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The pathophysiology of hyperthermia secondary to illicit drug toxicity can be associated with and complicated by additional precipitants such as exertion and high ambient temperature (&gt;\u200931\u00b0C). We present cases highlighting the clinical features, morbidity and mortality associated with IDIH. The priorities of management include interventions to decrease ongoing heat production, active cooling and targeted supportive care. Temperature control should ideally be achieved within 15\u2009min to prevent irreversible organ injury. IDIH presentations may be viewed as a high acuity low occurrence (HALO) event. As such, we recommend the use of a specific IDIH protocol and early consultation with clinical toxicology specialists for hyperthermia presentations with suspected illicit drug use.<\/jats:p>","DOI":"10.1111\/1742-6723.70065","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T02:42:21Z","timestamp":1749523341000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Illicit Drug Induced Hyperthermia (<scp>IDIH<\/scp>)"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4818-4980","authenticated-orcid":false,"given":"\u00dana","family":"Nic Ionmhain","sequence":"first","affiliation":[{"name":"NSW Poisons Information Centre Sydney Children's Hospitals Network  Sydeny New South Wales Australia"},{"name":"South West Sydney Clinical Campuses, School of Clinical Medicine, Medicine &amp; Health University of New South Wales  Sydney 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