1
|
Júnior EF, Bitencourt VS, Souza ÁBMD, Caldas ED. Target analysis of psychoactive drugs in oral fluid by QuEChERS extraction and LC-MS/MS. J Pharm Biomed Anal 2024; 244:116139. [PMID: 38608509 DOI: 10.1016/j.jpba.2024.116139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/03/2024] [Accepted: 04/06/2024] [Indexed: 04/14/2024]
Abstract
This study aimed to validate a modified QuEChERS method, followed by liquid chromatography-tandem mass spectrometry, for the determination of 51 psychoactive substances and screening of 22 ones in oral fluid from electronic dance music party (EDM) attendees. Unstimulated oral fluid was collected in a polypropylene tube and stored in a glass vial at -20 ºC. The sample was extracted with acetonitrile:water and MgSO4/NaOAc, followed by cleanup with primary secondary amine and MgSO4. The effectiveness of the sample storage conditions was shown to be comparable to when the Quantisal™ buffer was used, with no substantial concentration loss (< 15%) for all the substances after up to 72 hours at -20º C. The method was satisfactorily validated, with limits of detection (LOD) and quantification (LOQ) ranging from 0.04 to 0.5 ng/mL and 0.1-1.5 ng/mL, respectively, and was applied to the analysis of 62 real samples. The main substances detected were 3,4-methylenedioxymethamphetamine (MDMA) (<0.5-829 ng/mL) and/or methylenedioxyamphetamine (MDA) (10.1 - 460.6 ng/mL), found in 27 samples, and cocaine (13.0-407.3 ng/mL) and its metabolites (benzoylecgonine 0.17-214.1 ng/mL; ecgonine methyl ester 1.8-150.1 ng/mL) in eight samples. Methamphetamine (11-439 ng/mL) was detected in eight samples, along with MDMA and MDA; eutylone was detected in two cases (4.7 and 24.1 ng/mL) reported as "ecstasy" ingestion. A comparison between self-reported drug use and results of oral fluid analysis indicated that the use of illicit substances is often underreported among EDM attendees, who are often unaware of the substances they consume.
Collapse
Affiliation(s)
- Ettore Ferrari Júnior
- Forensic Analysis Laboratory, Criminalistics Institute, The Civil Police of the Federal District, Brasília, Federal District, Brazil
| | | | | | - Eloisa Dutra Caldas
- Laboratory of Toxicology, Department of Pharmacy, University of Brasília, Brasília, Federal District, Brazil.
| |
Collapse
|
2
|
Fitzgerald ND, Palamar JJ. Increases in the use of drug testing kits among nightclub and festival attendees in New York City who use ecstasy, 2017-2022. Drug Alcohol Rev 2024; 43:975-983. [PMID: 38408742 PMCID: PMC11052675 DOI: 10.1111/dar.13829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Ecstasy (3,4-methylenedioxymethamphetamine [MDMA]) is a drug commonly used by people who attend electronic dance music (EDM) events at nightclubs and dance festivals. Drug checking has gained popularity in recent years to test for adulterants, but epidemiology studies are needed to estimate potential shifts in prevalence of drug checking to further inform harm reduction efforts. METHODS Adults entering randomly selected EDM events in New York City were surveyed in 2017 and 2022. Those reporting past-year ecstasy use were asked if they tested their ecstasy in the past year using a drug testing kit and whether they found out or suspected their ecstasy contained other drugs. We compared estimates between 2017 and 2022. RESULTS In 2017, an estimated 23.1% had tested their ecstasy, and this estimate increased to 43.1% in 2022 (86.6% increase, p = 0.006). Among those who tested their ecstasy, in 2017, 31.2% always tested their drug, and this increased to 60.6% in 2022 (94.2% increase, p = 0.026). In 2017, 59.6% of those who tested their ecstasy reported finding out or suspecting their drug was adulterated, which decreased to 18.4% in 2022 (69.1% decrease, p < 0.001). Suspected methamphetamine adulteration in particular decreased, from 21.9% in 2017 to 3.6% in 2022 (83.6% decrease, p = 0.007). DISCUSSION AND CONCLUSIONS The use of drug testing kits has increased among EDM event attendees who use ecstasy and, at the same time, among those who had tested their ecstasy, suspected adulteration has decreased. Continued interest in understanding ecstasy contents among this population suggests the need for formal drug checking services.
Collapse
Affiliation(s)
- Nicole D. Fitzgerald
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, USA
| | - Joseph J. Palamar
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| |
Collapse
|
3
|
Ververi C, Galletto M, Massano M, Alladio E, Vincenti M, Salomone A. Method development for the quantification of nine nitazene analogs and brorphine in Dried Blood Spots utilizing liquid chromatography - tandem mass spectrometry. J Pharm Biomed Anal 2024; 241:115975. [PMID: 38280237 DOI: 10.1016/j.jpba.2024.115975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/31/2023] [Accepted: 01/08/2024] [Indexed: 01/29/2024]
Abstract
The detection of nitazenes in biological fluids is increasingly needed as they are repeatedly reported in intoxication and overdose cases. A simple method for the quantification of low levels of nine nitazene analogs and brorphine in Dried Blood Spots (DBS) was developed and validated. 10 μL of spiked whole blood is deposited on a Capitainer®B card and allowed to dry. The spot is punched out, and extracted with 500 μL methanol:acetonitrile (3:1 v/v) added with 1.5 μL of fentanyl-D5 as the internal standard. After stirring, sonication, and centrifugation of the vial, the solvent is dried under nitrogen, the extract is reconstituted in 30 μL methanol, and 1 μL is injected into a UHPLC-MS/MS instrument. The method validation showed linear calibration in the 1-50 ng/mL range, LOD values ranging between 0.3 ng/mL (isotonitazene) and 0.5 ng/mL (brorphine), average CV% and bias% within 15 % and 10 % for all compounds, respectively. The matrix effect due to blood and filter paper components was within 85-115 % while recovery was between 15-20 %. Stability tests against time and temperature showed no significant variations for storage periods up to 28 days. Room temperature proved to represent the best samples storage conditions. UHPLC-MS/MS proved capable to reliably identify all target analytes at low concentration even in small specimen volumes, as those obtained from DBS cards, which in turn confirmed to be effective and sustainable micro-sampling devices. This procedure improves the efficiency of toxicological testing and provides an innovative approach for the identification of the nitazene class of illicit compounds.
