The National Poisons Information Service (NPIS) has released its annual report for 2022 to 2023, which shows a marked increase in  NPIS activity related to nitrous oxide and ketamine.

THe NPIS is an expert toxicology advice service commissioned by the UK Health Security Agency (UKHSA) and the report details how often and for what reasons the NPIS was consulted by clinicians.

There has been an increase of approximately 175% in all forms of NPIS activity linked to nitrous oxide and an increase of approximately 25% in activity linked to ketamine since last year’s report. The data from the report is consistent with other reports which have shown an increase in the two substances.

Poisoning accounted for more than 380,000 hospital presentations in England in 2019 to 2020.

In adults, the majority of poisonings are caused by drug overdose in the context of self-harm and drug misuse. In children, accidental exposure is common.

However, most hospitals do not have specialist clinical toxicology services, leading them to rely on the NPIS for support.

Professor Raquel Duarte-Davidson, Radiation, Chemicals and Environmental Hazards Directorate, UKHSA said: "The NPIS annual report serves as a comprehensive statement of NPIS’s activities, emphasising its pivotal role in managing poisoning cases, offering expert advice, and contributing to public health efforts.

"The rise in nitrous oxide and ketamine-related activities underscores the need for targeted interventions to protect public health and prevent further harm.

Professor Michael Eddleston chair, NPIS Clinical Standards Group said: "This year’s annual report again demonstrates the value of the close collaboration between the NPIS, UKTIS and UKHSA to address problems of poisoning across the UK and globally.

"NPIS goes beyond clinical support, engaging in research, education, and the collection and sharing of surveillance data. This multifaceted approach contributes significantly to public health and health security efforts in the UK and internationally."