Knut Erik Hovda

• Busken, W. J. van den; Dines, Alison M.; Eyer, Florian; Heyerdahl, Fridtjof; Hovda, Knut Erik & Liechti, Matthias E. [Show all 13 contributors for this article] (2026). Cardiovascular effects associated with acute recreational drug toxicity presentations to the emergency department: a European drug emergencies network (Euro-DEN plus) study. Clinical Toxicology. ISSN 1556-3650. doi: 10.1080/15563650.2026.2669671. Full text in Research Archive
• Perkins, Janet E.; Sørensen, Jane Brandt; Islam, Md Shafiqul; Hovda, Knut Erik; Chowdhury, Fazle Rabbi & Ghose, Aniruddha [Show all 9 contributors for this article] (2026). Missed opportunities in methanol poisoning: a qualitative exploration of the socio-material practices of health professionals responding to acute methanol poisoning in Bangladesh. BMJ Open. 16(4). doi: 10.1136/bmjopen-2025-114864. Full text in Research Archive
• Ouwerkerk, Joep J.J.; Wood, David M.; Dines, Alison M.; Yates, Christopher; Eyer, Florian & Heyerdahl, Fridtjof [Show all 14 contributors for this article] (2025). Differences in the clinical presentation of acute 3,4-methylenedioxymetamfetamine intoxication by co-intoxication and patient sex to European emergency departments. Clinical Toxicology. ISSN 1556-3650. 63(3), p. 183–192. doi: 10.1080/15563650.2025.2453052. Full text in Research Archive
• Lyphout, Cathelijne; Paepe, Peter De; Dines, Alison M.; Eyer, Florian; Giraudon, Isabelle & Heyerdahl, Fridtjof [Show all 14 contributors for this article] (2025). Emergency Department Presentations Related to the Abuse of Illicit and Prescription Opioids Through a European Sentinel-centres–Based Registry. Journal of addiction medicine. ISSN 1932-0620. doi: 10.1097/adm.0000000000001632. Full text in Research Archive Show summary

  Objectives: Opioid use, both prescribed and illicit, has caused considerable harm and fatalities. This study aims at characterising patterns of emergency department (ED) presentations related to opioid abuse across Europe. Methods: Data on demographics, clinical features, and epidemiology were extracted from the Euro-DEN Plus data set for presentations involving acute opioid toxicity between October 2013 and December 2021. Results: Of 62,545 presentations, 3888 (6.2%) involved prescription opioids, 11,252 (18.0%) illicit opioids, and 587 (0.9%) both. Heroin accounted for 99.8% of illicit opioid cases. The most commonly reported prescription opioids were methadone (51.3%), buprenorphine (13.9%), morphine (9.3%), fentanyl (6.8%), and tramadol (6.7%). Co-use of benzodiazepines and Z-drugs (35.6%) and pregabalin (6.6%) was significantly higher in prescription opioid cases compared with illicit (20.6% and 1.5%, respectively; P < 0.001). Mortality was greater with prescription opioids (1.2%) than illicit opioids (0.4%, P < 0.001). Conclusions: Heroin remains the predominant opioid; though the relative contribution of prescription opioids varies significantly across centres and countries. Methadone and buprenorphine predominate among prescribed opioids, while fentanyl and oxycodone account for a small proportion, contrasting with North American patterns.

• Miró, Òscar; Galicia, Miguel; Dargan, Paul I.; Wood, David M.; Dines, Alison M. & Heyerdahl, Fridtjof [Show all 13 contributors for this article] (2025). Changes in clinical features and severity in patients presenting to European emergency departments with acute cannabis toxicity over the 10‐year period from 2013 to 2022. Addiction. ISSN 0965-2140. doi: 10.1111/add.70233. Full text in Research Archive Show summary

  Abstract Background and aims In recent years, the potency of natural cannabis products (herb and resin) has increased with a higher delta‐ 9‐tetrahydrocannabinol (Δ9‐THC) content, but there are limited data on trends on clinical presentation and severity of toxicity in cannabis users consulting the emergency department (ED) for acute intoxication. This study aimed to analyse the evolution over time of clinical findings and severity of presentations in a large series of patients presenting to European EDs with acute toxicity after lone cannabis use. Design Secondary analysis of data included in the Euro‐DEN Registry from 1 October 2013 to 31 December 2022. Setting 40 EDs in 25 European countries. Participants/cases ED presentations reporting lone cannabis use. Presentations reporting concomitant use of, or having positive toxicological tests for, ethanol or other drugs were excluded. 3839 ED presentations reporting lone cannabis use were analysed (median age 25 years, interquartile range= 20–33; 71% male). Measurements Temporal trends of 14 pre‐defined clinical signs/symptoms and 4 markers of severity, which included the need for ambulance transfer to the ED, hospitalisation, intensive care unit admission (ICU) and death. Findings The most frequent clinical features were anxiety (35%), agitation (22%), decreased alertness (drowsiness or coma, 21%) and vomiting (20%), while seizures, arrythmias and hyperthermia were observed in <3% of cases. Statistically significant changes over time were only found in the frequency of hypotension [adjusted odds ratio (OR) = 1.239 per every subsequent year, 95% confidence interval (CI) = 1.107–1.386], hypertensive crisis (OR = 1.168, 95% CI = 1.070–1.274) and palpitations (OR = 0.922, 95% CI = 0.883–0.962). Nonlinear analyses detected statistically significant mid‐period increases for anxiety, agitation and arrhythmias that subsided by the end of the study, and showed increases in chest pain and decreases in seizures that became statistically significant in the latter half of the period. Regarding episode severity, 76% of cases were brought to the ED by ambulance, 13% required hospitalisation, 1% were admitted to the ICU and 0.1% died. No statistically significant changes were observed over time in either the linear or the nonlinear models. Conclusion Very few changes in the clinical features of patients presenting to European emergency departments with lone acute cannabis toxicity were identified over 2013 to 2022, suggesting that despite the increase in potency of cannabis in Europe over this period, the severity of acute intoxication has remained unchanged.

• Ouwerkerk, Joep JJ; Wood, David M.; Dines, Alison M.; Yates, Christopher; Eyer, Florian & Heyerdahl, Fridtjof [Show all 13 contributors for this article] (2025). Differences in the clinical presentation of acute 3,4-methylenedioxymetamfetamine intoxication by co-intoxication and patient sex to European emergency departments. Clinical Toxicology. ISSN 1556-3650. 63, p. 183–192. doi: 10.1080/15563650.2025.2453052. Full text in Research Archive Show summary

  Introduction This study hypothesized that 3,4-methylenedioxymetamfetamine intoxication presents with distinct clinical features and outcomes when combined with other substances of misuse, compared to mono-3,4-methylenedioxymetamfetamine intoxication. This study investigated the clinical presentation of acute mono-3,4-methylenedioxymetamfetamine intoxication, 3,4-methylenedioxymetamfetamine intoxication with exclusive co-usage of ethanol, and 3,4-methylenedioxymetamfetamine-co-intoxication with co-usage of other substances with or without ethanol, with a focus on patient sex differences. Methods A retrospective analysis was conducted using the Euro-DEN Plus database (2013–2022), which collects data on emergency department presentations with acute drug intoxication from 28 sentinel centres in 18 European countries. Odds ratios for clinical features were calculated for the three study groups with mono-3,4-methylenedioxymetamfetamine intoxication as the reference group. A sub-analysis explored patient sex differences in clinical features. Results Among 4,102 presentations, 3,4-methylenedioxymetamfetamine-ethanol intoxication (n = 1,376) was associated with increased odds of agitation (OR: 1.34), drowsiness (OR: 2.30), and vomiting (OR: 1.85) compared to mono-3,4-methylenedioxymetamfetamine intoxication (n = 359). 3,4-Methylenedioxymetamfetamine-co-intoxication (n = 2,367) was associated with higher odds of bradycardia (OR: 3.14), psychosis (OR: 1.91), and coma (OR: 1.72). Mortality rates did not significantly differ across groups. Females reported a lower incidence of chest pain (OR 0.78) while reporting higher rates of vomiting (OR: 1.64), headache (OR: 1.61), and hypotension (OR: 1.89) compared to males. Discussion The variation in clinical manifestation of acute 3,4-methylenedioxymetamfetamine intoxication is associated with co-intoxication and patient sex. Co-intoxication with ethanol or other substances was associated with an increased incidence of more severe symptoms, such as agitation and psychosis, necessitating tailored management. These variations suggest the need for physicians to consider the type of co-intoxication and patient sex to optimize treatment strategies. Although co-intoxication affected the clinical trajectory, the mortality risk remains low. Conclusions Ethanol co-intoxication, co-intoxication with other substances of misuse, and patient sex were associated with varying clinical presentations in the emergency department, necessitating tailored treatment approaches.

• Perkins, Janet E; Hovda, Knut Erik; Chowdhury, Fazle Rabbi; Sørensen, Jane Brandt; Eddleston, Michael & Street, Alice (2025). Alcohol as poison: a narrative review of social science scholarship relevant to methanol poisoning in low- and middle-income countries. Alcohol and Alcoholism. ISSN 0735-0414. 60(3). doi: 10.1093/alcalc/agaf018. Full text in Research Archive Show summary

  Aims: Methanol poisoning is a tragic and avoidable health emergency that threatens life and often leads to irreversible disability. It primarily occurs when people unwittingly consume beverages contaminated with the chemical compound under the guise of alcoholic spirits. Although reliable data on its burden are unavailable, methanol poisoning is thought to be increasing globally, particularly in low- and middle-income countries. Current scholarship related to methanol poisoning draws almost exclusively from clinical and epidemiological research traditions. In this article, and in the absence of anthropological scholarship examining methanol poisoning specifically, we provide a narrative review of anthropological and social science literature that bears on this growing phenomenon. Methods: We bring key areas of anthropological thought and inquiry that coalesce around the social phenomenon of methanol poisoning in conversation with the clinical and epidemiological scholarship. Results: We begin with a biographical account of methanol, an unlikely character which has become omnipresent in the material world. We then turn to a social scientific examination of alcohol consumption, to which methanol poisoning is tethered. We pay special attention to alcohol consumption in Muslim-majority settings, where alcohol is often proscribed, but methanol-related incidents are common. Subsequently, we examine the scholarship related to health systems and technologies, which come to bear on diagnostic and treatment encounters for those who have consumed toxic alcohol. Conclusion: We argue that anthropological perspectives are urgently needed to contribute to a fuller understanding of methanol poisoning and to design socially sensitive clinical and public health responses to address this avertable scourge.