Collapse
Affiliation(s)
| | | | - Marta Massano
- Department of Chemistry, University of Turin, Turin, Italy
| | | | - Marco Vincenti
- Department of Chemistry, University of Turin, Turin, Italy; Centro Regionale Antidoping, Orbassano, Turin, Italy
| | - Alberto Salomone
- Department of Chemistry, University of Turin, Turin, Italy; Centro Regionale Antidoping, Orbassano, Turin, Italy
| |
Collapse
|
4
|
Willeman T, Grunwald J, Manceau M, Lapierre F, Krebs-Drouot L, Boudin C, Scolan V, Eysseric-Guerin H, Stanke-Labesque F, Revol B. Smartphone swabs as an emerging tool for toxicology testing: a proof-of-concept study in a nightclub. Clin Chem Lab Med 2024; 0:cclm-2024-0242. [PMID: 38578968 DOI: 10.1515/cclm-2024-0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/27/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVES Smartphones have become everyday objects on which the accumulation of fingerprints is significant. In addition, a large proportion of the population regularly uses a smartphone, especially younger people. The objective of this study was to evaluate smartphones as a new matrix for toxico-epidemiology. METHODS This study was conducted during two separate events (techno and trance) at an electronic music nightclub in Grenoble, France. Data on reported drug use and whether drugs were snorted directly from the surface of the smartphone were collected using an anonymous questionnaire completed voluntarily by drug users. Then, a dry swab was rubbed for 20 s on all sides of the smartphone. The extract was analyzed by liquid chromatography coupled to tandem mass spectrometry on a Xevo TQ-XS system (Waters). RESULTS In total, 122 swabs from 122 drug users were collected. The three main drugs identified were MDMA (n=83), cocaine (n=59), and THC (n=51). Based on declarative data, sensitivity ranged from 73 to 97.2 % and specificity from 71.8 to 88.1 % for MDMA, cocaine, and THC. Other substances were identified such as cocaine adulterants, ketamine, amphetamine, LSD, methamphetamine, CBD, DMT, heroin, mescaline, and several NPS. Numerous medications were also identified, such as antidepressants, anxiolytics, hypnotics, and painkillers. Different use patterns were identified between the two events. CONCLUSIONS This proof-of-concept study on 122 subjects shows that smartphone swab analysis could provide a useful and complementary tool for drug testing, especially for harm-reduction programs and toxico-epidemiolgy studies, with acceptable test performance, despite declarative data.
Collapse
Affiliation(s)
- Théo Willeman
- 36724 Laboratoire de Pharmacologie, Pharmacogénétique et Toxicologie, CHU Grenoble Alpes , 27015 Institut de Biologie et de Pathologie, Univ Grenoble Alpes , Grenoble, France
- 36724 Clinique de Médecine Légale, CHU Grenoble Alpes , 27015 Univ Grenoble Alpes , Grenoble, France
| | - Justine Grunwald
- 36724 Laboratoire de Pharmacologie, Pharmacogénétique et Toxicologie, CHU Grenoble Alpes , 27015 Institut de Biologie et de Pathologie, Univ Grenoble Alpes , Grenoble, France
- 36724 CEIP-Addictovigilance, CHU Grenoble Alpes , 27015 Univ Grenoble Alpes , Grenoble, France
| | - Marc Manceau
- Clinical Research Center, Inserm CIC1406, Grenoble Alpes University Hospital, Grenoble, France
| | | | - Lila Krebs-Drouot
- 36724 Clinique de Médecine Légale, CHU Grenoble Alpes , 27015 Univ Grenoble Alpes , Grenoble, France
| | - Coralie Boudin
- Laboratoire de Médecine Légale, Univ Grenoble Alpes, Grenoble, France
| | - Virginie Scolan
- 36724 Clinique de Médecine Légale, CHU Grenoble Alpes , 27015 Univ Grenoble Alpes , Grenoble, France
- Laboratoire de Médecine Légale, Univ Grenoble Alpes, Grenoble, France
| | - Hélène Eysseric-Guerin
- 36724 Laboratoire de Pharmacologie, Pharmacogénétique et Toxicologie, CHU Grenoble Alpes , 27015 Institut de Biologie et de Pathologie, Univ Grenoble Alpes , Grenoble, France
- Laboratoire de Médecine Légale, Univ Grenoble Alpes, Grenoble, France
| | - Françoise Stanke-Labesque
- 36724 Laboratoire de Pharmacologie, Pharmacogénétique et Toxicologie, CHU Grenoble Alpes , 27015 Institut de Biologie et de Pathologie, Univ Grenoble Alpes , Grenoble, France
- Laboratoire HP2 Inserm U1300, Univ Grenoble Alpes, Grenoble, France
| | - Bruno Revol
- 36724 CEIP-Addictovigilance, CHU Grenoble Alpes , 27015 Univ Grenoble Alpes , Grenoble, France
- Laboratoire HP2 Inserm U1300, Univ Grenoble Alpes, Grenoble, France
| |
Collapse
|
5
|
Chen S, Zhou W, Lai M. Synthetic Cathinones: Epidemiology, Toxicity, Potential for Abuse, and Current Public Health Perspective. Brain Sci 2024; 14:334. [PMID: 38671986 PMCID: PMC11048581 DOI: 10.3390/brainsci14040334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/11/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024] Open
Abstract
Synthetic cathinones, derived from cathinone found in the plant Catha edulis, represent the second largest and most frequently seized group of new psychoactive substances. They are considered as β-keto analogs of amphetamine, sharing pharmacological effects with amphetamine and cocaine. This review describes the neurotoxic properties of synthetic cathinones, encompassing their capacity to induce neuroinflammation, dysregulate neurotransmitter systems, and alter monoamine transporters and receptors. Additionally, it discusses the rewarding and abuse potential of synthetic cathinones drawing from findings obtained through various preclinical animal models, contextualized with other classical psychostimulants. The review also offers an overview of current abuse trends of synthetic cathinones on the illicit drug market, specifying the aspects covered, and underscores the risks they pose to public health. Finally, the review discusses public health initiatives and efforts to reduce the hazards of synthetic cathinones, including harm reduction methods, education, and current clinical management strategies.
Collapse
Affiliation(s)
- Shanshan Chen
- Zhejiang Provincial Key Laboratory of Addiction Research, The Affiliated Kangning Hospital of Ningbo University, Ningbo 315201, China; (S.C.); (W.Z.)
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo 315201, China
| | - Wenhua Zhou
- Zhejiang Provincial Key Laboratory of Addiction Research, The Affiliated Kangning Hospital of Ningbo University, Ningbo 315201, China; (S.C.); (W.Z.)
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo 315201, China
| | - Miaojun Lai
- Zhejiang Provincial Key Laboratory of Addiction Research, The Affiliated Kangning Hospital of Ningbo University, Ningbo 315201, China; (S.C.); (W.Z.)
