{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T13:58:47Z","timestamp":1792418327728,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Recent years have seen sporadic reports in Australia of stimulants being contaminated with opioids. Since late 2023, there has been an increase in opioid overdoses among individuals in New South Wales (NSW) using substances believed to be cocaine or methamphetamine. We analysed the frequency and characteristics of these cases and describe our public health responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Prescription, Recreational &amp; Illicit Substance Evaluation (PRISE), operated by NSW health since July 2018, is a statewide surveillance, epidemiology, and toxicity response programme. We did a retrospective analysis of each case of opioid toxicity following use of cocaine or methamphetamine submitted to the PRISE programme from January 2022 to June 2024, categorising cases into confirmed, probable, and suspected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010four cases were found, 19 involving cocaine and 15 involving methamphetamine. Twenty\u2010two (65%) were classified as confirmed, and 12 (35%) as probable. There were two deaths (6%). Twenty\u2010three cases (68%) were in Sydney. Multiple stakeholders reviewed trends and formulated public health responses, leading to the distribution of public drug warnings and media releases in November 2023 and February 2024 because of ongoing case detections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The increase in detections, which continued in the months following the public health responses, underscores the need for comprehensive surveillance, response, monitoring, and reporting of this phenomenon in NSW. Engagement with clinicians and the community is essential for the success of this programme.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1742-6723.70038","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T21:26:20Z","timestamp":1743801980000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Opioid overdoses following use of cocaine and methamphetamine in\n                    <scp>New South Wales<\/scp>\n                    , and the public health responses"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5270-2798","authenticated-orcid":false,"given":"Peter","family":"Chisholm","sequence":"first","affiliation":[{"name":"Centre for Alcohol and Other Drugs New South Wales Ministry of Health  Sydney New South Wales Australia"},{"name":"New South Wales Poisons Information Centre Sydney Children's Hospitals Network  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6855-3865","authenticated-orcid":false,"given":"Jared","family":"Brown","sequence":"additional","affiliation":[{"name":"Centre for Alcohol and Other Drugs New South Wales Ministry of Health  Sydney New South Wales Australia"},{"name":"New South Wales Poisons Information Centre Sydney Children's Hospitals Network  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9546-1939","authenticated-orcid":false,"given":"Thanjira","family":"Jiranantakan","sequence":"additional","affiliation":[{"name":"Centre for Alcohol and Other Drugs New South Wales Ministry of Health  Sydney New South Wales Australia"},{"name":"New South Wales Poisons Information Centre Sydney Children's Hospitals Network  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Edith Collins Centre, Drug Health Services Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8763-3115","authenticated-orcid":false,"given":"Mary Ellen","family":"Harrod","sequence":"additional","affiliation":[{"name":"NSW Users and AIDS Association  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3745-6653","authenticated-orcid":false,"given":"Catherine","family":"McDonald","sequence":"additional","affiliation":[{"name":"NSW Health Pathology, Forensic &amp; Analytical Science Service Forensic Toxicology Laboratory  Lidcombe New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Una","family":"Cullinan","sequence":"additional","affiliation":[{"name":"NSW Health Pathology, Forensic &amp; Analytical Science Service Illicit Drug Analysis Unit  Lidcombe New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9101-7577","authenticated-orcid":false,"given":"Darren M","family":"Roberts","sequence":"additional","affiliation":[{"name":"New South Wales Poisons Information Centre Sydney Children's Hospitals Network  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of New South Wales  Sydney New South Wales Australia"},{"name":"Edith Collins Centre, Drug Health Services Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Australian Institute of Health and Welfare.National Drug Strategy Household Survey 2022\u20132023. 2024. [Cited 10 Dec 2024.] Available from URL:https:\/\/www.aihw.gov.au\/about\u2010our\u2010data\/our\u2010data\u2010collections\/national\u2010drug\u2010strategy\u2010household\u2010survey\/2022\u2010ndshs"},{"key":"e_1_2_10_3_1","article-title":"Rates and patterns of Australian emergency department presentations of people who use stimulants: a systematic literature review","volume":"14","author":"Redona PT","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000717"},{"key":"e_1_2_10_5_1","first-page":"1","article-title":"Co\u2010involvement of opioids in drug overdose deaths involving cocaine and psychostimulants, 2011\u20132021","volume":"474","author":"Spencer MR","year":"2023","journal-title":"NCHS Data Brief."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109341"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108416"},{"key":"e_1_2_10_8_1","unstructured":"August 2024 Colombo Plan Bulletin\u2014Trends in Toxic Adulterants in Street Drugs in the United States: The Center for Forensic Science Research and Education. 2024. 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[Cited 10 Dec 2024.] Available from URL:https:\/\/www.health.nsw.gov.au\/aod\/programs\/Publications\/prise\u2010summary\u2010report\u20102018\u20102021.pdf"},{"key":"e_1_2_10_21_1","unstructured":"Australian Government Department of Health and Aged Care.CDNA Series of National Guidelines (SoNGs). 2023. [Cited 10 Dec 2024.] Available from URL:https:\/\/www.health.gov.au\/resources\/collections\/cdna\u2010series\u2010of\u2010national\u2010guidelines\u2010songs"},{"key":"e_1_2_10_22_1","unstructured":"NSW Health.Rise in Opioid Overdoses After Use of Cocaine or Methamphetamine. 2024. [Cited 23 Feb 2024.] Available from URL:https:\/\/www.health.nsw.gov.au\/aod\/public\u2010drug\u2010alerts\/Pages\/opioids\u2010in\u2010cocaine\u2010methamphetamine\u2010feb24.aspx"},{"key":"e_1_2_10_23_1","unstructured":"Heroin Overdose After Using Cocaine: NSW Health. 2023. [Cited 23 Feb 2024.] Available from URL:https:\/\/www.health.nsw.gov.au\/aod\/public\u2010drug\u2010alerts\/Pages\/opioids\u2010in\u2010cocaine\u2010methamphetamine\u2010feb24.aspx"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-023-00761-6"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2021.1904140"},{"key":"e_1_2_10_26_1","unstructured":"NSW Health.Four Heroin Overdoses Following Use of Cocaine. 2024. [Cited 13 Sep 2024.] Available from URL:https:\/\/www.health.nsw.gov.au\/aod\/public\u2010drug\u2010alerts\/Pages\/heroin\u2010overdose\u2010after\u2010cocaine.aspx"},{"key":"e_1_2_10_27_1","unstructured":"NSW Health.Multiple Heroin Overdoses Following Use of Cocaine. 2024. [Cited 21 Nov 2024.] Available from URL:https:\/\/www.health.nsw.gov.au\/aod\/public\u2010drug\u2010alerts\/Pages\/heroin\u2010overdose\u2010after\u2010cocaine\u2010nov24.aspx"},{"key":"e_1_2_10_28_1","unstructured":"Case Definition: Opioids (Fentanyl Etorphine or Others) Centers for Disease Control\u2014Emergency Preparedness and Response. [Cited 10 Dec 2024.] Available from URL:https:\/\/emergency\u2010origin.cdc.gov\/agent\/opioids\/casedef.asp"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.70038","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:14:11Z","timestamp":1747354451000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.70038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":27,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1111\/1742-6723.70038"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.70038","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"value":"1742-6731","type":"print"},{"value":"1742-6723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-09-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70038"}}