New Psychoactive Substances (NSP) intoxications data collection system in Poland

Aim The use of NPS has been a problem in Poland since 2010. According to ESPAD 2015 survey 4 % of the students in Europe reported lifetime experience with NPS, with the highest rates in Estonia and Poland (10 % each). One of the best quantitative indicator of NPS use is the amount of intoxications, including fatal cases. Data on intoxications (deaths, non-fatal and suspicions) have been collected in systematic way since 2013. A data collection system on the one hand makes it possible to compare data from all over country, on the other hand, it allows to react quickly to the sudden increase in poisoning in a given area in a short time, like in July 2015 (2000 cases in one month mainly in one region).

Methods Data on NPS intoxications from all over the country are collected by the Chief Sanitary Inspector (GIS) through local and regional structures. The register is kept in the form of a database, powered by Inspection employees at the local level, which are verified at the regional level. In addition, the entire database can be verified by the Toxicological Control Center in Warsaw for the purpose of eliminating poisoning not related to NPS. The register is classified as: "substitute drug", “unknown dope”, "unknown narcotic drug", unknown psychoactive substance, unspecified substance (psychoactive), named NSP or NPS products. Information on intoxications, suspicions of intoxication and deaths are collected in the database on an ongoing basis (up to 48 hours from the occurrence of the event) and verified in a two-week cycle. In a crisis situation data can be verified daily. Since 2018 date are collected on-line.

Results The database gives you the ability to prepare reports based on following variables: date of medical intervention / event (intoxication, NSP applications), the name of the submitting institution that medical intervention, age and gender and the initial of the patient, location of the event (place) place of medical assistance (name of a health care facility), the mode of assistance provided, indicating the severity of poisoning (outpatient treatment, hospitalization, intensive medical care), the name of the NPS product (if this information is obtained). The system gives the opportunity to prepare indicators (e.g. medical interventions into 100,000 inhabitants); to present data time series, by region, gender, age group. The trends can be learned. For example, since 2013, the percentage of intoxicated under 18 years has been steadily dropping: from 43% in 2013 to 20.5% in 2017. In 2018, there were more than 4,200 cases noticed, and since 2013, there have been almost 25,000 cases.

Conclusions Based on the assessment of the epidemiological situation resulting from the monitoring of NPS intoxications, a new anti-drug law was introduced in Poland in 2018 aimed at reducing the threat to public health due to the alarming epidemiological situation; the system also allows issuing public warnings; The database is also useful in preparing prevention programs.