Withdrawal-related calls to a statewide poison control center: a ten-year review

INTRODUCTION: Poison control centers are commonly utilized by the public and healthcare providers following potentially harmful substance exposures. Less frequently, poison control centers are contacted regarding substance withdrawal. This study characterizes a decade of withdrawal-related calls to a statewide poison control center and explores their potential value in identifying emerging public health concerns. METHODS: definitions as minor, moderate, or major. Descriptive statistics were performed. RESULTS: During the study period, 198 withdrawal-related calls were identified, averaging approximately 20 annually. Most calls originated from hospitals (58.1%), while 36.9% came from private residences. The most frequently implicated substances were tianeptine (24.2%), opioids (20.7%), and benzodiazepines (14.1%). Tianeptine first appeared in 2019 and contributed substantially to an increase in withdrawal-related calls beginning in 2020. The median patient age was 35 years, and 53.0% were male. Overall, 37.4% of cases resulted in at least a moderate medical outcome (34.8% moderate, 2.5% major). Tianeptine accounted for the largest proportion of moderate or major outcomes, followed by opioids, benzodiazepines, gamma-hydroxybutyrate, antidepressants, and phenibut. Sixty-three patients (31.8%) required hospital admission, including 36 (18.2%) admitted to an intensive care unit; tianeptine was associated with 27.8% of ICU admissions. No deaths were documented. DISCUSSION: This ten-year review demonstrates that withdrawal-related calls represent a small but clinically important component of PCC utilization. Although PCCs are traditionally associated with the management of acute toxic exposures, our findings highlight their broader role in providing consultation for substance withdrawal syndromes and their value as a real-time toxicovigilance resource. An important finding of this study was the changing pattern of substances associated with withdrawal over time. CONCLUSION: Poison control center utilization extends beyond substance exposure and includes management of substance withdrawal. Withdrawal-related calls may provide valuable surveillance data regarding emerging substance use trends and public health concerns, particularly involving tianeptine and opioids.