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo 315201, China
| |
Collapse
|
6
|
Won NY, Jabot B, Wang A, Palamar JJ, Cottler LB. Willingness to provide a hair sample for drug testing: results from an anonymous multi-city intercept survey. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:261-268. [PMID: 38547406 PMCID: PMC11052666 DOI: 10.1080/00952990.2024.2309654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/21/2024] [Indexed: 04/28/2024]
Abstract
Background: Hair provision for drug testing can provide secondary measurement to complement self-reported drug use data, thereby providing a more accurate representation of an individual's drug use. Understanding factors associated with hair provision offers valuable insights into recruitment methods.Objective: To identify demographic and drug-related correlates of providing hair samples in a multi-site venue-intercept study.Methods: We utilized venue-intercept sampling for our Rapid Street Reporting study across 12 US cities between January and November 2022. Participants reported past 12-month drug use and were asked if they would provide a hair sample. We conducted multivariable (generalized linear model with logit link) analyses on demographics and drug use characteristics correlated to hair provision for drug testing.Results: Among 3,045 participants, 55.8% were male, 13.6% provided hair samples. Compared to males, those identifying as "other gender" had higher odds of hair collection (adjusted odds ratio = 2.24, 95% confidence interval: 1.28-3.80). Participants identifying as Black (aOR = 0.32, CI: 0.23-0.45) or "other race" (aOR = 0.50, 95% CI: 0.29-0.80) had lower odds of providing hair than those identifying as White. All levels of reported drug use - one drug (aOR=1.50, 95% CI: 1.15-1.96), two-three drugs (aOR=1.51, 95% CI: 1.11-2.05), four or more (aOR = 2.13, 95% CI: 1.50-3.01) - had higher odds of providing hair samples than those reporting no drug use. Similar associations applied to reporting cannabis use with or without another drug (aOR = 1.52-1.81, 95% CI: 1.15-2.38).Conclusion: Differential hair provision based on participant sex, race/ethnicity, and drug use may introduce biases in drug testing, limiting generalizability to individuals from minority backgrounds.
Collapse
Affiliation(s)
- Nae Y. Won
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Brittney Jabot
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Anna Wang
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Joseph J. Palamar
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Linda B. Cottler
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| |
Collapse
|
7
|
Palamar JJ, Massano M, Salomone A. Five cases of unintentional exposure to BZO-4en-POXIZID among nightclub attendees in New York City. J Anal Toxicol 2024; 48:75-80. [PMID: 37952092 PMCID: PMC10981447 DOI: 10.1093/jat/bkad086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 10/29/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023] Open
Abstract
A new class of synthetic cannabinoids called OXIZIDs has emerged in recent years. This class consists of compounds with oxindole cores and hydrazide/hydrazone linker moieties and has often been described as being designed to circumvent a Chinese class-wide ban that was effective as of 1 July 2021. However, through hair testing of nightclub attendees in New York City-a high-risk population for recreational drug use-we have evidence suggesting exposures to an OXIZID called BZO-4en-POXIZID (4en-pentyl MDA-19) prior to the effective ban. Through analysis of 6 cm segmented hair samples from attendees collected in 2021, we detected five cases of exposure. Specifically, we detected a cluster of three cases based on hair samples collected on 20 June 2021, and then two additional cases from samples collected on 16 July 2021. Four of these hair samples were long enough to analyze two 6 cm hair segments (representing approximately two 6-month timeframes) and three of four of these cases tested positive for repeated exposure (for an estimated exposure over 6 months prior to hair collection). All cases included young adult females reporting past-year cannabis use but all tested negative for tetrahydrocannabinol exposure. Three cases also reported past-year use of cocaine, ecstasy, and/or ketamine, and four cases tested positive for exposure to cocaine, 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), methamphetamine and/or eutylone. These subjects were exposed to BZO-4en-POXIZID-likely as an adulterant in other drugs, and these cases are among the first documented cases which occurred approximately half a year before the Chinese legislative ban.
Collapse
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, Room 1752, New York, NY 10016, USA
| | - Marta Massano
- Department of Chemistry, University of Turin, via Giuria 5, Turin 10125, Italy
| | - Alberto Salomone
- Department of Chemistry, University of Turin, via Giuria 5, Turin 10125, Italy
- Centro Regionale Antidoping, Regione Gonzole 10, Orbassano (TO) 10043, Italy
| |
Collapse
|
8
|
Palamar JJ, Salomone A, Massano M, Cleland CM. Trends in reported and biologically confirmed drug use among people who use ecstasy in the nightclub/festival-attending population, 2016-2022. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 9:100198. [PMID: 38023341 PMCID: PMC10665664 DOI: 10.1016/j.dadr.2023.100198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023]
Abstract
Background Nightclub/festival attendees are a population with high rates of party drug use, but research is needed to determine whether there have been shifts in unintended drug exposure in this population (e.g., via adulterants) to inform prevention and harm reduction efforts. Methods Adults entering nightclubs and festivals in New York City were asked about past-year drug use in 2016 through 2022, with a subset providing a hair sample for testing. We focused on the 1943 who reported ecstasy use (of which 247 had a hair sample analyzed) and compared trends in self-reported drug use, drug positivity, and adjusted prevalence (adjusting for unreported use). Results MDMA positivity decreased from 74.4 % to 42.3 %, and decreases occurred regarding detection of synthetic cathinones ("bath salts"; a 100.0 % decrease), MDA (a 76.9 % decrease), amphetamine (an 81.3 % decrease), methamphetamine (a 64.2 % decrease), and ketamine (a 33.4 % decrease) (ps < .05). Although prevalence of MDA and synthetic cathinone use was comparable between self-report and adjusted report in 2022, gaps in prevalence were wider in 2016 (ps < .01). Adjusted prevalence of synthetic cathinone use decreased more across time than prevalence based on self-report (a 79.4 % vs. 69.1 % decrease) and adjusted report for MDA use decreased more than prevalence based on self-report (a 50.6 % vs. 38.9 % decrease). Conclusions Combining self-report and toxicology tests helped us determine that decreases in drug use/exposure were steeper regarding adjusted prevalence. Underreported drug exposure-possibly due to exposure to adulterants-appears to have had less of an effect on prevalence in 2022 than it did in 2016.
