The following is a summary of “Self-discharge during treatment for acute recreational drug toxicity: an observational study from emergency departments in seven European countries,” published in the November 2023 issue of Emergency Medicine by Vallersnes et al.

The potential for self-discharge poses a risk of increased rates of readmission and higher mortality.

Researchers conducted a retrospective study to examine the self-discharge rate in acute recreational drug toxicity cases presented to the emergency department (ED) and identify associated factors.

They extracted data from 11 centers in seven European countries (2014 to 2017), utilizing the Euro-DEN Plus database of ED presentations for acute recreational drug toxicity. Self-discharge was either opting for one’s own discharge or leaving the ED without medical clearance. Multiple logistic regression analyses were employed to identify factors associated with self-discharge.

The result showed 15,135 presentations, 11.9% (1,807) resulted in self-discharge, with rates ranging from 1.7% to 17.1% across centers. Synthetic cannabinoids exhibited an adjusted odds ratio of 1.44 (95% CI 1.10–1.89) for self-discharge, as did heroin (1.44, 1.26–1.64), agitation (1.27, 1.10–1.46), and naloxone treatment (1.27, 1.07–1.51). Sedation was associated with protection from self-discharge, with an odds ratio of 0.38 (0.30–0.48).

Investigators concluded that high self-discharge rates among patients with drug toxicity, with variations suggesting room for improvement in discharge procedures and managing agitation and withdrawal symptoms.

Source: intjem.biomedcentral.com/articles/10.1186/s12245-023-00566-1