• Miró, Òscar; Galicia, Miguel; Dargan, Paul I.; Wood, David M.; Dines, Alison M. & Heyerdahl, Fridtjof [Show all 11 contributors for this article] (2025). Age and sex related differences in clinical manifestations and severity of acute cocaine toxicity presentations to European emergency departments. American Journal of Emergency Medicine. ISSN 0735-6757. 96, p. 151–160. doi: 10.1016/j.ajem.2025.06.035. Full text in Research Archive
• Waters, Mitchell L; Dargan, Paul I.; Yates, Christopher; Dines, Alison M.; Eyer, Florian & Giraudon, Isabelle [Show all 62 contributors for this article] (2024). Clinical effects of cannabis compared to synthetic cannabinoid receptor agonists (SCRAs): a retrospective cohort study of presentations with acute toxicity to European hospitals between 2013 and 2020. Clinical Toxicology. ISSN 1556-3650. 62(6), p. 378–384. doi: 10.1080/15563650.2024.2346125. Full text in Research Archive Show summary

  Introduction: Cannabis is the most common recreational drug worldwide and synthetic cannabinoid receptor agonists are currently the largest group of new psychoactive substances. The aim of this study was to compare the clinical features and outcomes of lone acute cannabis toxicity with lone acute synthetic cannabinoid receptor agonist toxicity in a large series of presentations to European emergency departments between 2013-2020. Methods: Self-reported drug exposure, clinical, and outcome data were extracted from the European Drug Emergencies Network Plus which is a surveillance network that records data on drug-related emergency department presentations to 36 centres in 24 European countries. Cannabis exposure was considered the control in all analyses. To compare the lone cannabis and lone synthetic cannabinoid receptor agonist groups, univariate analysis using chi squared testing was used for categorical variables and non-parametric Mann-Whitney U- testing for continuous variables. Statistical significanc

• Ghannoum, Marc; Waters, Paula J.; Hovda, Knut Erik; Choquette, Gabrielle; Elgstøen, Katja B. Prestø & Nygaard, Ilah Le [Show all 10 contributors for this article] (2024). Can endogenous ethylene glycol production occur in humans? A detailed investigation of adult monozygotic twin sisters. Clinical Toxicology. ISSN 1556-3650. 62(11), p. 698–706. doi: 10.1080/15563650.2024.2401076. Full text in Research Archive Show summary

  Introduction To the best of our knowledge, clinically significant endogenous ethylene glycol production has never been reported in humans, very seldom reported in other animals or microorganisms, and then only under rare and specific conditions. We describe the detailed investigations we undertook in two adult monozygotic twin sisters to ascertain whether they were producing endogenous ethylene glycol. Methods Two previously healthy monozygotic adult twin sisters presented with recurrent episodes of apparent ethylene glycol poisoning beginning at age 35, requiring chronic hemodialysis to remove ethylene glycol and its metabolites as well as to restore metabolic homeostasis. The sisters denied ingestion or exposure to ethylene glycol. At their request, they were admitted to hospital under strict supervision to exclude surreptitious ingestion of ethylene glycol and to evaluate the need for treatment. Hemodialysis was withheld during this prospective study. Twin A was admitted for 14 days and twin B for 11 days. Serial biochemical analyses were performed in blood and urine. Clinical exome sequencing and mitochondrial deoxyribonucleic acid sequencing were also completed. Results In both twins, ethylene glycol was detected in urine, along with intermittent increases in concentrations of lactate, glycolate, and glycine in blood and/or urine. Blood ethylene glycol concentrations, however, remained <62 mg/L (<1 mmol/L) but became positive soon after discharge. The oxalate concentration remained normal in blood and urine. Plasma and urine amino acid profiles showed intermittent small increases in glycine, serine, taurine, proline, and/or alanine concentrations. Exome sequencing and mitochondrial deoxyribonucleic acid sequencing were non-diagnostic. Neither twin has been admitted with metabolic acidosis nor ethylene glycol poisoning since chronic hemodialysis was started. Twin A developed a calcium oxalate dihydrate lithiasis. Discussion Mitochondrial disease, methylmalonic/propionic/isovaleric aciduria, primary hyperoxaluria, and analyte error were all excluded in these twins, as were obvious common environmental exposures. Conclusion Detailed investigations were performed in adult monozygotic twin sisters to ascertain whether they were producing endogenous ethylene glycol. Alternative explanations were excluded to the very best of our efforts and knowledge. Global metabolomics, gut microbiome analyses, and whole genome sequencing are pending.

• McMartin, Kenneth; Jacobsen, Dag & Hovda, Knut Erik (2024). Antidotes for poisoning by alcohols that form toxic metabolites. British Journal of Clinical Pharmacology. ISSN 0306-5251. doi: 10.1111/bcp.16232. Full text in Research Archive
• Noseda, Roberta; Franchi, Matteo; Pagnamenta, Alberto; Müller, Laura; Dines, Alison M. & Giraudon, Isabelle [Show all 16 contributors for this article] (2023). Determinants of Admission to Critical Care Following Acute Recreational Drug Toxicity: A Euro-DEN Plus Study. Journal of Clinical Medicine. 12(18). doi: 10.3390/jcm12185970. Full text in Research Archive Show summary

  This study aimed to characterize patients admitted to critical care following Emergency Department (ED) presentation with acute recreational drug toxicity and to identify determinants of admission to critical care. A retrospective multicenter matched case-control study was conducted by the European Drug Emergency Network Plus (Euro-DEN Plus) over the period 2014–2021. The cases were ED presentations with acute recreational drug toxicity admitted to critical care, the controls consisted of ED presentations with acute recreational drug toxicity medically discharged directly from the ED. The potential determinants of admission to critical care were assessed through multivariable conditional stepwise logistic regression analysis and multiple imputation was used to account for the missing data. From 2014 to 2021, 3448 Euro-DEN Plus presentations involved patients admitted to critical care (76.9% males; mean age 33.2 years; SD 10.9 years). Patient age ≥35 years (as compared to ≤18 years) was a determinant of admission to critical care following acute recreational drug toxicity (adjusted odds ratio, aOR, 1.51, 95% confidence interval, CI, 1.15–1.99), along with polydrug use (aOR 1.39, 95% CI 1.22–1.59), ethanol co-ingestion (aOR 1.44, 95% CI 1.26–1.64), and the use of gamma-hydroxybutyrate/gamma-butyrolactone (GHB/GBL, aOR 3.08, 95% CI 2.66–3.57). Conversely, lower odds of admission to critical care were associated with the use of cocaine (aOR 0.85, 95% CI 0.74–0.99), cannabis (aOR 0.44, 95% CI 0.37–0.52), heroin (aOR 0.80, 95% CI 0.69–0.93), and amphetamine (aOR 0.65, 95% CI 0.54–0.78), as was the arrival to the ED during the night (8 p.m.–8 a.m., aOR 0.88, 95% CI 0.79–0.98). These findings, which deserve confirmation and further investigation, could contribute to a more complete understanding of the decision-making process underlying the admission to critical care of patients with acute recreational drug toxicity.

• Vallersnes, Odd Martin; Dines, Alison M.; Wood, David M.; Heyerdahl, Fridtjof; Hovda, Knut Erik & Yates, Christopher [Show all 20 contributors for this article] (2023). Self-discharge during treatment for acute recreational drug toxicity: an observational study from emergency departments in seven European countries. International Journal of Emergency Medicine. ISSN 1865-1372. 16(1). doi: 10.1186/s12245-023-00566-1. Full text in Research Archive Show summary

  Background Self-discharge is a risk factor for readmission and excess mortality. We assess the rate of self-discharge from the emergency department (ED) among presentations for acute recreational drug toxicity and identify factors associated with self-discharge. Methods From the Euro-DEN Plus database of presentations to the ED with acute recreational drug toxicity, we extracted data from 11 centres in seven European countries from 2014 to 2017. Self-discharge was defined as taking one’s own discharge or escaping from the ED before being medically cleared. We used multiple logistic regression analyses to look for factors associated with self-discharge. Results Among 15,135 included presentations, 1807 (11.9%) self-discharged. Self-discharge rates varied from 1.7 to 17.1% between centres. Synthetic cannabinoids were associated with self-discharge, adjusted odds ratio 1.44 (95% confidence interval 1.10–1.89), as were heroin, 1.44 (1.26–1.64), agitation, 1.27 (1.10–1.46), and naloxone treatment, 1.27 (1.07–1.51), while sedation protected from self-discharge, 0.38 (0.30–0.48). Conclusion One in eight presentations self-discharged. There was a large variation in self-discharge rates across the participating centres, possibly partly reflecting different discharge procedures and practices. Measures to improve the management of agitation and cautious administration of naloxone to avoid opioid withdrawal symptoms may be approaches worth exploring to reduce self-discharge.

