffed by specialists in poisons information and supported by consultant clinical toxicologists for advice on more serious or challenging cases.
NPIS operates from 4 NHS hospitals in Birmingham, Cardiff, Edinburgh and Newcastle, working collaboratively to deliver a fully integrated national service across the whole of the UK.
NPIS also offers information and advice about thousands of drugs and chemicals through its online database TOXBASE and the TOXBASE app. This service is freely available to all UK healthcare professionals, supporting informed decision-making in poisoning cases. The service extends to include the UK Teratology Information Service (UKTIS), delivering expert advice regarding exposure to drugs and chemicals during pregnancy.
Professor Raquel Duarte-Davidson, Radiation, Chemicals and Environmental Hazards Directorate, UKHSA said:
The NPIS annual report serves as a comprehensive statement of NPIS’s activities, emphasising its pivotal role in managing poisoning cases, offering expert advice, and contributing to public health efforts.The rise in nitrous oxide and ketamine-related activities underscores the need for targeted interventions to protect public health and prevent further harm.
Professor Michael Eddleston Chair, NPIS Clinical Standards Group said:
This year’s annual report again demonstrates the value of the close collaboration between the NPIS, UKTIS and UKHSA to address problems of poisoning across the UK and globally.NPIS goes beyond clinical support, engaging in research, education, and the collection and sharing of surveillance data. This multifaceted approach contributes significantly to public health and health security efforts in the UK and internationally.