Collapse
Affiliation(s)
- Joseph J. Palamar
- NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA
| | - Alberto Salomone
- Department of Chemistry, University of Turin, Turin, Italy
- Centro Regionale Antidoping, Orbassano (TO), Italy
| | - Marta Massano
- Department of Chemistry, University of Turin, Turin, Italy
| | - Charles M. Cleland
- NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA
| |
Collapse
|
9
|
Palamar JJ, Cleland CM, Vincenti M, Salomone A. A multivariable analysis delineating hair color, hair dyeing, and hat wearing as predictors of level of cocaine and MDMA detection in human hair samples. Drug Test Anal 2023:10.1002/dta.3607. [PMID: 37986705 PMCID: PMC11102931 DOI: 10.1002/dta.3607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/28/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
Research suggests that hair color, hair dyeing, and perspiration can bias hair test results regarding drug exposure, but research is needed to examine such associations in a multivariable manner. In this epidemiology study, adults were surveyed entering nightclubs and dance festivals in New York City, and 328 provided hair samples, which were analyzed using ultra-high-performance liquid chromatography-tandem mass spectrometry to determine the level of detection of cocaine and 3,4-methylenedioxymethamphetamine (MDMA). Reporting use was not an inclusion criterion for analysis. We used two-part multivariable models to delineate associations of hair color, past-year hair dyeing, and frequency of past-month hat wearing (which may increase perspiration) in relation to any vs. no detection of cocaine and MDMA as well as level of detection, controlling for hair length, self-reported past-year cocaine/ecstasy/MDMA use, and age, sex, and race/ethnicity. Those reporting having dyed their hair were at increased odds of having any level of cocaine detected (adjusted odds ratio [aOR] = 3.75, 95% CI confidence interval [CI]: 1.85-6.70), and compared to those with brown hair, those with blond(e) hair on average had lower levels of cocaine (ng/mg) detected (beta = -7.97, p = 0.025). Those reporting having dyed their hair were at increased odds of having any level of MDMA detected (aOR = 3.05, 95% CI: 1.44-6.48), and compared to those who reported never wearing a hat, those who reported wearing a hat daily or almost daily on average had lower levels of MDMA (ng/mg) detected (beta = -6.61, p = 0.025). This study demonstrates the importance of using multivariable models to delineate predictors of drug detection.
Collapse
Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA
| | - Charles M. Cleland
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA
| | - Marco Vincenti
- Department of Chemistry, University of Turin, Turin, Italy
- Centro Regionale Antidoping, Orbassano, Italy
| | - Alberto Salomone
- Department of Chemistry, University of Turin, Turin, Italy
- Centro Regionale Antidoping, Orbassano, Italy
| |
Collapse
|
10
|
Calvetti C, Salomone A, Verzeletti A, Di Nardo F, Begni PMG, Vezzoli S. Are the NPS commonly used? An extensive investigation in Northern Italy based on hair analysis. J Anal Toxicol 2023; 47:574-579. [PMID: 37506041 DOI: 10.1093/jat/bkad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/07/2023] [Accepted: 07/26/2023] [Indexed: 07/30/2023] Open
Abstract
New psychoactive substances (NPS) are present on the Italian illicit markets, but data from the analysis of biological samples to evaluate their real consumption are rare. For this reason, an epidemiological study was carried out by means of a ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS-MS) method for the determination of 115 NPS on the keratin matrix. A total of 847 hair samples were collected in 2020 and 2021 and analyzed. The sample donors were in the age range of 18-40 years, from both genders, and were tested either for driving relicensing or for drug withdrawal monitoring. The UPLC-MS-MS system consisted of a Waters ACQUITY UPLC® I-Class, coupled with a Waters XEVO TQ-XS triple quadrupole mass spectrometer. The method was developed and fully validated according to international guidelines. Limits of detection were set as the minimum criterion to identify positive samples. Overall, 56 samples resulted positive for ketamine, 35 for norketamine, 6 for fentanyl, 3 for norfentanyl, 3 for 4-ANPP, 3 for MDMB-4en-PINACA, 2 for N,N-DMT, 2 for 5-chloro AB-PINACA, 1 for α-PHP and 1 for methcathinone. NPS were detected in a small part of samples (8.4%), which seems in contrast with their apparent wide diffusion in Italy, yet it is congruent with similar investigations based on hair analysis. Future studies will be performed to expand the investigated population, especially in terms of age and origin.
Collapse
Affiliation(s)
- Cristina Calvetti
- Institute of Legal Medicine, University of Brescia, Piazzale Spedali Civili, 1, Brescia 25123, Italy
| | - Alberto Salomone
- Department of Chemistry, University of Turin, via P. Giuria 5, Torino 10125, Italy
| | - Andrea Verzeletti
- Institute of Legal Medicine, University of Brescia, Piazzale Spedali Civili, 1, Brescia 25123, Italy
| | - Fabio Di Nardo
- Department of Chemistry, University of Turin, via P. Giuria 5, Torino 10125, Italy
| | - Paola Maria Giulia Begni
- Institute of Legal Medicine, University of Brescia, Piazzale Spedali Civili, 1, Brescia 25123, Italy
| | - Sara Vezzoli
- Institute of Legal Medicine, University of Brescia, Piazzale Spedali Civili, 1, Brescia 25123, Italy
| |
Collapse
|
11
|
Palamar JJ. Tusi: a new ketamine concoction complicating the drug landscape. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:546-550. [PMID: 37162319 PMCID: PMC10636235 DOI: 10.1080/00952990.2023.2207716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
A drug concoction called tusi has emerged in Latin America and in Europe and is now beginning to acquire popularity in the United States. "Tusi" is a phonetic translation of "2C," a series of psychedelic phenethylamines. The concoction is also sometimes referred to as "pink cocaine" as it typically comes in the form of pink powder. However, despite its name, the concoction rarely contains 2C series drugs. Multiple drug checking studies have found that the majority of tusi samples contain ketamine, often combined with 3,4-methylenedioxymethamphetamine (MDMA), methamphetamine, cocaine, opioids, and/or new psychoactive substances. The tusi phenomenon complicates the drug landscape because it has the potential to confuse both people who use it and researchers alike. People using may think the drug is 2C/2C-B, and they may also be unaware that the concoction tends to consist of ketamine and a wide variety of other drugs. Unintentional exposure to its contents can lead to increased risk of adverse effects. The tusi phenomenon also has the potential to complicate drug research as unknown exposure to drugs like ketamine and MDMA will lead to underreporting of use. A combination of self-report and toxicological testing may be needed to inform the most accurate estimates of use. Both researchers and people at risk for use need to be informed about this new concoction. Drug researchers need to be cognizant about the way they query use, and people at risk for using need to be educated about the possible contents of tusi and associated dangers.
