Abstract
The Toxicology Investigators Consortium (ToxIC) Core Registry was established by the American College of Medical Toxicology in 2010. The Core Registry collects data from participating sites with the agreement that all bedside and telehealth medical toxicology consultations will be entered. This twelfth annual report summarizes the registry’s 2021 data and activity with its additional 8552 cases. Cases were identified for inclusion in this report by a query of the ToxIC database for any case entered from January 1 to December 31, 2021. Detailed data was collected from these cases and aggregated to provide information, which included demographics, reason for medical toxicology evaluation, agent and agent class, clinical signs and symptoms, treatments and antidotes administered, mortality, and whether life support was withdrawn. Gender distribution included 50.4% of cases in females, 48.2% of cases in males, and 1.4% of cases in transgender or gender non-conforming individuals. Non-opioid analgesics were the most commonly reported agent class (14.9%), followed by opioids (13.1%). Acetaminophen was the most common agent reported. Fentanyl was the most common opioid reported and was responsible for the greatest number of fatalities. There were 120 fatalities, comprising 1.4% of all cases. Major trends in demographics and exposure characteristics remained similar to past years’ reports. Sub-analyses were conducted to describe new demographic characteristics, including marital status, housing status and military service, the continued COVID-19 pandemic and related toxicologic exposures, and novel substances of exposure.
| Original language | English |
|---|---|
| Pages (from-to) | 267-296 |
| Number of pages | 30 |
| Journal | Journal of Medical Toxicology |
| Volume | 18 |
| Issue number | 4 |
| DOIs | |
| State | Published - Oct 2022 |
Bibliographical note
Funding Information:This multicenter 5-year project supported by the National Institutes of Health National Institute on Drug Abuse (NIH NIDA, Award Number R01DA048009) is a prospective clinical study of opioid overdoses in the emergency department, led by Alex Manini, MD, Professor of Emergency Medicine at the Icahn School of Medicine at Mount Sinai, and a long time ToxIC collaborator. ToxIC is assessing the prevalence and role of fentalogs, novel psychoactive drugs, adulterants, and other substances in the clinical presentation and treatment of opioid overdose patients. In a supplement to this grant, ToxIC is also partnering with the Mount Sinai Health System on data collection specific to factors related to COVID-19 infections in patients with a history of opioid misuse.
Funding Information:
Toxicology Investigators Consortium (ToxIC) Study Group Collaborators: Michael Abesamis, Jennifer Acciani, Elizabeth Adeyeye, Alek Adkins, Peter Akpunonu, Hassan Al Balushi, Timothy Albertson, Adam Algren, Alexandra Amaducci, John Archer, Robert Avera, Kavita Babu, Keith Baker, Kevin Baumgartner, Noah Bearlin, Gillian Beauchamp, Vik Bebarta, David Betting, Michael Beuhler, Steven Bird, Matthew Blundell, William Boroughf, Kayla Bourgeois, Katherine Boyle, Evan Bradley, Wells Brambl, Nicklaus Brandehoff, Marielle Brenner, Daniel Brooks, Jennie Buchanan, Michele Burns, Alfred Cahana, Kevin Caja, Diane Calello, Vince Calleo, Alexa Camarena-Michel, Joshua Canning, Robert Cannon, Dazhe Cao, Jennifer Carey, Joseph Carpenter, Stephanie Carreiro, Jorge Castaneda, Rachel Castelli, Vincent Ceretto, Edward Cetaruk, James Chenoweth, Michael Christian, Richard Church, Joseph Clemons, Daniel Colby, Grant Comstock, Albert