Background: The growing number of novel psychoactive substances (NPS), also labelled as “legal highs”, constitutes a challenge to public health. It is uncertain whether this trend is related to the increase in number of poising cases reported by emergency rooms. The aim of this study was to investigate the occurrence of NPS in acute cases of poisoning in the Swedish county Värmland. The numbers of NPS casualties were correlated with poisoning by other substances. Both, the gender and age distribution of the reported cases were recorded. Method: Records classified as poisoning casualties at the emergency rooms in Värmland during 2007- 2013 were collected and analyzed. Results: NPS and illicit drugs constituted only a small part (1.67% and 7.84% respectively) of the total poisoning casualties. The results also revealed that alcohol and pharmaceuticals were present in the majority of cases (91.2%), and were to a larger extent involved in polydrug abuse and suicide attempts. Furthermore, the results uncovered an alarming poisoning problem among women who had taken pharmaceuticals and for suicidal young people. Conclusions: It is unclear whether the comparatively low prevalence of NPS and illicit drug related poisoning casualties reflect the real prevalence of injury cases or a possible under-reporting.