Collapse
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| |
Collapse
|
12
|
Hill RD, Shetty RA, Sumien N, Forster MJ, Gatch MB. Locomotor and discriminative stimulus effects of three benzofuran compounds in comparison to abused psychostimulants. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 8:100182. [PMID: 37600151 PMCID: PMC10432784 DOI: 10.1016/j.dadr.2023.100182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 07/15/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023]
Abstract
Aims Benzofurans are used recreationally, due their ability to cause psychostimulant and/or entactogenic effects, but unfortunately produce substantial adverse effects, including death. Three benzofurans 5-(2-aminopropyl)-2,3-dihydrobenzofuran (5-APDB), 5-(2-aminopropyl)-2,3-dihydrobenzofuran (5-MAPB) and 6-(2-aminopropyl) benzofuran (6-APB) were tested to determine their behavioral effects in comparison with 2,3-methylenedioxymethamphetamine (MDMA), cocaine, and methamphetamine. Methods Locomotor activity was tested in groups of 8 male Swiss-Webster mice in an open-field task to screen for locomotor stimulant or depressant effects and to identify behaviorally active doses and times of peak effect. Discriminative stimulus effects were tested in groups of 6 male Sprague-Dawley rats trained to discriminate MDMA (1.5 mg/kg), cocaine (10 mg/kg), or methamphetamine (1 mg/kg) from saline using a FR 10 for food in a two-lever operant task. Results In the locomotor activity test, MDMA (ED50 = 8.34 mg/kg) produced peak stimulant effects 60 to 80 min following injection. 5-MAPB (ED50 = 0.92 mg/kg) produced modest stimulant effects 50 to 80 min after injection, whereas 6-APB (ED50 = 1.96 mg/kg) produced a robust stimulant effect 20 to 50 min after injection. 5-APDB produced an early depressant phase (ED50 = 3.38 mg/kg) followed by a modest stimulant phase (ED50 = 2.57 mg/kg) 20 to 50 min after injection. In the drug discrimination tests, 5-APDB (ED50 = 1.02 mg/kg), 5-MAPB (ED50 = 1.00 mg/kg) and 6-APB (ED50 = 0.32 mg/kg) fully substituted in MDMA-trained rats, whereas only 5-MAPB fully substituted for cocaine, and no compounds fully substituted for methamphetamine. Conclusions The synthetic benzofuran compound 5-APDB and 5-MAPB produced weak locomotor effects, whereas 6-APB produced robust locomotor stimulant effects. All compounds were more potent than MDMA. All three compounds fully substituted in MDMA-trained rats suggesting similar subjective effects. Taken together, these results suggest that these benzofuran compounds may have abuse liability as substitutes for MDMA.
Collapse
Affiliation(s)
- Rebecca D. Hill
- University of North Texas Health Science Center, Department of Pharmacology and Neuroscience, 3500 Camp Bowie Blvd, Fort Worth, TX 76109, United States
| | - Ritu A. Shetty
- University of North Texas Health Science Center, Department of Pharmacology and Neuroscience, 3500 Camp Bowie Blvd, Fort Worth, TX 76109, United States
| | - Nathalie Sumien
- University of North Texas Health Science Center, Department of Pharmacology and Neuroscience, 3500 Camp Bowie Blvd, Fort Worth, TX 76109, United States
| | - Michael J. Forster
- University of North Texas Health Science Center, Department of Pharmacology and Neuroscience, 3500 Camp Bowie Blvd, Fort Worth, TX 76109, United States
| | - Michael B. Gatch
- University of North Texas Health Science Center, Department of Pharmacology and Neuroscience, 3500 Camp Bowie Blvd, Fort Worth, TX 76109, United States
| |
Collapse
|
13
|
Palamar JJ, Salomone A. Trends and correlates of discordant reporting of drug use among nightclub/festival attendees, 2019-2022. Clin Toxicol (Phila) 2023; 61:665-673. [PMID: 37988115 PMCID: PMC10664866 DOI: 10.1080/15563650.2023.2273770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/17/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION People who attend nightclubs and festivals are known for high prevalence of party drug use, but more research is needed on underreporting in this population, in part because unintentional drug exposure through adulterated drug products is common. We examined the prevalence of drug use in this population, based both on self-reporting and on hair test results, with a focus on the detection of underreported use. METHODS Adults entering nightclubs and festivals in New York City were asked about past-year drug use in 2019-2022 (n = 1,953), with 328 providing an analyzable hair sample for testing. We compared trends in self-reported drug use, drug positivity, and "corrected" prevalence, adjusting for unreported use, and delineated correlates of testing positive for ketamine and cocaine after not reporting use (discordant reporting). RESULTS Of the 328 who provided a sample, cocaine and ketamine were the most frequently detected drugs (55.2% [n = 181] and 37.2% [n = 122], respectively), but these were also the two most underreported drugs, with 37.1% (n = 65) and 26.4% (n = 65), respectively, testing positive after not reporting use. Between 2019 and 2022, positivity decreased for cocaine, ketamine, 3,4-methylenedioxy-metamfetamine, and amfetamine, and underreported exposure to cocaine and ketamine also decreased (P < 0.05). Underreporting of the use of these drugs was common, but we also detected underreported exposure to ethylone, fentanyl, 3,4-methylenedioxyamfetamine, metamfetamine, and synthetic cannabinoids. Prevalence of discordant reporting of cocaine use was higher among those testing positive for ketamine exposure (adjusted prevalence ratio = 2.63; 95% CI: 1.48-4.69) and prevalence of discordant reporting of ketamine use was lower post-coronavirus disease caused by the SARS-CoV-2 virus (adjusted prevalence ratio = 0.39; 95% CI: 0.16-0.91) and among those reporting cocaine use (adjusted prevalence ratio = 0.53; 95% CI: 0.32-0.89). DISCUSSION Underreporting of drug use was common, suggesting the need for researchers to better deduce intentional underreporting versus unknown drug exposure via adulterants. CONCLUSIONS Researchers should consider both self-report and toxicology results from biological samples when examining trends in use.
Collapse
Affiliation(s)
- Joseph J. Palamar
- New York University Grossman School of Medicine, Department of Population Health, New York, NY, USA
| | - Alberto Salomone
- Department of Chemistry, University of Turin, Turin, Italy
- Centro Regionale Antidoping, Orbassano (TO), Italy
| |
Collapse
|
14
|
Zhai W, Qiao Z, Xiang P, Dang Y, Shi Y. A UPLC-MS/MS methodological approach for the analysis of 75 phenethylamines and their derivatives in hair. J Pharm Biomed Anal 2023; 229:115367. [PMID: 37018959 DOI: 10.1016/j.jpba.2023.115367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/10/2023] [Accepted: 03/24/2023] [Indexed: 03/28/2023]
Abstract
A rapid ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed and validated for the targeted analysis of 75 phenethylamines and their derivatives from the hair matrix. The monitored classes of phenethylamines included the 2C series, D series, N-benzyl derivatives, mescaline-derived compounds, MDMA analogs, and benzodifurans. Approximately 20 mg of hair was weighed and pulverized with 0.1% formic acid in methanol by cryogenic grinding. After ultrasonication, centrifugation, and filtration, the supernatant was analyzed by LC-MS/MS operating in the scheduled multiple reaction monitoring mode. Phenethylamines and their derivatives were separated in 13 min on a biphenyl column (2.6 µm, 100 Å, 100 × 3.0 mm) using a gradient eluting mobile phase composed of 0.1% formic acid in water and acetonitrile. The developed and validated method showed good selectivity, sensitivity (LOD: 0.5-10 pg/mg and LOQ: 1-20 pg/mg), linearity (R2 > 0.997), accuracy and precision (< 20%), and stability. The method also showed good recovery and acceptable matrix effects for most of the targeted compounds. This analytical approach was successfully applied for the identification and quantification of phenethylamines in hair from authentic forensic cases.
