Illicit drug use presents an ongoing challenge for emergency departments, particularly as new and unfamiliar substances continue to emerge.

Through his Career Advancement Fellowship, Dr David McCutcheon investigated a new approach to identifying the drugs responsible for serious emergency department presentations and understanding how these substances affect patients. The Western Australian Illicit Substance Evaluation (WISE) Study combined detailed clinical information with specialised analysis of blood samples from patients presenting to the Royal Perth Hospital Emergency Department after illicit drug use. The research aimed to identify both conventional and novel psychoactive substances, understand how detected drugs related to patients’ symptoms, and compare laboratory findings with what patients believed they had taken.

The WISE Study identified methamphetamine as the most common drug associated with harm among participants, while also detecting a wide range of newer psychoactive substances.

Importantly, the study demonstrated the value of combining blood sampling with advanced toxicology testing to better understand drug-related presentations. This approach was subsequently incorporated into routine care for patients presenting to the emergency department with suspected illicit drug intoxication.

The research also helped establish the Emerging Drugs Network of Australia (EDNA), a national collaboration bringing together emergency clinicians, toxicologists and forensic scientists to monitor new and emerging substances causing harm.

By linking laboratory results with information about how patients present clinically, EDNA provides an early-warning system for changing patterns of illicit drug use and toxicity. During the Fellowship, the network established collaborations across Australia and identified emerging synthetic benzodiazepines and opioids associated with patient harm.

The Fellowship gave Dr McCutcheon dedicated research time away from clinical duties to analyse the WISE dataset, publish findings and further develop the EDNA collaboration.

The work contributed to additional research funding, including a National Health and Medical Research Council (NHMRC) Ideas Grant, while EDNA was also recognised with a WA Health Excellence Award.

Dr McCutcheon also progressed his PhD in Emergency Medicine through The University of Western Australia and continued to build his career in academic emergency medicine.

The research supported through the Fellowship has helped transform a hospital-based study into a national system that supports clinicians, health agencies and harm-reduction organisations to identify emerging drug threats earlier and respond with better information.