• Miró, Òscar; Burillo-Putze, Guillermo; Schmid, Yasmin; Salgado, Emilio; Liechti, Matthias E & Dines, Alison M. [Show all 14 contributors for this article] (2022). Severity of emergency department presentations due to acute drug toxicity in Europe: a longitudinal analysis over a 6-year period (2014–2019) stratified by sex. European journal of emergency medicine. ISSN 0969-9546. doi: 10.1097/MEJ.0000000000000978. Full text in Research Archive
• Ingebrigtsen, Erlend; Persett, Per Sverre; Brekke, Mette; Heyerdahl, Fridtjof; Hovda, Knut Erik & Vallersnes, Odd Martin (2022). Poisoning with central stimulant drugs: an observational study from Oslo, Norway. International Journal of Emergency Medicine. ISSN 1865-1372. 15(1). doi: 10.1186/s12245-022-00457-x. Full text in Research Archive Show summary

  Background The use of central stimulant drugs causes significant morbidity. We describe poisonings with central stimulant drugs and compare the different central stimulants concerning combinations with other drugs, treatment, and clinical course.  Methods Patients presenting from 1 October 2013 to 31 March 2016 with poisoning related to the recreational use of central stimulant drugs were retrospectively included at a primary care emergency outpatient clinic and at a hospital emergency department in Oslo, Norway. Diagnosis of toxic agents was mainly based on the clinical assessment of the doctor treating the patient. Amphetamine and methamphetamine were co-categorized as amphetamine. Results Among the 1131 cases of acute poisoning with central stimulant drugs at the outpatient clinic, amphetamine was involved in 808 (71.4%), cocaine in 252 (22.3%) methylenedioxymethamphetamine (MDMA) in 104 (9.2%), and methylphenidate in 13 (1.1%). Among the 211 cases at the hospital, amphetamine was involved in 167 (79.1%), cocaine in 60 (28.4%), and MDMA in 38 (18.0%). Amphetamine was frequently combined with opioids (40.1% at the outpatient clinic and 41.9% at the hospital) and benzodiazepines (28.3% and 45.5%), while MDMA often was combined with ethanol (64.4% and 71.1%), as was cocaine (62.7% and 61.7%). Sedation was given in 5.2% and 38.4% of cases, naloxone in 9.4% and 37.0%, and flumazenil in 0.1% and 28.0%. In total, 16.5% of the cases at the outpatient clinic were transferred to a hospital for medical review and 8.5% to a psychiatric hospital. Among the hospital patients, 92.9% were admitted to intensive care. Conclusion Amphetamine was the most common central stimulant drug involved in acute poisoning in Oslo, often combined with opioids and benzodiazepines.

• Mahdavi, Seyed Amirhosein; Zamani, Nasim; Mcdonald, Rebecca Silvia; Akhgari, Maryam; Kolahi, Ali-Asghar & Gheshlaghi, Farzad [Show all 30 contributors for this article] (2022). A cross-sectional multicenter linkage study of hospital admissions and mortality due to methanol poisoning in Iranian adults during the COVID-19 pandemic. Scientific Reports. 12(1). doi: 10.1038/s41598-022-14007-1. Full text in Research Archive Show summary

  Abstract A methanol poisoning outbreak occurred in Iran during the initial months of coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the epidemiology of the outbreak in terms of hospitalizations and deaths. A cross-sectional linkage study was conducted based on the hospitalization data collected from thirteen referral toxicology centers throughout Iran as well as mortality data obtained from the Iranian Legal Medicine Organization (LMO). Patient data were extracted for all cases aged &gt; 19 years with toxic alcohol poisoning during the study period from February until June 2020. A total of 795 patients were hospitalized due to methanol poisoning, of whom 84 died. Median [interquartile ratio; IQR] age was 32 [26, 40] years (range 19–91 years). Patients had generally ingested alcohol for recreational motives (653, 82.1%) while 3.1% (n = 25) had consumed alcohol-based hand sanitizers to prevent or cure COVID-19 infection. Age was significantly lower in survivors than in non-survivors (P &lt; 0.001) and in patients without sequelae vs. with sequelae (P = 0.026). Twenty non-survivors presented with a Glasgow Coma Scale (GCS) score &gt; 8, six of whom were completely alert on presentation to the emergency departments. The time from alcohol ingestion to hospital admission was not significantly different between provinces. In East Azerbaijan province, where hemodialysis was started within on average 60 min of admission, the rate of sequelae was 11.4% (compared to 19.6% average of other provinces)—equivalent to a reduction of the odds of sequelae by 2.1 times [95% CI 1.2, 3.7; p = 0.009]. Older patients were more prone to fatal outcome and sequelae, including visual disturbances. Early arrival at the hospital can facilitate timely diagnosis and treatment and may reduce long-term morbidity from methanol poisoning. Our data thus suggest the importance of raising public awareness of the risks and early symptoms of methanol intoxication.

• Lao, Yvonne Elisabeth; Heyerdahl, Fridtjof; Jacobsen, Dag & Hovda, Knut Erik (2022). An enzymatic assay with formate oxidase for point-of-care diagnosis of methanol poisoning. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. 131(6), p. 547–554. doi: 10.1111/bcpt.13789. Full text in Research Archive Show summary

  Gas chromatographic analysis for quantification of plasma methanol requires laboratory equipment and personnel, and it is typically unavailable in short time notice, especially in low- and middle-income countries. Detection of formate with the enzyme formate oxidase (FOX) is a promising method that can make the diagnosis of methanol poisoning simple and fast. The aims of this study were to test the sensitivity and specificity of a modified FOX-enzyme and to test the specificity of a point-of-care (POC)-model containing FOX-enzyme with samples from patients with metabolic acidosis. The sensitivity and specificity of FOX-enzyme in aqueous solution were evaluated with a spectrometer and by visual detection for colour change. Formate concentrations between 1 and 20 mmol/L were used to test sensitivity, and 18 potentially interfering substances were tested for specificity. The sensitivity of the FOX-enzyme was 100% and the specificity 97%. When specificity of the POC-model was tested, no false positives were detected. As such, the sensitivity and specificity of this modified FOX-enzyme for detection of formate were high. The results with this enzyme confirm the potential for its use in formate analysis as a fast diagnosis of methanol poisoning.

• Crulli, Benjamin; Dines, Alison M.; Blanco, Georgina; Giraudon, Isabelle; Eyer, Florian & Liechti, Matthias E [Show all 13 contributors for this article] (2022). Novel psychoactive substances-related presentations to the emergency departments of the European drug emergencies network plus (Euro-DEN plus) over the six-year period 2014–2019. Clinical Toxicology. ISSN 1556-3650. doi: 10.1080/15563650.2022.2137524. Full text in Research Archive Show summary

  Introduction Novel psychoactive substances (NPS) have been increasingly reported in the last 15–20 years. We aimed to describe presentations to the emergency department (ED) with acute recreational drug toxicity involving NPS. Methods Data were extracted from the European Drug Emergencies Network (Euro-DEN) Plus database for all presentations to ED (36 EDs in 24 European countries) with acute toxicity between January 2014 and December 2019. Patient demographics, agents involved, and clinical outcomes were described and the subgroup of presentations involving NPS was compared with the rest of the cohort. Results Out of 43,633 Euro-DEN Plus presentations, 3304 (7.6%) involved at least one NPS. Agents were identified mainly based on self-report or clinical presentation, with analytical confirmation being performed only in 17.9% of NPS presentations. The proportion of NPS presentations varied by centre (0–48.8%). For centres where data were available for all 6 years, NPS-related presentations peaked in 2015 (11.9%). In 2014, 78.4% of NPS agents reported were cathinones, while only 3.4% were synthetic cannabinoids (SCs); conversely, in 2019 only 11.6% of NPS agents reported were cathinones, while 72.2% were SCs. NPS-related presentations involved younger patients (median 30 (23–37) vs. 32 (25–40) years, p < 0.001) and more males (84.8 vs. 75.8%, p < 0.001) compared with the rest of the cohort. Patients presenting to ED after using NPS were more likely to self-discharge (22.8 vs. 15.1%), less likely to be admitted to critical care (3.6 vs. 6.1%) but had a longer length of stay in hospital (median 5.1 (2.7–18.7) vs. 4.7 (2.5–9.2) h, p < 0.001). Death occurred in 0.5% of all presentations involving NPS and in 0.4% of non-NPS presentations. Conclusions This large multicentre series of NPS presentations to European EDs showed marked geographical variation and changes over time in the proportion of presentations to ED involving NPS, as well as the proportion of NPS subgroups.

• Beaulieu, Jessie; Roberts, Darren M.; Gosselin, Sophie; Hoffman, Robert S.; Lavergne, Valery & Hovda, Knut Erik [Show all 10 contributors for this article] (2022). Treating ethylene glycol poisoning with alcohol dehydrogenase inhibition, but without extracorporeal treatments: a systematic review. Clinical Toxicology. ISSN 1556-3650. doi: 10.1080/15563650.2022.2049810. Full text in Research Archive
• Ruszkiewicz, Dorota M; Myers, Renelle; Henderson, Ben; Yusof, Hazim; Meister, Austin & Moreno, Sergi [Show all 15 contributors for this article] (2022). Peppermint protocol: First results for gas chromatography-ion mobility spectrometry. Journal of Breath Research. ISSN 1752-7155. 16(3). doi: 10.1088/1752-7163/ac6ca0. Full text in Research Archive
• Roberts, Darren M.; Hoffman, Robert S.; Brent, Jeffrey; Lavergne, Valéry; Hovda, Knut Erik & Porter, William H. [Show all 8 contributors for this article] (2022). The serum glycolate concentration: its prognostic value and its correlation to surrogate markers in ethylene glycol exposures. Clinical Toxicology. ISSN 1556-3650. doi: 10.1080/15563650.2022.2049811. Full text in Research Archive
• Schmid, Yasmin; Galicia, Miguel; Vogt, Severin B.; Liechti, Matthias E.; Burillo-Putze, Guillermo & Dargan, Paul I. [Show all 13 contributors for this article] (2022). Differences in clinical features associated with cannabis intoxication in presentations to European emergency departments according to patient age and sex. Clinical Toxicology. ISSN 1556-3650. 60(8), p. 912–919. doi: 10.1080/15563650.2022.2060116. Full text in Research Archive
• Dhanarisi, Jeevan; Tzotzolaki, Tanita Maria; Vasileva, Ana-Mariya D.; Kjellberg, Matti A.; Hakulinen, Hanna & Vanninen, Paula [Show all 10 contributors for this article] (2022). Osmolal and anion gaps after acute self-poisoning with agricultural formulations of the organophosphorus insecticides profenofos and diazinon: A pilot study. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. 130(2), p. 320–327. doi: 10.1111/bcpt.13686. Full text in Research Archive
• Heier, Eva-Carina; Eyer, Florian; Rabe, Christian; Geith, Stefanie; Dargan, Paul I & Wood, David M. [Show all 15 contributors for this article] (2022). Clinical effect of ethanol co-use in patients with acute drug toxicity involving the use of central nervous system depressant recreational drugs. European journal of emergency medicine. ISSN 0969-9546. 29(4), p. 291–300. doi: 10.1097/MEJ.0000000000000932. Full text in Research Archive
• Lao, Yvonne Elisabeth; Goffeng, Anne; Spillum, Barbro Johanne; Jacobsen, Dag; Nakstad, Espen Rostrup & Hovda, Knut Erik (2021). A survey of the antidote preparedness in Norwegian hospitals. European Journal of Hospital Pharmacy (EJHP). ISSN 2047-9956. p. 1–5. doi: 10.1136/ejhpharm-2020-002544. Full text in Research Archive Show summary