Collapse
Affiliation(s)
- Wenya Zhai
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China; College of Medicine and Forensics, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Zheng Qiao
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China
| | - Ping Xiang
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China
| | - Yonghui Dang
- College of Medicine and Forensics, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yan Shi
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China.
| |
Collapse
|
15
|
Comparison of Psychiatric and Clinical Profiles Between People Who Use Synthetic Cathinones and Methamphetamine: A Matched Case-Control Study. J Clin Psychopharmacol 2023; 43:122-130. [PMID: 36706307 PMCID: PMC9988231 DOI: 10.1097/jcp.0000000000001649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Synthetic cathinones are the most used novel psychoactive substances in Taiwan because they exhibit psychoactive effects similar to those of methamphetamine, inducing acute psychosis, violence, and self-harm. However, the differences in the clinical characteristics of patients with synthetic cathinone and methamphetamine intoxication admitted to psychiatric emergency departments (EDs) remain unclear. METHODS This study recruited patients with stimulant intoxication who were admitted to a psychiatric ED from April 2019 to May 2020. Sociodemographic, lifestyle, and psychopathological data were collected through face-to-face interviews and evaluated. Immunoassay tests and liquid chromatography-quadrupole time-of-flight mass spectrometry were performed to detect substances in urine specimens. The patients were matched by sex and age (in 5-year intervals). The associations between the 2 groups and physical complications were analyzed through logistic regression. RESULTS Twenty-four patients with synthetic cathinone intoxication were identified and matched with 48 patients with methamphetamine intoxication. The 2 groups exhibited similar clinical severity of psychotic symptoms and high risks of violence and self-harm. Both groups were predominated by unmarried patients, unemployed patients, and habitual smokers and drinkers. However, family histories of substance use and criminal records were less prevalent among the patients with synthetic cathinone intoxication, but they had a higher rate of physical complications (odds ratio, 8.55; 95% confidence interval, 2.15-34.03), compared with patients with methamphetamine intoxication. CONCLUSIONS Compared with patients intoxicated with methamphetamine, those intoxicated with synthetic cathinones may have similar tendencies toward psychosis, violence, and self-harm but higher risks of physical complications, which are prioritized in psychiatric EDs.
Collapse
|
16
|
Palamar JJ, Salomone A. On the challenges of hair testing to detect underreported substance use in research settings. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:1-4. [PMID: 36812241 PMCID: PMC10026183 DOI: 10.1080/00952990.2023.2166414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 02/24/2023]
Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University
Grossman School of Medicine, New York, NY, USA
| | - Alberto Salomone
- Department of Chemistry, University of Turin, Turin,
Italy
- Centro Regionale Antidoping, Orbassano (TO), Italy
| |
Collapse
|
17
|
Poyatos L, Pérez-Mañá C, Hladun O, Núñez-Montero M, de la Rosa G, Martín S, Barriocanal AM, Carabias L, Kelmendi B, Taoussi O, Busardò FP, Fonseca F, Torrens M, Pichini S, Farré M, Papaseit E. Pharmacological effects of methylone and MDMA in humans. Front Pharmacol 2023; 14:1122861. [PMID: 36873994 PMCID: PMC9981643 DOI: 10.3389/fphar.2023.1122861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
Methylone is one of the most common synthetic cathinones popularized as a substitute for 3,4-methylenedioxymethamphetamine (MDMA, midomafetamine) owing to its similar effects among users. Both psychostimulants exhibit similar chemistry (i.e., methylone is a β-keto analog of MDMA) and mechanisms of action. Currently, the pharmacology of methylone remains scarcely explored in humans. Herein, we aimed to evaluate the acute pharmacological effects of methylone and its abuse potential in humans when compared with that of MDMA following oral administration under controlled conditions. Seventeen participants of both sexes (14 males, 3 females) with a previous history of psychostimulant use completed a randomized, double-blind, placebo-controlled, crossover clinical trial. Participants received a single oral dose of 200 mg of methylone, 100 mg of MDMA, and a placebo. The variables included physiological effects (blood pressure, heart rate, oral temperature, pupil diameter), subjective effects using visual analog scales (VAS), the short form of the Addiction Research Center Inventory (ARCI), the Evaluation of Subjective Effects of Substances with Abuse Potential questionnaire (VESSPA-SSE), and the Sensitivity to Drug Reinforcement Questionnaire (SDRQ), and psychomotor performance (Maddox wing, psychomotor vigilance task). We observed that methylone could significantly increase blood pressure and heart rate and induce pleasurable effects, such as stimulation, euphoria, wellbeing, enhanced empathy, and altered perception. Methylone exhibited an effect profile similar to MDMA, with a faster overall onset and earlier disappearance of subjective effects. These results suggest that abuse potential of methylone is comparable to that of MDMA in humans. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT05488171; Identifier: NCT05488171.
