{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T13:58:22Z","timestamp":1775656702329,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":97,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The nonmedical use of prescription drugs (NMUPD) through channels outside the healthcare system has emerged as a significant public health issue; however, its clinical implications in overdose cases remain underexplored in Japan. This study aimed to elucidate the prevalence and characteristics of NMUPD in patients with acute drug overdose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this observational study, we retrospectively studied patients with overdose who were admitted to a tertiary emergency department in Japan between April 2017 and March 2024. Patients were categorized into the NMUPD group (obtained drugs via nonmedical routes, such as family, acquaintances, the Internet, and unauthorized workplace access) and prescribed group. Demographic, clinical, and overdose\u2010related variables were compared between the groups. Statistical analyses included the chi\u2010square and Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests, with multiple imputation for missing data.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 416 patients with overdose, 7.9% met the NMUPD criteria. The primary sources of NMUPD were family members, followed by friends\/acquaintances, Internet purchases, and unauthorized pharmacy access. The NMUPD group showed significantly higher rates of alcohol coingestion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029) and absence of psychiatric diagnoses (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). Benzodiazepines predominated in both groups, with frequent use of non\u2010benzodiazepine and antidepressants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study revealed that NMUPD occurs even within Japan's tightly regulated healthcare system, primarily via informal sources such as patients' families and friends. NMUPD was linked to alcohol coingestion and limited psychiatric follow\u2010ups. NMUPD involved several commonly prescribed psychotropic drug classes rather than a single class.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ams2.70126","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T13:11:01Z","timestamp":1775653861000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics of Patients With Overdose Engaging in Nonmedical Use of Prescription Drugs: A Single\u2010Center Study in Japan"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3464-7035","authenticated-orcid":false,"given":"Nobuki","family":"Shioya","sequence":"first","affiliation":[{"name":"Critical Care and Emergency Center National Hospital Organization Hokkaido Medical Center  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nozomu","family":"Inoue","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Center National Hospital Organization Hokkaido Medical Center  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Nishitani","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Center National Hospital Organization Hokkaido Medical Center  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naonori","family":"Kawashima","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Center National Hospital Organization Hokkaido Medical Center  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Tsukamoto","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Center National Hospital Organization Hokkaido Medical Center  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiro","family":"Sato","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Center National Hospital Organization Hokkaido Medical Center  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Sadamoto","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Center National Hospital Organization Hokkaido Medical Center  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Naito","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Center National Hospital Organization Hokkaido Medical Center  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohji","family":"Hazama","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Center National Hospital Organization Hokkaido Medical Center  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Shichinohe","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Center National Hospital Organization Hokkaido Medical Center  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"22","article-title":"Clinical and Psychosocial Factors Associated With Deliberate Self\u2010Poisoning Using Psychotropic Medications at the Emergency Medical Center","volume":"18","author":"Takai M.","year":"2015","journal-title":"Journal of the Japanese Society for Emergency Medicine"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/BF03379620","article-title":"Current Situation and Clinical Characteristics of Sedative\u2010Related Disorder Patients in Japan: Comparison With Methamphetamine\u2010Related Disorder Patients","volume":"57","author":"Matsumoto T.","year":"2015","journal-title":"Activitas Nervosa Superior"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"901","DOI":"10.3893\/jjaam.19.901","article-title":"Clinical Characteristics of Patients With Psychotropic Drug Overdose Admitted to the Emergency Department","volume":"19","author":"Ookura R.","year":"2008","journal-title":"Nihon Kyukyu Igakukai Zasshi"},{"key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1186\/s12888-016-0909-3","article-title":"Nonmedical Use of Prescription Drugs in the European Union","volume":"16","author":"Novak S. P.","year":"2016","journal-title":"BMC Psychiatry"},{"key":"e_1_2_13_6_1","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.drugalcdep.2018.02.010","article-title":"The Source and Diversion of Pharmaceutical Drugs for Non\u2010Medical Use: A Systematic Review and Meta\u2010Analysis","volume":"186","author":"Hulme S.","year":"2018","journal-title":"Drug and Alcohol Dependence"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1248\/yakushi.24-00154","article-title":"Analysis of Overdose\u2010Related Posts on Social Media","volume":"144","author":"Sato R.","year":"2024","journal-title":"Yakugaku Zasshi"},{"key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1248\/yakushi.22-00048","article-title":"A Survey of Illegal Medication Trading Through Twitter in Japan","volume":"142","author":"Hakariya H.","year":"2022","journal-title":"Yakugaku Zasshi"},{"key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.jadohealth.2012.01.011","article-title":"Nonmedical Use of Prescription Medications Among Adolescents in the United States: A Systematic Review","volume":"51","author":"Young A. 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K.","year":"2010","journal-title":"Journal of Substance Abuse Treatment"},{"key":"e_1_2_13_14_1","first-page":"1164","article-title":"Psychiatric Comorbidity and Access to Mental Health Care in Persons Who Use Drugs and Report Suicidal Ideation","volume":"72","author":"Hoover D. 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