  Objectives Antidotes are an important part of the emergency preparedness in hospitals. In the case of a major chemical accident or a fire, large quantities of antidotes may be needed within a short period of time. For time-critical antidotes it is therefore necessary that they be immediately available. We wanted to evaluate the antidote preparedness in Norwegian hospitals as regards the national recommendations and compare this with other international guidelines. Methods A digital survey was sent to the 50 hospitals in Norway that treat acute poisonings. Of these, four hospitals are categorised as regional hospitals, 15 as large hospitals and 31 as small hospitals. Each hospital was asked which antidotes they stockpiled from a list of 35 antidotes. The financial costs (low, moderate, high) were added to an established efficacy scale to illustrate the cost-effectiveness of the different antidotes. Results The response rate was 100%. Eleven of fifty (22%) hospitals stockpiled all antidotes recommended for their hospital size. All four regional hospitals had all the recommended antidotes. Large hospitals which were not regional hospitals had the least availability of antidotes, and only one large hospital stockpiled all antidotes recommended for this hospital size. Conclusions We found varying compliance with the national recommendations for antidote storage in hospitals. To strengthen antidote preparedness, we recommend standardised European guidelines to support national guidelines.

• Hovda, Knut Erik; Lao, Yvonne Elisabeth; Gadeholt, Gaut & Jacobsen, Dag (2021). Formate test for bedside diagnosis of methanol poisoning. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. 129(1), p. 86–88. doi: 10.1111/bcpt.13597. Full text in Research Archive
• Noseda, Roberta; Schmid, Yasmin; Scholz, Irene; Liakoni, Evangelia; Liechti, Matthias E. & Dargan, Paul I. [Show all 36 contributors for this article] (2021). MDMA-related presentations to the emergency departments of the European Drug Emergencies Network plus (Euro-DEN Plus) over the four-year period 2014-2017. Clinical Toxicology. ISSN 1556-3650. 59(2), p. 131–137. doi: 10.1080/15563650.2020.1784914. Full text in Research Archive
• Lao, Yvonne Elisabeth; Vartdal, Trond; Frøyshov, Sten; Latimer, Brian; Kværner, Christiane & Mataric, Marija [Show all 11 contributors for this article] (2021). Fomepizole dosing during continuous renal replacement therapy–an observational study. Clinical Toxicology. ISSN 1556-3650. doi: 10.1080/15563650.2021.1980581. Full text in Research Archive Show summary

  Background Fomepizole is the preferred antidote for treatment of methanol and ethylene glycol poisoning, acting by inhibiting the formation of the toxic metabolites. Although very effective, the price is high and the availability is limited. Its availability is further challenged in situations with mass poisonings. Therefore, a 50% reduced maintenance dose for fomepizole during continuous renal replacement therapy (CRRT) was suggested in 2016, based on pharmacokinetic data only. Our aim was to study whether this new dosing for fomepizole during CRRT gave plasma concentrations above the required 10 µmol/L. Secondly, we wanted to study the elimination kinetics of fomepizole during CRRT, which has never been studied before. Methods Prospective observational study of adult patients treated with fomepizole and CRRT. We collected samples from arterial line (pre-filter) = plasma concentration, post-filter and dialysate for fomepizole measurements. Fomepizole was measured using high-pressure liquid chromatography with a reverse phase column. Results Ten patients were included in the study. Seven were treated with continuous veno-venous hemodialysis (CVVHD) and three with continuous veno-venous hemodiafiltration (CVVHDF). Ninety-eight percent of the plasma samples were above the minimum plasma concentration of 10 µmol/L. Fomepizole was removed during CRRT with a median saturation/sieving coefficient of 0.85 and dialysis clearance of 28 mL/min. Conclusion Fomepizole was eliminated during CCRT. The new dosing recommendations for fomepizole and CRRT appeared safe, by maintaining the plasma concentration above the minimum value of 10 µmol/L. Based on these data, the fomepizole maintenance dose during CRRT could be reduced to half as compared to intermittent hemodialysis.

• Waldman, Wojciech; Kabata, Pm; Dines, Alison M.; Wood, David M.; Yates, Christopher & Heyerdahl, Fridtjof [Show all 10 contributors for this article] (2021). Rhabdomyolysis related to acute recreational drug toxicity—A Euro-DEN study. PLOS ONE. 16(3), p. 1–11. doi: 10.1371/journal.pone.0246297. Full text in Research Archive
• Leaper, Craig; Dines, Alison M.; Dargan, Paul I.; Yates, Christopher; Hovda, Knut Erik & Heyerdahl, Fridtjof [Show all 8 contributors for this article] (2021). Impact of pregabalin co-use in patients presenting with acute heroin toxicity to the European Drug Emergencies Network plus project. European journal of emergency medicine. ISSN 0969-9546. 28(2), p. 144–146. doi: 10.1097/MEJ.0000000000000738. Full text in Research Archive
• Miro, Oscar; Waring, W. Stephen; Dargan, Paul I.; Wood, David M.; Dines, Alison M. & Yates, Christopher [Show all 25 contributors for this article] (2021). Variation of drugs involved in acute drug toxicity presentations based on age and sex: an epidemiological approach based on European emergency departments. Clinical Toxicology. ISSN 1556-3650. doi: 10.1080/15563650.2021.1884693. Full text in Research Archive
• Gundem, Trine; Olasveengen, Theresa M.; Hovda, Knut Erik; Gaustad, Knut; Schøndorf, Christina Luise & Rostrup, Morten [Show all 11 contributors for this article] (2020). Ventilasjonsstotte for hypoksemiske intensivpasienter med covid-19. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 140(11), p. 1–10. doi: 10.4045/tidsskr.20.0445. Full text in Research Archive Show summary

  BAKGRUNN Covid-19-pneumoni kan gi alvorlig hypoksemisk respirasjonssvikt som krever intensivmedisinsk behandling. Vi ønsket å beskrive covid-19-intensivpasienter som ble behandlet med og uten invasiv ventilasjonsstøtte. MATERIALE OG METODE Materialet er hentet fra lokalt kvalitetsregister og består av data om pasienter med covid-19 innlagt på intensivavdelingen ved Oslo universitetssykehus, Ullevål i perioden 5.3–28.5.2020. Pasientene ble kategorisert i tre grupper basert på respirasjonssviktbehandlingen (oksygen alene, tillegg av ikke-invasiv ventilasjonsstøtte (NIV) og intubasjon/respirator) og beskrevet med deskriptiv statistikk. RESULTATER Av 165 innlagte covid-19-pasienter ble 26 (16 %) behandlet ved vår intensivavdeling. Fire av disse hadde behandlingsbegrensninger og ble ekskludert. De 22 pasientene inkludert i denne studien hadde gjennomsnittsalder 56 år (spredning 25–78 år), 17 (77 %) var menn. Elleve pasienter fikk respiratorbehandling, syv oksygen på maske og fire tillegg av ikke-invasiv ventilasjonsstøtte. I respiratorgruppen var to døde per 28.5.2020, resten var skrevet ut av intensivavdelingen i live, hvorav én fortsatt lå på sengepost. Alle pasienter behandlet med oksygen og ikke-invasiv ventilasjonsstøtte var i live og utskrevet fra sykehus. FORTOLKNING Mange pasienter med covid-19-respirasjonssvikt og behov for intensivbehandling kan klare seg med økt oksygentilbud og ikke-invasiv ventilasjonsstøtte, men behov for intubasjon må fortløpende vurderes. Over 90 % av aktivt behandlede intensivpasienter overlevde.

• Lao, Yvonne Elisabeth; Molden, Espen; Kringen, Marianne K.; Annexstad, Ellen Johanne; Sæverud, Håvard Andreassen & Jacobsen, Dag [Show all 7 contributors for this article] (2020). Fatal liver failure after therapeutic doses of paracetamol in a patient with Duchenne muscular dystrophy and atypical pharmacogenetic profile of drug-metabolizing enzymes. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. 127(1), p. 47–51. doi: 10.1111/bcpt.13389. Full text in Research Archive Show summary

  Paracetamol has a good safety profile, but pharmacogenetic differences in drug-metabolizing enzymes may have an impact on its risk of hepatotoxicity. We present a case of fatal acute liver failure (ALF) after therapeutic doses of paracetamol in a patient with Duchenne muscular dystrophy, where pharmacogenetic screening was conducted. This 30-year-old man was electively admitted for a tracheostomy. A total of 14.5 g paracetamol was given over four days. He developed a severe ALF and died 11 days after admission. Pharmacogenetic screening showed absent CYP2D6 metabolism and increased CYP1A2 activity, which may have increased the formation of toxic intermediate metabolite, N-acetyl-p-benzo-quinone imine (NAPQI). He also had decreased function of UGT2B15, which increases the amount of paracetamol available for metabolism to NAPQI. Having a reduced muscle mass and thus a reduced glutathione levels to detoxify produced NAPQI may add to the risk of toxicity. This case may indicate that pharmacogenetic variability is of potential relevance for the risk of paracetamol-induced hepatotoxicity in patients with neuromuscular diseases. Further studies should investigate if pharmacogenetic screening could be a tool to detect potentially increased risk of hepatotoxicity in these patients at therapeutic doses of paracetamol, and hence provide information for selection of analgesic treatment.