Collapse
Affiliation(s)
- Lourdes Poyatos
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Clara Pérez-Mañá
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
- *Correspondence: Clara Pérez-Mañá, ; Magí Farré,
| | - Olga Hladun
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Melani Núñez-Montero
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Georgina de la Rosa
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Soraya Martín
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
| | - Ana Maria Barriocanal
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
| | - Lydia Carabias
- Department of Pharmacy, Hospital Universitari Germans Trias i Pujol (HUGTiP), Badalona, Spain
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Omayema Taoussi
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Francina Fonseca
- Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
- Addiction Program, Institut de Neuropsiquiatria i Adiccions (INAD), Barcelona, Spain
| | - Marta Torrens
- Addiction Program, Institut de Neuropsiquiatria i Adiccions (INAD), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Magí Farré
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
- *Correspondence: Clara Pérez-Mañá, ; Magí Farré,
| | - Esther Papaseit
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| |
Collapse
|
18
|
Palamar JJ, Le A, Rutherford C, Keyes KM. Exploring Potential Bellwethers for Drug-Related Mortality in the General Population: A Case for Sentinel Surveillance of Trends in Drug Use among Nightclub/Festival Attendees. Subst Use Misuse 2022; 58:188-197. [PMID: 36469638 PMCID: PMC9877192 DOI: 10.1080/10826084.2022.2151315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Background: Drug-related deaths in the US continue to increase. Sentinel surveillance of high-risk populations can provide early warning for shifts in trends. Nightclub/festival attendees have high levels of drug use, so we explored whether use among this population can serve as a potential bellwether or indicator for use-related mortality in the general population.Methods: Trends in past-year cocaine and methamphetamine use were estimated from nightclub/festival attendees in New York City (NYC) and among NY residents, and trends were estimated for related death rates in NYC (2014/15-2019/20). Using national data from England and Wales (2010-2019), trends in past-year cocaine and ecstasy use (among the full population and among nightclub attendees) and related deaths were also estimated.Results: In NY/NYC, cocaine use remained stable in the general population, but use among nightclub/festival attendees and cocaine-related deaths doubled. Methamphetamine use among nightclub/festival attendees and death rates also more than doubled while use among the general population remained stable. In UK countries, increases in cocaine and ecstasy use were larger for infrequent/frequent nightclub attendees than in the general population, with 3.6- and 8-fold increases in related deaths, respectively. In UK countries, the association between nightclub attendance and death rates increased in a dose-response-like manner with larger associations detected when death rates were lagged by one year.Conclusions: Patterns of use among nightclub/festival attendees, more so than patterns in the general population, were similar to patterns of drug-related deaths. Use among this subpopulation could possibly serve as a bellwether for use-related outcomes. Continued surveillance is recommended.
Collapse
Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Austin Le
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
- New York University College of Dentistry, New York, NY, USA
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|
19
|
Feltmann K, Elgán TH, Böttcher M, Lierheimer S, Hermansson S, Beck O, Gripenberg J. Feasibility of using breath sampling of non-volatiles to estimate the prevalence of illicit drug use among nightlife attendees. Sci Rep 2022; 12:20283. [PMID: 36434044 PMCID: PMC9700783 DOI: 10.1038/s41598-022-24741-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022] Open
Abstract
The prevalence of drug use among nightlife attendees needs to be accurately estimated to, for example, evaluate preventive interventions. This study tested the feasibility of using a breath-sampling device to estimate the prevalence of drug use among nightlife attendees. The study was conducted at five nightclubs and a large music festival in Stockholm, Sweden. Participants were invited to participate and microparticles in exhaled breath were sampled and analyzed for 47 compounds using a state-of-the-art analytic method that follows forensic standards. In addition, participants' breath alcohol concentration was measured and they were interviewed about demographics, drinking habits, and drug use. Of the people invited, 73.7% (n = 1223) agreed to participate, and breath samples were collected from 1204 participants. Breath sampling was fast and well-accepted by participants. 13 percent of participants tested positive for an illicit drug, but only 4.3% self-reported drug use during the last 48 h. The most common substances detected were cocaine, amphetamine, and MDMA. There was no agreement between self-reported and measured use of any drug. Breath sampling is a convenient method to test illicit drug use among a large number of participants at events, and can be used as an estimate of drug use prevalence.
Collapse
Affiliation(s)
- Kristin Feltmann
- STAD, Stockholm Prevents Alcohol and Drug Problems, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, plan 7, 11364 Stockholm, Sweden
| | - Tobias H. Elgán
- STAD, Stockholm Prevents Alcohol and Drug Problems, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, plan 7, 11364 Stockholm, Sweden
| | - Michael Böttcher
- MVZ Medizinische Labore Dessau Kassel GmbH, Dessau-Roßlau, Germany
| | | | | | - Olof Beck
- grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, plan 7, 11364 Stockholm, Sweden
| | - Johanna Gripenberg
- STAD, Stockholm Prevents Alcohol and Drug Problems, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, plan 7, 11364 Stockholm, Sweden
| |
Collapse
|
20
|
Michienzi AE, Borek HA. Emerging Agents of Substance Use/Misuse. Emerg Med Clin North Am 2022; 40:265-281. [DOI: 10.1016/j.emc.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
21
|
Levy NS, Palamar JJ, Mooney SJ, Cleland CM, Keyes KM. What is the prevalence of drug use in the general population? Simulating underreported and unknown use for more accurate national estimates. Ann Epidemiol 2022; 68:45-53. [DOI: 10.1016/j.annepidem.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 11/01/2022]
|
22
|
Palamar JJ. Kratom Use Is Underestimated, but Prevalence Still Appears to Be Low. Am J Prev Med 2022; 62:133-134. [PMID: 34922652 PMCID: PMC8697708 DOI: 10.1016/j.amepre.2021.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 07/29/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, New York
| |
Collapse
|
23
|
Niebel A, Pragst F, Krumbiegel F, Hartwig S. Prevalence of cathinones and other new psychoactive substances in hair of parents and children of families with known or suspected parental abuse of conventional illegal drugs. Forensic Sci Int 2021; 331:111148. [PMID: 34923263 DOI: 10.1016/j.forsciint.2021.111148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Hair analysis of parents and their children was regularly used since 2011 as a diagnostic tool in a social support project for families with known or suspected abuse of conventional illegal drugs and revealed a high incidence of cocaine, cannabinoids, amphetamines, ecstasy and heroin. In this context, the prevalence of new psychoactive substances (NPS) in these families should be important for a realistic estimate of the situation. METHODS The extracts of 1537 hair samples from 318 children (age 1-14 years), 44 adolescents and 611 adults, which were collected and tested for conventional drugs between June 2016 and April 2021 and frozen at -20 °C, were reanalyzed by a validated LC-MS/MS method (limits of quantitation 5-24 pg/mg) for 33 cathinones, 10 phenylethylamines, 5 piperazines including the antidepressant trazodone, 2 tryptamines, 9 designer benzodiazepines, 4 synthetic opioids and 4 ketamine-like substances including phencyclidine. RESULTS Between one and up to five from 42 of these substances were detected in 227 samples (14.8%). The most frequently detected substances were benzedrone (62x), α-pyrrolidinovalerophenone (41x), N-ethylamphetamine (29x), dimethyltryptamine (13x) and pyrovalerone (11x). The quantification was possible only for 34 results of 15 drugs and the remaining majority of the results were unambiguously identified below LLOQ. The relative frequency of conventional drugs in the 227 NPS positive samples was higher than in all 1310 NPS negative samples for cocaine (69.6% vs. 56.0%), heroin (6-acetylmorphine 8.8% vs. 4.9%), amphetamine (16.3% vs. 7.7%) and MDMA (16.3% vs. 7.0%) but was similar for THC (38.3% vs. 36.3%) and benzodiazepines (1.8% vs. 1.7%). The high prevalence of N-ethylamphetamine can be explained as a byproduct of the illicit amphetamine synthesis from benzaldehyde and nitroethane rather than as a separate drug or as a combined metabolite of amphetamine and ethanol. The isolated appearance of 3-trifluoromethylphenylpiperazine in 9 hair samples collected in January 2017 can be caused either by its use as an NPS or by its formation as a metabolite of the medical drug flibanserin. The results were compared within 17 families whose members were tested at the same time and showed positive NPS results. The detected drugs agreed between both parents only in about half of the cases whereas the drugs found in children's hair was always detected also in hair of one or both parents. CONCLUSION The re-testing of hair extracts for NPS after long-time storage in frozen state enables an impression about the relative high prevalence in the tested population group, despite the limitation by partial degradation of the substances and the corresponding impossibility in quantitative assessments. In addition to conventional drugs, the hair test for these substances should be useful in unclear cases of child's welfare endangerment and in family law.
