{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:32:33Z","timestamp":1777667553089,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T00:00:00Z","timestamp":1615334400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPG3H0921"],"award-info":[{"award-number":["CMRPG3H0921"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hum Exp Toxicol"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Synthetic cathinone abuse is a global health issue. Synthetic cathinones emerged in Taiwan in 2009, and their prevalence rapidly rose. They are usually made into \u201cinstant coffee packets,\u201d and these so-called \u201ctoxic coffee packets\u201d may also contain psychoactive drugs other than synthetic cathinones. Due to the diversity of the ingredients, clinical presentations can be complex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective analysis of emergency department (ED) patients who reported ingesting toxic coffee packets at three Chang-Gung Memorial Hospitals located in northern Taiwan between January, 2015 and December, 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Sixty patients were included. Their mean age was 28.85 \u00b1 9.24 years and 47(78.33%) were male. The most common presentations were palpitation, agitation, hallucination, and altered consciousness. Tachycardia and hypertension were common, while hyperthermia was observed in only three patients. Three patients (5%) developed rhabdomyolysis, and one underwent transient hemodialysis. Most patients were discharged from the ED, but 15(25%) were admitted, of whom nine (15%) were admitted to the intensive care unit (ICU), and one eventually died. Confirmation tests (mass-spectrometry-based analysis) were available in 10 patients; all reported positive for at least one type of synthetic cathinone. Polysubstance exposure was common. In multivariate logistic regression analyses, Glasgow coma scale \u226413 and the presence of seizure were associated with ICU admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Patients who report ingesting toxic coffee packets are very likely to have been exposed to synthetic cathinones. Polysubstance exposure is common following ingestion. Cardiovascular and neurological symptoms are the main presentations, and severe complications such as rhabdomyolysis and life-threatening dysrhythmia can occur.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0960327121996043","type":"journal-article","created":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T04:50:27Z","timestamp":1615351827000},"page":"1403-1412","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["Synthetic cathinone poisoning from ingestion of drug-laced \u201cinstant coffee packets\u201d in Taiwan"],"prefix":"10.1177","volume":"40","author":[{"given":"H-H","family":"Chou","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C-H","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3702-7499","authenticated-orcid":false,"given":"C-H","family":"Chaou","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou"},{"name":"College of Medicine, Chang Gung University, Taoyuan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9353-026X","authenticated-orcid":false,"given":"C-K","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0907-1505","authenticated-orcid":false,"given":"T-H","family":"Yen","sequence":"additional","affiliation":[{"name":"College of Medicine, Chang Gung University, Taoyuan"},{"name":"Department of Nephrology and Clinical Poison Center, Chang Gung Memorial Hospital, Taoyuan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S-C","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C-J","family":"Seak","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou"},{"name":"College of Medicine, Chang Gung University, Taoyuan"},{"name":"Department of Emergency Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H-Y","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou"},{"name":"College of Medicine, Chang Gung University, Taoyuan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,3,10]]},"reference":[{"key":"bibr1-0960327121996043","unstructured":"United Nations Office on Drugs and Crime (UNODC). 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