• Layne, Kerry A.; Dargan, Paul I.; Dines, Alison M.; Leaper, Craig; Yates, Christopher & Hovda, Knut Erik [Show all 10 contributors for this article] (2020). Acute toxicity related to misuse (nonmedical use) of tramadol: Experience of the European Drug Emergencies Network Plus. British Journal of Clinical Pharmacology. ISSN 0306-5251. p. 1–8. doi: 10.1111/bcp.14408. Full text in Research Archive
• Miro, Oscar; Dargan, Paul I; Wood, David M.; Dines, Alison M.; Yates, Christopher & Heyerdahl, Fridtjof [Show all 9 contributors for this article] (2019). Epidemiology, clinical features and management of patients presenting to European emergency departments with acute cocaine toxicity: comparison between powder cocaine and crack cocaine cases. Clinical Toxicology. ISSN 1556-3650. 57(8), p. 718–726. doi: 10.1080/15563650.2018.1549735. Full text in Research Archive
• Hassanian-Moghaddam, Hossein; Zamani, Nasim; Roberts, Darren M.; Brent, Jeffrey; McMartin, Kenneth & Aaron, Cynthia [Show all 22 contributors for this article] (2019). Consensus statements on the approach to patients in a methanol poisoning outbreak. Clinical Toxicology. ISSN 1556-3650. p. 1–9. doi: 10.1080/15563650.2019.1636992. Full text in Research Archive
• Wolfe, Caitlin E; Wood, David M.; Dines, Alison; Whatley, Benjamin P; Yates, Christopher & Heyerdahl, Fridtjof [Show all 9 contributors for this article] (2019). Seizures as a complication of recreational drug use: Analysis of the Euro-DEN Plus data-set. Neurotoxicology. ISSN 0161-813X. 73, p. 183–187. doi: 10.1016/j.neuro.2019.04.003. Full text in Research Archive
• Wood, David M.; Rue, Luke De La; Hosin, Ali A; Jurgens, Gesche; Liakoni, Evangelia & Heyerdahl, Fridtjof [Show all 11 contributors for this article] (2019). Poor Identification of Emergency Department Acute Recreational Drug Toxicity Presentations Using Routine Hospital Coding Systems: the Experience in Denmark, Switzerland and the UK. Journal of Medical Toxicology. ISSN 1556-9039. 15(2), p. 112–120. doi: 10.1007/s13181-018-0687-z. Full text in Research Archive
• Galicia, Miguel; Dargan, Paul I.; Dines, Alison M.; Yates, Christopher; Heyerdahl, Fridtjof & Hovda, Knut Erik [Show all 9 contributors for this article] (2019). Clinical relevance of ethanol coingestion in patients with GHB/GBL intoxication. Toxicology Letters. ISSN 0378-4274. 314, p. 37–42. doi: 10.1016/j.toxlet.2019.07.001. Full text in Research Archive
• Lao, Yvonne Elisabeth; Pham, Bich Diep; Le, Huong; Van, Hien Nguyen & Hovda, Knut Erik (2019). Methanol content in homemade alcohol from a province in North Vietnam. Drug and Alcohol Review. ISSN 0959-5236. 38(5), p. 537–542. doi: 10.1111/dar.12937. Full text in Research Archive
• Syse, Victoria Lykke; Brekke, Mette; Grimsrud, Marit Mæhle; Persett, Per Sverre; Heyerdahl, Fridtjof & Hovda, Knut Erik [Show all 7 contributors for this article] (2019). Gender differences in acute recreational drug toxicity: a case series from Oslo, Norway. BMC Emergency Medicine. 19(1). doi: 10.1186/s12873-019-0244-3. Full text in Research Archive Show summary

  Background Female drug users report poorer physical and mental health than male drug users. We describe female and male patients treated for acute recreational drug toxicity, and look for gender differences in clinical state, treatment, and toxic agents taken. Methods Retrospective case series from a primary care emergency outpatient clinic and a hospital emergency department in Oslo, Norway. All patients treated for acute recreational drug toxicity from October 2013 through March 2015 were included, except patients with lone alcohol intoxication. Patients were grouped according to whether they had taken opioids or not, as a proxy differentiation between heavy drug users and party drug users. Data from the two clinical settings were analysed separately. Results In total, 2495 cases were included, 567 (22.7%) were women. Female patients were younger than males, median 31 vs 34 years (p < 0.001). On most comparisons of clinical variables there were no significant differences between genders. A larger proportion of females in the outpatient opioid group were hypotensive, 10.9% vs 3.9% (p < 0.001). Fewer females were intubated, none vs 21.1% (p = 0.019) in the hospital opioid group, and 6.4% vs 21.0% (p = 0.039) in the hospital non-opioid group. The proportion of gamma-hydroxybutyrate (GHB) poisoning was larger among females both at the outpatient clinic (14.4% vs 8.6%, p < 0.001) and at the hospital (60.3% vs 36.4%, p = 0.001), while the proportion of heroin poisoning was smaller among females at the outpatient clinic (37.1% vs 47.0%, p < 0.001). Conclusion One in four patients treated for acute recreational drug toxicity were women. Female patients were younger, had more frequently taken GHB and were less frequently intubated. Otherwise, the gender differences regarding clinical state and treatment were small. Although female drug users are known to report poorer health than males, we did not find that women had a more severe clinical course than men when presenting with overdose.

• Yamamoto, Takahiro; Dargan, Paul Ivor; Dines, Alison M.; Yates, Christopher B.; Heyerdahl, Fridtjof & Hovda, Knut Erik [Show all 31 contributors for this article] (2018). Concurrent Use of Benzodiazepine by Heroin Users—What Are the Prevalence and the Risks Associated with This Pattern of Use? Journal of Medical Toxicology. ISSN 1556-9039. 15(1), p. 4–11. doi: 10.1007/s13181-018-0674-4. Full text in Research Archive
• Drangsholt, Elise Rebekka; Vangstad, Marie; Zakharov, Sergey; Hovda, Knut Erik & Jacobsen, Dag (2018). The hypothesis of circulus hypoxicus and its clinical relevance in patients with methanol poisoning - An observational study of 35 patients. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. 123(6), p. 749–755. doi: 10.1111/bcpt.13074. Full text in Research Archive
• Miro, Oscar; Yates, Christopher; Dines, Alison M.; Wood, David M.; Dargan, Paul I. & Galan, Itxaso [Show all 26 contributors for this article] (2018). Emergencies related to recreational drug abuse in Spain compared to emergencies attended in 3 European areas. Emergencias. ISSN 1137-6821. 30, p. 385–394. Full text in Research Archive
• Liakoni, Evangelia; Yates, Christopher; Dines, Alison M.; Dargan, Paul I; Heyerdahl, Fridtjof & Hovda, Knut Erik [Show all 9 contributors for this article] (2018). Acute recreational drug toxicity: Comparison of self-reports and results of immunoassay and additional analytical methods in a multicenter European case series. Medicine. ISSN 0025-7974. 97(5), p. 1–7. doi: 10.1097/MD.0000000000009784. Full text in Research Archive
• Lyphout, Cathelijne; Yates, Christopher B.; Margolin, Zachary R.; Dargan, Paul Ivor; Dines, Alison M. & Heyerdahl, Fridtjof [Show all 11 contributors for this article] (2018). Presentations to the emergency department with non-medical use of benzodiazepines and Z-drugs: profiling and relation to sales data. European Journal of Clinical Pharmacology. ISSN 0031-6970. 75(1), p. 77–85. doi: 10.1007/s00228-018-2550-1. Full text in Research Archive
• Zakharov, Sergey; Rulisek, Jan; Nurieva, Olga; Kotikova, Katerina; Navrátil, Tomáš & Komarc, Martin [Show all 8 contributors for this article] (2017). Intermittent versus continuous renal replacement therapy in acute methanol poisoning: comparison of clinical effectiveness in mass poisoning outbreaks. Annals of Intensive Care. 7:77, p. 1–11. doi: 10.1186/s13613-017-0300-7. Full text in Research Archive
• Miro, Oscar; Galicia, Miguel; Dargan, Paul; Dines, Alison M.; Giraudon, Isabelle & Heyerdahl, Fridtjof [Show all 9 contributors for this article] (2017). Intoxication by gamma hydroxybutyrate and related analogues: Clinical characteristics and comparison between pure intoxication and that combined with other substances of abuse. Toxicology Letters. ISSN 0378-4274. 277, p. 84–91. doi: 10.1016/j.toxlet.2017.05.030. Full text in Research Archive
• Vallersnes, Odd Martin; Persett, Per Sverre; Øiestad, Elisabeth Leere; Karinen, Ritva Anneli; Heyerdahl, Fridtjof & Hovda, Knut Erik (2017). Underestimated impact of novel psychoactive substances: laboratory confirmation of recreational drug toxicity in Oslo, Norway. Clinical Toxicology. ISSN 1556-3650. 55(7), p. 636–644. doi: 10.1080/15563650.2017.1312002. Full text in Research Archive Show summary

  Context: Recreational drug toxicity is frequent. Availability of new psychoactive substances is steadily increasing. However, data with verified analyses from clinical settings are limited. To evaluate the impact of novel psychoactive substances (NPS) on recreational drug toxicity in Oslo, Norway, we analysed samples from a selection of patients. Methods: All the patients presenting with recreational drug toxicity at the Oslo Accident and Emergency Outpatient Clinic (OAEOC) and at the Oslo University Hospital (OUH) were registered from April through September 2014. Oral fluid samples were collected at the OAEOC. Blood samples were collected at the OUH. The samples were screened using ultra-high performance liquid chromatography – tandem mass spectrometry (UHPLC-MS/MS). Results: Nine hundred and sixty-four cases were included, 841 (87.2%) at the OAEOC and 123 (12.8%) at the OUH. A total of 55 oral fluid samples (OAEOC) and 103 blood samples (OUH) could be analysed. NPS were not clinically suspected in any of the screened cases. At the outpatient clinic, the most commonly found substances were clonazepam in 42/55 (76.4%) cases, amfetamines in 40/55 (72.7%) and heroin in 39/55 (70.9%). In seven (12.7%) cases NPS were detected: 4-methylamfetamine in three cases, dimethyltryptamine in two, methylone in one, and N,N-dimethyl-3,4-methylenedioxyamfetamine in one. Among the hospital patients, the most commonly found substances were clonazepam in 51/103 (49.5%) cases, amfetamines in 48/103 (46.6%), heroin in 31/103 (30.1%), and diazepam in 30/103 (29.1%). In five (4.9%) cases NPS were detected: JWH-210 in two cases, AM-2201 in two, and 5-EAPB in one. Conclusion: NPS were clinically not suspected, though found in eight percent of cases. Still, the vast majority of patients treated for recreational drug toxicity in Oslo have taken classical drugs. Management of these patients should be based on their clinical condition. However, it is highly important to be alert to atypical presentations possibly resulting from unsuspected drugs. This is an Accepted Manuscript of an article published by Taylor & Francis Group in Clinical Toxicology on 13/04/2017, available online: http://www.tandfonline.com/10.1080/15563650.2017.1312002