Conicella, Matthew Cook, Matt Correia, Robert Cox, Arthur Daigh, Paul Dargan, Klara De Baerdemaeker, Anthony DeGelorm, Jonathan De Olano, Jason Devgun, Christopher Dion, William Dribben, Anna Dulaney, Bernard Eisenga, Lindsey Epperson, Rita Farah, Hank Farrar, Sing-Yi Feng, Derek Fikse, Erik Fisher, Jonathan Ford, Carolyn Fox, Keith French, Blake Froberg, Jakub Furmaga, Michael Ganetsky, Ann-Jeannette Geib, Mellisa Gittinger, Kimberlie Graeme, Powell Graham, Kevin Greene, Spencer Greene, Stacey Hail, Laurie Halmo, Riley Hartmann, Benjamin Hatten, Kennon Heard, William Heise, Robert Hendrickson, Michelle Hieger, Ruby Hoang, Michael Hodgman, Jason Hoppe, Zane Horowitz, Cory Howard, Christopher Hoyte, Katherine Hurlbut, Adrienne Hughes, Laura Hunter, Janetta Iwanicki, Jeena Jacob, Laura James, Mohamed Jefri, Lilyanne Jewett, David Johnson, Seth Jones, Bryan Judge, Eric Kaczor, Sasha Kaiser, Louise Kao, Kenneth Katz, Ziad Kazzi, Mike Keenan, Emily Kiernan, Ronald Kirschner, Kurt Kleinschmidt, Nattakarn Kongkaew, Andrew Koons, Kathryn Kopec, Michael Kosnett, Anna Krasik, Melissa Kroll, Shana Kusin, Jeffrey Lai, Melisa Lai-Becker, Becky Latch, Ophir Lavon, Eric Lavonas, Michael Levine, Brian Lewis, Erica Liebelt, Natalie Linnemeyer, David Liss, Jean Lo, Annette Lopez, David Loughran, Scott Lucyk, Yael Lurie, Nima Majlesi, Gregory Makar, Jade Malcho, Carin Malley, Michael Marlin, Stacy Marshall, Kelsey Martin, Nik Matsler, Charles McElyea, Christopher Meaden, Andrew Monte, Brent Morgan, Michael Mullins, Christine Murphy, Nicholas Nacca, Kris Nanagas, Lewis Nelson, Natalie Neumann, Anh Nguyen, Supa Niruntarai, Matthew Noble, Cherie Obilom, Aryn O'Connor, Katherine O'Donnell, Rittirak Othong, Daniel Ovakim, Daniel Overbeek, Kelly Owen, Palungwachira Pakhawadee, Mehruba Parris, Lesley Pepin, Todd Phillips, Chris Pitotti, Anthony Pizon, Lawrence Quang, John Rague, Tony Rianprakaiasang, Shannon Rickner-Schmidt, Marc Rigatti, Morgan Riggan, Brad Riley, Daniel Rivera, Bryan Ross, Brett Roth, Lindsay Schaack Rothstein, Michelle Ruha, Steven Salhanick, Ellen Salmo, Cynthia Santos, Matt Scanlon, Jay Schauben, Pieter Scheerlinck, Evan Schwarz, Kartik Shah, Kerollos Shaker, Kapil Sharma, Sophia Sheikh, Joshua Shulman, Michael Simpson, Jerry Snow, Dawn Sollee, Alaina Steck, Jennifer Stephani, Molly Stott, Ross Sullivan, Ryan Surmaitis, Courtney Temple, John Thompson, Michelle Thompson, Stephen Thornton, Lisa Thurgur, Michael Toce, Laura Tormoehlen, William Trautman, Chiemela Ubani, David Vearrier, George Wang, Sam Wang, George Warpinski, James Watson, Mitchell Waters, Mary Wermuth, James Whitledge, Timothy Wiegand, Brian Wolk, David Wood, Mark Yarema, Luke Yip, Amy Young, Matthew Zuckerman
Funding Information:
The Toxicology Investigators Consortium received funding from the US National Institute of Drug Abuse (1RO1DA037317-02) and the American Academy of Addiction Psychiatry (1H79TI083343) and has data-sharing contracts with the U.S. Food and Drug Administration, Centers for Disease Control and Prevention, and BTG International, Inc. (North America).
Funding Information:
In 2021, ToxIC was supported by the NIH, US FDA, the United States Centers for Disease Control and Prevention, and BTG International, Inc. These collaborations have been enriching for ToxIC, but more importantly have provided unique networking opportunities for ToxIC investigators.
Publisher Copyright:
© 2022, American College of Medical Toxicology.
Keywords
- Epidemiology
- Medical toxicology
- Overdose
- Poisoning
- Surveillance
ASJC Scopus subject areas
- Toxicology
- Health, Toxicology and Mutagenesis