{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T02:02:16Z","timestamp":1771207336815,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007281","name":"National Drug and Alcohol Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007281","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003921","name":"Department of Health and Aged Care, Australian Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Recent years have seen marked increases in the non\u2010medical use of ketamine. We aimed to determine: (i) the population mortality rates of self\u2010administered fatal ketamine\u2010related poisoning cases in Australia, 2000\u20132022; (ii) the characteristics, toxicology and major autopsy findings of cases in Australia, 2000\u20132025; and (iii) changes in case characteristics across the period 2000\u20132025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective study of fatal ketamine\u2010related poisoning in Australia retrieved from the National Coronial Information System.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>118 cases were identified, 100 (84.7%) of which occurred after 2014. There was a significant upward trend in event rates between 2000 and 2022 (IRR\u2009=\u20091.16). The mean age was 36.2\u2009years and 77.1% were male. The majority (72.9%) of poisonings were unintentional, in 19.5% the final route of ketamine administration was by injection, and a history of substance use problems was documented in 50.8%. There were no significant differences in these case characteristics across the study period. In 14 cases, the decedent was documented as being prescribed take\u2010home ketamine at the time of death and had consumed this medication. The median blood ketamine concentration was 0.20\u2009mg\/L (range 0.01\u201325.0), which did not significantly differ across time. Psychoactive drugs other than ketamine were present in all cases, most frequently hypnosedatives (68.6%) and opioids (62.7%), with a significant difference across time observed in the presence of hypnosedatives (OR 1.45). Cardiomegaly was diagnosed in 13.9% and cardiac fibrosis in 11.1%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>There has been a significant increase in self\u2010administered ketamine\u2010related poisoning deaths. Caution should be exercised in prescribing ketamine for self\u2010administration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70058","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T04:00:36Z","timestamp":1761105636000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rates and Clinical Characteristics of Self\u2010Administered Fatal Ketamine\u2010Related Poisoning in Australia, 2000\u20132025"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8718-7055","authenticated-orcid":false,"given":"Shane","family":"Darke","sequence":"first","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Farrell","sequence":"additional","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"Duflou","sequence":"additional","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre UNSW Sydney  Sydney Australia"},{"name":"Sydney Medical School The University of Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Lappin","sequence":"additional","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre UNSW Sydney  Sydney Australia"},{"name":"Discipline of Psychiatry and Mental Health UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agata","family":"Chrzanowska","sequence":"additional","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5705-2026","authenticated-orcid":false,"given":"Amy","family":"Peacock","sequence":"additional","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/02698811241273850"},{"key":"e_1_2_9_3_1","volume-title":"Disposition of Toxic Drugs and Chemicals in man","author":"Baselt R. C.","year":"2020"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22536"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2021.1061"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/02698811211021588"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2023.2212125"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2021.1949454"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2021.02.020"},{"key":"e_1_2_9_10_1","volume-title":"Low\u2010Prevalence Illicit Drugs in the NDSHS","author":"Australian Institute of Health and Welfare","year":"2024"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2021.82.188"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7344a4"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.12.108"},{"key":"e_1_2_9_14_1","first-page":"6","article-title":"Emergency Department Presentation of Ketamine Abusers in Hong Kong: a Review of 233 Cases","volume":"16","author":"Ng S. H.","year":"2010","journal-title":"Hong Kong Medical Journal"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2018.04.066"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.70052"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2022.2132506"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15154"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1520\/JFS14742J"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/02698811221140006"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/12.5.268"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e3181612cdc"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2021-0287-OA"},{"key":"e_1_2_9_24_1","volume-title":"SPSS for Windows, 28.0","author":"IBM Inc","year":"2024"},{"key":"e_1_2_9_25_1","volume-title":"National, State and Territory Population","author":"Australian Bureau of Statistics","year":"2024"},{"key":"e_1_2_9_26_1","volume-title":"Operational Statistics, April 2025","author":"National Coronial Information System","year":"2025"},{"key":"e_1_2_9_27_1","volume-title":"Stata 18","author":"StataCorp LLC","year":"2024"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674251333577"},{"key":"e_1_2_9_29_1","volume-title":"Australian Drug Trends 2025: Key Findings From the National Ecstasy and Related Drugs Reporting System (EDRS) Interviews","author":"Sutherland R.","year":"2025"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16377"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16055"}],"container-title":["Drug and Alcohol Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.70058","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dar.70058","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.70058","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T01:11:57Z","timestamp":1771204317000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dar.70058"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,21]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/dar.70058"],"URL":"https:\/\/doi.org\/10.1111\/dar.70058","archive":["Portico"],"relation":{},"ISSN":["0959-5236","1465-3362"],"issn-type":[{"value":"0959-5236","type":"print"},{"value":"1465-3362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,21]]},"assertion":[{"value":"2025-08-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70058"}}