• Zakharov, Sergey; Pelclová, Daniela; Navratil, Tomas; Běláček, Jaromír; Latta, Jiří & Pisar, Michal [Show all 23 contributors for this article] (2017). Efficiency of acidemia correction on intermittent versus continuous hemodialysis in acute methanol poisoning. Clinical Toxicology. ISSN 1556-3650. 55(2), p. 123–132. doi: 10.1080/15563650.2016.1250901. Full text in Research Archive
• Zakharov, Sergey; Pelclova, Daniela; Urban, Pavel; Navratil, Tomas; Nurieva, Olga & Kotikova, Katerina [Show all 12 contributors for this article] (2016). Use of Out-of-Hospital Ethanol Administration to Improve Outcome in Mass Methanol Outbreaks. Annals of Emergency Medicine. ISSN 0196-0644. 68(1), p. 52–61. doi: 10.1016/j.annemergmed.2016.01.010. Full text in Research Archive
• McMartin, Kenneth E.; Jacobsen, Dag & Hovda, Knut Erik (2016). Antidotes for poisoning by alcohols that form toxic metabolites. British Journal of Clinical Pharmacology. ISSN 0306-5251. 81(3), p. 505–515. doi: 10.1111/bcp.12824. Full text in Research Archive
• Rostrup, Morten; Edwards, Jeffrey K.; Abukalish, Mohamed; Ezzabi, Masoud; Some, David & Ritter, Helga [Show all 13 contributors for this article] (2016). The methanol poisoning outbreaks in Libya 2013 and Kenya 2014. PLOS ONE. 11(3). doi: 10.1371/journal.pone.0152676. Full text in Research Archive
• Wood, David M.; Dines, Alison M.; Heyerdahl, Fridtjof; Yates, Christopher; Giraudon, Isabelle & Paasma, Raido [Show all 8 contributors for this article] (2016). Review of European-Drug Emergencies Network (Euro-DEN) training package for non-specialist workers to assess acute recreational drug and new psychoactive substance toxicity in night-time economy environments. Drugs: education prevention and policy. ISSN 0968-7637. 23(1), p. 73–77. doi: 10.3109/09687637.2015.1081379. Full text in Research Archive
• Vallersnes, Odd Martin; Dines, Alison M.; Wood, David M.; Yates, Christopher; Heyerdahl, Fridtjof & Hovda, Knut Erik [Show all 8 contributors for this article] (2016). Psychosis associated with acute recreational drug toxicity: a European case series. BMC Psychiatry. 16:293, p. 1–8. doi: 10.1186/s12888-016-1002-7. Full text in Research Archive Show summary

  Background Psychosis can be associated with acute recreational drug and novel psychoactive substance (NPS) toxicity. However, there is limited data available on how common this is and which drugs are most frequently implicated. We describe a European case series of psychosis associated with acute recreational drug toxicity, and estimate the frequency of psychosis for different recreational drugs. Methods The European Drug Emergencies Network (Euro-DEN) collects data on presentations to Emergency Departments (EDs) with acute recreational drug and NPS toxicity at 16 centres in ten countries. Euro-DEN data from October 2013 through September 2014 was retrospectively searched, and cases with psychosis were included. The proportion of cases with psychosis per drug was calculated in the searched Euro-DEN dataset. Results Psychosis was present in 348 (6.3 %) of 5529 cases. The median (interquartile range) age was 29 (24-38) years, 276 (79.3 %) were male and 114 (32.8 %) were admitted to psychiatric ward. The drugs most commonly reported were cannabis in 90 (25.9 %) cases, amphetamine in 87 (25.0 %) and cocaine in 56 (16.1 %). More than one drug was taken in 189 (54.3 %) cases. Psychosis was frequent in those ED presentations involving tryptamines (4/7; 57.1 %), methylenedioxypyrovalerone (MDPV) (6/22; 27.3 %), methylphenidate (6/26; 23.1 %), lysergic acid diethylamide (LSD) (18/86; 20.9 %), psilocybe mushrooms (3/16; 18.8 %), synthetic cannabinoid receptor agonists (4/26; 15.4 %) and amphetamine (87/593; 14.7 %), but less common in those involving mephedrone (14/245; 5.7 %), methylenedioxymethamphetamine (MDMA) (20/461; 4.3 %) and methedrone (3/92; 3.3 %). Amphetamine was the most frequent drug associated with psychosis when only one agent was reported, with psychosis occurring in 32.4 % of these presentations. Conclusion The frequency of psychosis in acute recreational drug toxicity varies considerably between drugs, but is a major problem in amphetamine poisoning. In rapidly changing drug markets and patterns of use, the Euro-DEN sentinel network contributes to measuring the scale of drug-related harms in Europe beyond other more established indicators.

• Dines, Alison M.; Woods, David; Galicia, Miguel; Yates, Christopher; Heyerdahl, Fridtjof & Hovda, Knut Erik [Show all 9 contributors for this article] (2015). Presentations to the emergency department following cannabis use - a multi-centre case series from ten European countries. Journal of Medical Toxicology. ISSN 1556-9039. 11(4), p. 415–421. doi: 10.1007/s13181-014-0460-x. Full text in Research Archive
• Zakharov, Sergey; Pelclova, Daniela; Navratil, Tomas; Belacek, Jaromir; Komarc, Martin & Eddleston, Michael [Show all 7 contributors for this article] (2015). Fomepizole versus ethanol in the treatment of acute methanol poisoning: Comparison of clinical effectiveness in a mass poisoning outbreak. Clinical Toxicology. ISSN 1556-3650. 53(8), p. 797–806. doi: 10.3109/15563650.2015.1059946. Full text in Research Archive
• Hovda, Knut Erik; Gadeholt, Gaut; Evtodienko, Vladimir & Jacobsen, Dag (2015). A novel bedside diagnostic test for methanol poisoning using dry chemistry for formate. Scandinavian Journal of Clinical and Laboratory Investigation. ISSN 0036-5513. 75(7), p. 610–614. doi: 10.3109/00365513.2015.1066847. Full text in Research Archive
• Dalaker, Vivian M; Vallersnes, Odd Martin; Fosshaug, Linn Elisabeth Lillerud; Andersson, Kirsti Svendsen & Hovda, Knut Erik (2015). En ung kvinne som drakk streptestreagens. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 135(22), p. 2067–2070. doi: 10.4045/tidsskr.15.0190. Full text in Research Archive
• Dines, Alison M.; Wood, David M.; Yates, Christopher; Heyerdahl, Fridtjof; Hovda, Knut Erik & Giraudon, Isabelle [Show all 8 contributors for this article] (2015). Acute recreational drug and new psychoactive substance toxicity in Europe: 12 months data collection from the European Drug Emergencies Network (Euro-DEN). Clinical Toxicology. ISSN 1556-3650. 53(9), p. 893–900. doi: 10.3109/15563650.2015.1088157. Full text in Research Archive
• Zakharov, Sergey; Pelclova, Daniela; Diblik, Pavel; Urban, Pavel; Kuthan, Pavel & Nurieva, Olga [Show all 20 contributors for this article] (2015). Long-term visual damage after acute methanol poisonings: Longitudinal cross-sectional study in 50 patients. Clinical Toxicology. ISSN 1556-3650. 53(9), p. 884–892. doi: 10.3109/15563650.2015.1086488. Full text in Research Archive
• Zakharov, Sergey; Pelclova, Daniela; Urban, Pavel; Navratil, Tomas; Diblik, Pavel & Kuthan, Pavel [Show all 20 contributors for this article] (2014). Czech mass methanol outbreak 2012: Epidemiology, challenges and clinical features. Clinical Toxicology. ISSN 1556-3650. 52(10), p. 1013–1024. doi: 10.3109/15563650.2014.974106. Full text in Research Archive
• Heyerdahl, Fridtjof; Hovda, Knut Erik; Giraudon, Isabelle; Yates, Christopher; Dines, Alison M. & Sedefov, Roumen [Show all 8 contributors for this article] (2014). Current European data collection on emergency department presentations with acute recreational drug toxicity: Gaps and national variations. Clinical Toxicology. ISSN 1556-3650. 52(10), p. 1005–1012. doi: 10.3109/15563650.2014.976792. Full text in Research Archive
• Zakharov, Sergey; Pelclova, Daniela; Navratil, Tomas; Belacek, Jaromir; Kurcova, Ivana & Komzak, Ondrej [Show all 16 contributors for this article] (2014). Intermittent hemodialysis is superior to continuous veno-venous hemodialysis/hemodiafiltration to eliminate methanol and formate during treatment for methanol poisoning. Kidney International. ISSN 0085-2538. 86(1), p. 199–207. doi: 10.1038/ki.2014.60. Full text in Research Archive
• Lund, Cathrine; Bjørnaas, Mari Asphjell; Sandvik, Leiv; Ekeberg, Øivind; Jacobsen, Dag & Hovda, Knut Erik (2013). Five-year mortality after acute poisoning treated in ambulances, an Emergency outpatient clinic and hospitals in Oslo. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 21:65. doi: 10.1186/1757-7241-21-65. Full text in Research Archive
• Krayeva, Yulia V.; Brusin, Konstantin M.; Bushuev, Alexander V.; Kondrashov, Dimitry L.; Sentsov, Valentin G. & Hovda, Knut Erik (2013). Pre-hospital management and outcome of acute poisonings by ambulances in Yekaterinburg, Russia. Clinical Toxicology. ISSN 1556-3650. 51(8), p. 752–760. doi: 10.3109/15563650.2013.827707. Full text in Research Archive
• Lund, Cathrine; Vallersnes, Odd Martin; Jacobsen, Dag; Ekeberg, Øivind & Hovda, Knut Erik (2012). Outpatient treatment of acute poisonings in Oslo : poisoning pattern, factors associated with hospitalization, and mortality. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 20, p. 10–10. doi: 10.1186/1757-7241-20-1. Full text in Research Archive Show summary

