Clinical Analyses

Several psychoactive species have been used for centuries as a part of religious rituals or as medicines. These drugs are now being used recreationally by young people both because plants are considered safer than chemicals and because most of them are not illegal to use, possess, grow or distribute and cannot be detected by specific laboratory drug tests. Despite being ‘natural substances’ they can produce severe toxic effects, such as coma, seizures or cardiac dysrhythmias. We reviewed all the calls concerning suspected plant poisonings collected from poison control centre (PCC) of Milan between 2001 and 2005 to point out the cases related to recreational use of psychoactive species. Hallucinogen mushrooms and Cannabis spp. were not included in this search. Among 4580 calls concerning plant poisonings, 41 were closely connected to the recreational use of psychoactive species. The age range was 16–36. Datura stramonium, Argyreia nervosa, Myristica fragrans, Salvia divinorum, Mandragora officinarum were the species involved. The recreational use of psychoactive plants among young people in Italy is difficult to assess because of the lack of epidemiological data. The assumption of such natural drugs would be suspected in young people showing acute psychiatric, neurological or cardiac symptoms, especially when urinary drug test results negative. The identification of clinical cases by PCCs and their report to Health Authorities is of primary importance for making preventive public health interventions, such as the recent insertion of A. nervosa and S. divinorum in the list of psychotropic substances under Law control.