The spice of life: An analysis of nutmeg exposures in California

Background. Nutmeg is widely used as a household spice. Numerous citations in the medical literature report its abuse as a psychoactive agent, primarily for its purported hallucinogenic effects that are thought to be due to the compound myristicin; these are primarily limited to case reports. Methods. We performed a retrospective review of the California Poison Control System database for the years 1997-2008 for all cases of single-substance human exposure to nutmeg. Results. There were a total of 119 single-substance exposures to nutmeg. Eighty-six (72.3%) exposures were intentional. Patients intentionally abusing nutmeg were more likely to be between the ages of 13 and 20 than those with unintentional exposure to the spice (80.2% vs. 9.1%, p < 0.05). Abusers were significantly more likely to require medical evaluation than nonabusers (61.6% vs. 33.3%, p < 0.05). Patients who abused nutmeg were significantly more likely (p < 0.05) to experience tachycardia and agitation than those whose exposure was unintentional. No major effects and no deaths were reported to occur in either group. Conclusions. Although nutmeg exposure is uncommonly encountered, clinical effects from ingestion can be significant and can require medical intervention. While clinically significant effects were common, life-threatening toxicity and death did not occur in this series.