Globally, drug poisoning ranks as the second leading cause of poisoning-related fatalities. It is now the top killer in Brazil and many other nations, surpassing smoking1. Most cases of chemical poisoning, especially in youngsters, are unintentional2. Acute poisoning, such as chemical poisoning, causes serious symptoms to appear in less than 24 hours and may have a devastating impact on the victim3. Various causes have led to reports of chemical poisoning in people of all ages in many Saudi cities, including Jeddah, Riyadh, Makkah, Najran, and Al-Qassim4,5.
understanding the scope and patterns of intentional analgesic poisonings, which pose serious public health concerns is required to develop targeted interventions to mitigate the risks associated with deliberate misuse or overdose. By examining data from national surveillance systems, the study seeks to identify key demographic factors, geographic variations, and temporal trends associated with intentional analgesics poisoning incidents, thereby informing evidence-based strategies for prevention and intervention efforts in Saudi Arabia.
A retrospective investigation was employed to analyse existing national poisoning surveillance data collected from January 2017 to December 2021. The sample size comprised the entire accessible population of intentional analgesics poisoning cases as documented in the national poisoning surveillance data in Saudi Arabia from 2017 to 2021.
A comprehensive analysis of intentional analgesics misuse cases in Saudi Arabia from 2017 to 2021 yielded a total of 863 documented incidents. Most of cases were females (n= 671, 77.8%). Among these cases, the majority (699 cases, 81%) were attributed to Saudi nationals (Figure 1).
Regarding presenting symptoms, abdominal symptoms were the most prevalent, reported in 176 cases, followed by nausea in 130 cases and vomiting in 107 cases. A smaller subset of patients presented with dizziness (18 cases) or other symptoms (17 cases), underscoring the diverse clinical manifestations associated with intentional analgesics misuse (Figure 2).
In terms of the specific drugs involved, paracetamol emerged as the predominant agent, implicated in 645 cases (75%). Aspirin and Ibuprofen were also identified, albeit less frequently, with 24 and 17 cases, respectively, indicating a varied spectrum of analgesic agents utilized in cases of intentional misuse.
Geographically, the distribution of cases across regions revealed notable disparities. Riyadh, the capital city, reported the highest incidence with 245 cases (28%), followed by Jeddah (120 cases, 14%), Alhasa (110 cases, 13%), the Eastern region (75 cases, 9%), Najran (38 cases, 4%), and Qassim (35 cases, 4%). These findings underscore the need for targeted interventions tailored to the specific regional epidemiological profiles (Figure 3).
Tragically, the outcomes of intentional analgesics misuse were not uniformly benign. Seventeen patients experienced deterioration in their condition, while one fatality was recorded, highlighting the gravity of the consequences associated with deliberate misuse or overdose of analgesic medications.
In terms of the form and route of ingestion, solid forms of medication were overwhelmingly predominant, accounting for 772 cases (89%). Additionally, oral ingestion emerged as the most common route, implicated in 851 cases (99%), underscoring the importance of preventive measures targeting this mode of exposure. Blood samples were obtained from 436 participants (50.5%) while urine sampled from 165 participants (19.1%) and gastric samples from 99 participants (11.5%). Majority of participants recovered; however, one participant was reported to death.
This study provides valuable insights that can inform the development and implementation of targeted public health policies and interventions aimed at reducing the burden of intentional analgesics poisoning in Saudi Arabia and improving public health outcomes in the country.
Figure 1: Participants distribution based on nationality
Figure 2: Participants distribution based on symptoms
Figure 3: Participants distribution based on geographical region
References
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