  Background Most patients with acute poisoning are treated as outpatients worldwide. In Oslo, these patients are treated in a physician-led outpatient clinic with limited diagnostic and treatment resources, which reduces both the costs and emergency department overcrowding. We describe the poisoning patterns, treatment, mortality, factors associated with hospitalization and follow-up at this Emergency Medical Agency (EMA, "Oslo Legevakt"), and we evaluate the safety of this current practice. Methods All acute poisonings in adults (> or = 16 years) treated at the EMA during one year (April 2008 to April 2009) were included consecutively in an observational study design. The treating physicians completed a standardized form comprising information needed to address the study's aims. Multivariate logistic regression analysis was used to identify the factors associated with hospitalization. Results There were 2348 contacts for 1856 individuals; 1157 (62%) were male, and the median age was 34 years. The most frequent main toxic agents were ethanol (43%), opioids (22%) and CO or fire smoke (10%). The physicians classified 73% as accidental overdoses with substances of abuse taken for recreational purposes, 15% as other accidents (self-inflicted or other) and 11% as suicide attempts. Most (91%) patients were treated with observation only. The median observation time until discharge was 3.8 hours. No patient developed sequelae or died at the EMA. Seventeen per cent were hospitalized. Gamma-hydroxybutyric acid, respiratory depression, paracetamol, reduced consciousness and suicidal intention were factors associated with hospitalization. Forty-eight per cent were discharged without referral to follow-up. The one-month mortality was 0.6%. Of the nine deaths, five were by new accidental overdose with substances of abuse. Conclusions More than twice as many patients were treated at the EMA compared with all hospitals in Oslo. Despite more than a doubling of the annual number of poisoned patients treated at the EMA since 2003, there was no mortality or sequelae, indicating that the current practice is safe. Thus, most low- to intermediate-acuity poisonings can be treated safely without the need to access hospital resources. Although the short-term mortality was low, more follow-up of patients with substance abuse should be encouraged.

• Paasma, Raido; Hovda, Knut Erik; Hassanian-Moghaddam, Hossein; Brahmi, Nozha; Afshari, Reza & Sandvik, Leiv [Show all 7 contributors for this article] (2012). Risk factors related to poor outcome after methanol poisoning and the relation between outcome and antidotes - a multicenter study. Clinical Toxicology. ISSN 1556-3650. 50(9), p. 823–831. doi: 10.3109/15563650.2012.728224. Full text in Research Archive
• Lund, Cathrine; Drottning, Per; Stiksrud, Birgitte; Vahabi, Javad; Lyngra, Marianne & Ekeberg, Ivind [Show all 8 contributors for this article] (2012). A one-year observational study of all hospitalized acute poisonings in Oslo: complications, treatment and sequelae. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 20(49). doi: 10.1186/1757-7241-20-49. Full text in Research Archive
• Lund, Cathrine; Teige, Brita; Drottning, Per; Stiksrud, Birgitte; Rui, Tor Olav & Lyngra, Marianne [Show all 9 contributors for this article] (2012). A one-year observational study of all hospitalized and fatal acute poisonings in Oslo: Epidemiology, intention and follow-up. BMC Public Health. 12(1). doi: 10.1186/1471-2458-12-858. Full text in Research Archive Show summary

  Background Up to date information on poisoning trends is important. This study reports the epidemiology of all hospitalized acute poisonings in Oslo, including mortality, follow-up referrals, and whether the introduction of over-the-counter sales of paracetamol outside pharmacies had an impact on the frequency of poisonings. Methods All acute poisonings of adults (≥16 years) treated at the five hospitals in Oslo from April 2008 to April 2009 were included consecutively in an observational cross-sectional multicentre study. A standardized form was completed by the treating physician, which covered the study aims. All deaths by poisoning in and outside hospitals were registered at the Institute of Forensic Medicine. Results There were 1065 hospital admissions of 912 individuals; 460 (50%) were male, and the median age was 36 years. The annual incidence was 2.0 per 1000. The most frequent toxic agents were ethanol (18%), benzodiazepines (15%), paracetamol (11%), and opioids (11%). Physicians classified 46% as possible or definite suicide attempts, 37% as accidental overdoses with substances of abuse (AOSA), and 16% as other accidents. Twenty-four per cent were discharged without any follow-up and the no follow-up odds were highest for AOSA. There were 117 deaths (eight in hospital), of which 75% were males, and the median age was 41 years. Thus, the annual mortality rate was 25 per 100 000 and the in-hospital mortality was 0.8%. Opioids were the most frequent cause of death. Conclusions The incidence of hospitalized acute poisonings in Oslo was similar to that in 2003 and there was an equal sex distribution. Compared with a study performed in Oslo in 2003, there has been an increase in poisonings with a suicidal intention. The in-hospital mortality was low and nine out of ten deaths occurred outside hospitals. Opioids were the leading cause of death, so preventive measures should be encouraged among substance abusers. The number of poisonings caused by paracetamol remained unchanged after the introduction of over-the-counter sales outside pharmacies and there were no deaths, so over-the-counter sales may be considered safe.

• Hovda, Knut Erik; Julsrud, Joar; Øvrebø, Steinar; Brørs, Odd & Jacobsen, Dag (2011). Studies on ethylene glycol poisoning: One patient - 154 admissions. Clinical Toxicology. ISSN 1556-3650. 49(6), p. 478–484. doi: 10.3109/15563650.2011.590140. Full text in Research Archive Show summary

  Objective. Fomepizole is the antidote of choice in toxic alcohol poisonings. Potential side effects from frequent use of fomepizole were studied in a patient admitted 154 times with ethylene glycol (EG) poisoning. The intra-individual correlation between the serum-ethylene glycol (serum-EG) and the osmolal gap (OG) EG-kinetics, and other laboratory parameters were also studied. Methods. Combined pro- and retrospective collection of material from three different hospitals, and results from autopsy. Results. A 26-year-old female with a dissociative disorder was admitted with EG poisoning a total of 154 times. Her admission data revealed a median pH of 7.31 (range 6.87–7.49), pCO2: 4.2 kPa (1.2–6.7) (32 mmHg [9–50]), HCO–3: 15 mmol/L (4–26) (15 mEq/L [4–26]), base deficit (BD): 10 mmol/L (− 4 to 27) (10 mEq/L [–4 to 27]), serum-creatinine 65 μmol/L (40–133) (0.74 mg/dL [0.45–1.51]), OG 81 mOsm/kgH2O (25–132), and serum-EG 44 mmol/L (4–112) (250 mg/dL [25–700]). She was treated with fomepizole 99 times, ethanol 60 times (with a combination of both six times), and dialysis 73 times. The correlation between serum-EG and OG was good (r2 = 0.76). She was finally found dead outside hospital with an EG blood concentration of 81 mmol/L (506 mg/dL). An autopsy revealed calcium oxalate crystals in the kidneys, slight liver steatosis, and slight edema of the lungs. Discussion. The frequent use of fomepizole in this young patient was not associated with any detectable side effects; neither on clinical examination and lab screening, nor on the later autopsy. Regarding the sequelae from the repetitive EG-poisoning episodes, her kidney function seemed to normalize after each overdose. She was treated with buffer and antidote without hemodialysis 81 times without complications, supporting the safety of this approach in selected cases.

• Kolvik, Hallgeir; Bjørnaas, Mari Asphjell; Hovda, Knut Erik; Jacobsen, Dag; Ekeberg, Øivind & Heyerdahl, Fridtjof (2011). Levekår og forgiftningsmønster i Oslos bydeler. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 131, p. 1424–1428. doi: 10.4045/tidsskr.10.0531. Full text in Research Archive
• Bjørnaas, Mari Asphjell; Teige, Brita; Hovda, Knut Erik; Ekeberg, Øivind; Heyerdahl, Fridtjof & Jacobsen, Dag (2010). Fatal poisonings in Oslo: A one-year observational study. BMC Emergency Medicine. 10(6), p. 10–13. doi: 10.1186/1471-227X-10-13. Full text in Research Archive Show summary

  Background Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Methods Fatal and non-fatal acute poisonings in subjects aged ≥16 years in Oslo (428 198 inhabitants) were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic), and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. Results In Oslo, during the one-year period studied, 103 subjects aged ≥16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years). In 92 cases (89%), death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases), followed by ethanol (9%), tricyclic anti-depressants (TCAs) (4%), benzodiazepines (4%), and zopiclone (4%). Seventy-one (69%) were evaluated as accidental deaths and 32 (31%) as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04). Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91), 14% (95% C.I., 0.04-0.33), and 10% (95% C.I., 0.02-0.27), respectively. Conclusions Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental deaths. Although case fatality rates were highest for methanol, TCAs, and antihistamines, most deaths were caused by opiates or opioids.

• Hovda, Knut Erik; Guo, Chungang; Austin, Ronald & McMartin, Kenneth E. (2010). Renal toxicity of ethylene glycol results from internalization of calcium oxalate crystals by proximal tubule cells. Toxicology Letters. ISSN 0378-4274. 192(3), p. 365–372. doi: 10.1016/j.toxlet.2009.11.013. Full text in Research Archive
• Bjørnaas, Mari Asphjell; Hovda, Knut Erik; Heyerdahl, Fridtjof; Skog, Karina; Drottning, Per & Opdahl, Anders [Show all 8 contributors for this article] (2010). Suicidal intention, psychosocial factors and referral to further treatment: A one-year cross-sectional study of self-poisoning. BMC Psychiatry. 10. doi: 10.1186/1471-244X-10-58. Full text in Research Archive Show summary

  Background Patients treated for self-poisoning have an increased risk of death, both by natural and unnatural causes. The follow-up of these patients is therefore of great importance. The aim of this study was to explore the differences in psychosocial factors and referrals to follow-up among self-poisoning patients according to their evaluated intention. Methods A cross-sectional multicenter study of all 908 admissions to hospital because of self-poisoning in Oslo during one year was completed. Fifty-four percent were females, and the median age was 36 years. The patients were grouped according to evaluated intention: suicide attempts (moderate to high suicide intent), appeals (low suicide intent) and substance-use related poisonings. Multinomial regression analyses compared patients based on their evaluated intention; suicide attempts were used as the reference. Results Of all self-poisoning incidents, 37% were suicide attempts, 26% were appeals and 38% were related to substance use. Fifty-five percent of the patients reported previous suicide attempts, 58% reported previous or current psychiatric treatment and 32% reported daily substance use. Overall, patients treated for self-poisoning showed a lack of social integration. Only 33% were employed, 34% were married or cohabiting and 53% were living alone. Those in the suicide attempt and appeal groups had more previous suicide attempts and reported more psychiatric treatment than those with poisoning related to substance use. One third of all patients with substance use-related poisoning reported previous suicide attempts, and one third of suicide attempt patients reported daily substance use. Gender distribution was the only statistically significant difference between the appeal patients and suicide attempt patients. Almost one in every five patients was discharged without any plans for follow-up: 36% of patients with substance use-related poisoning and 5% of suicide attempt patients. Thirty-eight percent of all suicide attempt patients were admitted to a psychiatric ward. Only 10% of patients with substance use-related poisoning were referred to substance abuse treatment. Conclusions All patients had several risk factors for suicidal behavior. There were only minor differences between suicide attempt patients and appeal patients. If the self-poisoning was evaluated as related to substance use, the patient was often discharged without plans for follow-up.

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• Lyphout, Cathelijne; Dargan, Paul I.; Wood, David M.; Dines, Alison M.; Giraudon, Isabelle & Heyerdahl, Fridtjof [Show all 14 contributors for this article] (2024). Profiling emergency department presentations related to recreational illicit and prescription opioid use through a European Sentinel-Centre Based Registry. Full text in Research Archive
• Hovda, Knut Erik & Jacobsen, Dag (2024). Comment on “Elevated osmol gaps in patients with alcoholic ketoacidosis”. Clinical Toxicology. ISSN 1556-3650. doi: 10.1080/15563650.2024.2433122. Full text in Research Archive
• Wood, David M.; Dines, Alison M.; Liechti, Matthias E.; Giraudon, Isabelle; Heyerdahl, Fridtjof & hovda, knut erik [Show all 10 contributors for this article] (2023). Diphenidine, methoxyphenidine and related 1,2-diarylethylamine acute toxicity reported to the Euro-DEN Plus project. Full text in Research Archive
• Tosterud, Mari & Hovda, Knut Erik (2023). Giftinformasjonen gir trygghet og redder liv. 143(2). doi: 10.4045/tidsskr.22.0816. Full text in Research Archive
• Waters, Mitchell; Wood, David M.; Yates, Christopher; Dines, Alison M.; Giraudon, Isabelle & Liechti, Matthias E. [Show all 11 contributors for this article] (2022). Clinical effects of cannabis compared to synthetic cannabinoids (SCs): a retrospective cohort study. Full text in Research Archive
• Slørdahl, Johannes Thomassen; Persett, Per Sverre; Brekke, Mette; Heyerdahl, Fridtjof; Hovda, Knut Erik & Vallersnes, Odd Martin (2021). Acute poisoning from concurrent use of opioids and amphetamine. Full text in Research Archive
• Gundem, Trine; Olasveengen, Theresa M.; Schøndorf, Christina Luise; Hovda, Knut Erik; Rostrup, Morten & Frøyshov, Sten [Show all 11 contributors for this article] (2020). T.M. Gundem og medarbeidere svarer. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 140(12), p. 1–2. doi: 10.4045/tidsskr.20.0650. Full text in Research Archive
• Hassanian-Moghaddam, Hossein; Zamani, Nasim; Kolahi, Ali-Asghar; McDonald, Rebecca & Hovda, Knut Erik (2020). Double trouble: Methanol outbreak in the wake of the COVID-19 pandemic in Iran - A cross-sectional assessment. Critical Care. ISSN 1364-8535. 24(1). doi: 10.1186/s13054-020-03140-w. Full text in Research Archive
• Vallersnes, Odd Martin; Dines, Alison M.; Wood, David M.; Heyerdahl, Fridtjof; Hovda, Knut Erik & Yates, Christopher [Show all 8 contributors for this article] (2020). Self-discharge during treatment for acute recreational drug toxicity: an analysis of four-years of Euro-DEN Plus presentations. Full text in Research Archive
• Syse, Victoria Lykke; Brekke, Mette; Grimsrud, Marit Mæhle; Persett, Per Sverre; Heyerdahl, Fridtjof & Hovda, Knut Erik [Show all 7 contributors for this article] (2019). Acute recreational drug toxicity in women: a case series from Oslo, Norway. Full text in Research Archive
• Zakharov, Sergey; Roberts, Darren M. & Hovda, Knut Erik (2017). Reply to “Letter in response to efficiency of acidemia correction on intermittent versus continuous hemodialysis in acute methanol poisoning”. Clinical Toxicology. ISSN 1556-3650. 55(4), p. 306–307. doi: 10.1080/15563650.2017.1284338. Full text in Research Archive
• Paasma, Raido; Tönisson, Mailis; Føreid, Siri; Gadeholt, Gaut & Hovda, Knut Erik (2016). Methanol and formate concentrations in brain after methanol poisining. Full text in Research Archive
• Hovda, Knut Erik; Gadeholt, Gaut & Jacobsen, Dag (2016). Ethanol strips for monitoring of ethanol concentrations during treatment of toxic alkohol: preliminary results. Full text in Research Archive
• Vallersnes, Odd Martin; Dines, Alison M.; Wood, David M.; Yates, Christopher; Heyerdahl, Fridtjof & hovda, knut erik [Show all 8 contributors for this article] (2016). Erratum to: Psychosis associated with acute recreational drug toxicity: A European case series [BMC Psychiatry, 16 (2016), (293)], DOI:10.1186/s12888-016-1002-7. BMC Psychiatry. 16(1). doi: 10.1186/s12888-016-1066-4. Full text in Research Archive
• Øiestad, Elisabeth Leere; Nordfjærn, Trond; Edland-Gryt, Marit; Bretteville-Jensen, Anne Line; Hovda, Knut Erik & Persett, Per Sverre [Show all 9 contributors for this article] (2015). Use of oral fluid for analysis of new psychoactive substances. Full text in Research Archive
• Vallersnes, Odd Martin; Dines, Alison M.; Wood, David M.; Yates, Christopher; Heyerdahl, Fridtjof & Hovda, Knut Erik [Show all 9 contributors for this article] (2015). Psychosis associated with acute poisoning by recreational drugs: a European case series. Full text in Research Archive
• Dalaker, Vivian; Vallersnes, Odd Martin; Fosshaug, Linn E; Andersson, Kirsti Svendsen & Hovda, Knut Erik (2015). Drinking strep test reagents: a case of nitrite poisoning. Full text in Research Archive
• Persett, Per Sverre; Vallersnes, Odd Martin; Øiestad, Elisabeth Leere; Karinen, Ritva Anneli; Bogstrand, Stig Tore & Heyerdahl, Fridtjof [Show all 7 contributors for this article] (2015). Laboratory confirmation of recreational drugs in Oslo, Norway. Full text in Research Archive
• Paasma, Raido; Hovda, Knut Erik; Hassanian-Moghaddan, H; Brahmi, Nozha; Afshari, Reza & Sandvik, Leiv [Show all 7 contributors for this article] (2013). Response to the letter "Risk assessment of methanol poisoning in outbreaks not applicable to isolated cases". Clinical Toxicology. ISSN 1556-3650. 51(2), p. 120–120. doi: 10.3109/15563650.2013.764430. Full text in Research Archive
• Pelclova, Daniela; Zakharov, Sergej; Navratil, Tomas & Hovda, Knut Erik (2013). Methanol outbreak in the Czech Republic in 2012: Epidemiology and clinical features. Clinical Toxicology. ISSN 1556-3650. 51(4), p. 252–253. Full text in Research Archive
• Lund, Caroline; Hovda, Knut Erik; Gudmundsdottir, Helga; Andersson, Kirsti Svendsen; NYVOLD, CECILIE & Froyshov, Sten [Show all 8 contributors for this article] (2013). Severe metformin-induced lactic acidosis: Case series of 10 patients. Clinical Toxicology. ISSN 1556-3650. 51(4), p. 365–365. Full text in Research Archive
• Hovda, Knut Erik (2013). Formate analysis as a simple methanol diagnostic approach: The cost-beneficial answer for evaluating metabolic acidosis. Clinical Toxicology. ISSN 1556-3650. 51(4), p. 298–298. Full text in Research Archive
• Paasma, Raido; Hovda, Knut Erik; Hassanian-Moghaddan, H; Brahmi, Nozha; Afshari, Reza & Jacobsen, Dag (2012). Risk Assessment Score for Methanol Poisoning. Clinical Toxicology. ISSN 1556-3650. 50(4), p. 350–351. Full text in Research Archive
• Hovda, Knut Erik; Refsum, Helge & Jacobsen, Dag (2012). A Case of Extraordinary High Serum-Venlafaxine and Prolonged Elimination without Genetic Predisposal. Clinical Toxicology. ISSN 1556-3650. 50(4), p. 324–325. Full text in Research Archive
• Lund, Cathrine; Vallersnes, Odd Martin; Jacobsen, Dag; Ekeberg, Øivind & Hovda, Knut Erik (2011). Acute poisonings treated at the outpatient accident and emergency clinic (EMA) in Oslo, 2008. Full text in Research Archive

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