Collapse
Affiliation(s)
- André Niebel
- Charité - Universitätsmedizin Berlin, Institute of Forensic Medicine, Turmstraße 21 (Haus N), 10559 Berlin, Germany; Freie Universität Berlin, Institute of Pharmacy, Pharmaceutical Chemistry, Königin-Luise-Straße 2+4, 14195 Berlin, Germany
| | - Fritz Pragst
- Charité - Universitätsmedizin Berlin, Institute of Forensic Medicine, Turmstraße 21 (Haus N), 10559 Berlin, Germany.
| | - Franziska Krumbiegel
- Charité - Universitätsmedizin Berlin, Institute of Forensic Medicine, Turmstraße 21 (Haus N), 10559 Berlin, Germany
| | - Sven Hartwig
- Charité - Universitätsmedizin Berlin, Institute of Forensic Medicine, Turmstraße 21 (Haus N), 10559 Berlin, Germany
| |
Collapse
|
24
|
New Synthetic Cathinones and Phenylethylamine Derivatives Analysis in Hair: A Review. Molecules 2021; 26:molecules26206143. [PMID: 34684725 PMCID: PMC8538434 DOI: 10.3390/molecules26206143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022] Open
Abstract
The analysis of psychoactive substances in hair is of great importance for both clinical and forensic toxicologists since it allows one to evaluate past and continuative exposure to xenobiotics. In particular, a new challenge is represented by new psychoactive substances: Among this new class of drugs of abuse, synthetic cathinone and phenethylamine derivatives are often detected in biological samples. Hence, there is a growing need to develop new analytical procedures or improve old ones in order to conduct evaluations of these emerging substances. This study is a systematic review of all the instrumental and experimental data available in the literature. A total of 32 articles were included in the review. Acidic solvents proved to be the most reliable solutions for extraction. Gas chromatography and liquid chromatography coupled to tandem mass spectrometric and high-resolution mass spectrometric systems represent the majority of the involved instrumental techniques. Sensitivity must be maintained at the pg/mg level to detect any occurrences up to occasional consumption. In total, 23 out of 32 articles reported real positive samples. The most frequently detected substance in hair was mephedrone, followed by butylone, methylone, MDPV, and α-pyrrolidinophenone-type substances.
Collapse
|
25
|
Application of a Low Transition Temperature Mixture for the Dispersive Liquid-Liquid Microextraction of Illicit Drugs from Urine Samples. Molecules 2021; 26:molecules26175222. [PMID: 34500656 PMCID: PMC8434511 DOI: 10.3390/molecules26175222] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 11/17/2022] Open
Abstract
The use of psychoactive substances is a serious problem in today’s society and reliable methods of analysis are necessary to confirm their occurrence in biological matrices. In this work, a green sample preparation technique prior to HPLC-MS analysis was successfully applied to the extraction of 14 illicit drugs from urine samples. The isolation procedure was a dispersive liquid–liquid microextraction based on the use of a low transition temperature mixture (LTTM), composed of choline chloride and sesamol in a molar ratio 1:3 as the extracting solvent. This mixture was classified as LTTM after a thorough investigation carried out by FTIR and DSC, which recorded a glass transition temperature at −71 °C. The extraction procedure was optimized and validated according to the main Food and Drug Administration (FDA) guidelines for bioanalytical methods, obtaining good figures of merit for all parameters: the estimated lower limit of quantitation (LLOQ) values were between 0.01 µg L−1 (bk-MMBDB) and 0.37 µg L−1 (PMA); recoveries, evaluated at very low spike levels (in the ng-µg L−1 range), spanned from 55% (MBDB) to 100% (bk-MMBDB and MDPV); finally, both within-run and between-run precisions were lower than 20% (LLOQ) and 15% (10xLLOQ).
Collapse
|
26
|
Palamar JJ, Fitzgerald ND, Cottler LB. Shifting awareness among electronic dance music party attendees that drugs may contain fentanyl or other adulterants. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 97:103353. [PMID: 34242960 DOI: 10.1016/j.drugpo.2021.103353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 06/08/2021] [Accepted: 06/13/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Drugs like ecstasy, cocaine, and counterfeit prescription pills can contain fentanyl. We examined knowledge about potential adulteration/contamination of such drugs among people attending electronic dance music (EDM) parties. METHODS Adults in New York City were surveyed entering randomly selected EDM parties during the summers of 2018 (n=1,029) and 2019 (n=559). Surveys assessed perceptions that: 1) ecstasy/Molly can contain adulterants more dangerous than MDMA, 2) cocaine can contain fentanyl, and 3) prescription pills from non-pharmacy sources can contain fentanyl. We compared prevalence of perceptions between 2018 and 2019. RESULTS Prevalence of agreeing that cocaine can contain fentanyl increased from 42.1% to 58.6%, a 39.2% increase (p=.003). Increases in agreement were not significant regarding ecstasy potentially containing adulterants (55.0% vs. 59.0%) and non-pharmacy prescription drugs potentially containing fentanyl (46.8% vs. 52.9%). Those reporting past-year ecstasy use in particular reported increased agreement that ecstasy can be adulterated (from 52.9% to 80.0%, a 51.2% increase; p<.001) and those reporting past-year cocaine use reported increased agreement that cocaine can be adulterated (from 48.2% to 70.7%, a 46.7% increase; p=.016). CONCLUSIONS Knowledge of potential adulteration or contamination of commonly used drugs in this high-risk scene is increasing. Continued education about possible drug contents is needed.
Collapse
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, Room 1752, New York, NY 10016, United States.
| | - Nicole D Fitzgerald
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Linda B Cottler
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, United States
| |
Collapse
|
27
|
Bade R, White JM, Gerber C. How the recreational stimulant market has changed: Case study in Adelaide, Australia 2016-2019. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 757:143728. [PMID: 33277018 DOI: 10.1016/j.scitotenv.2020.143728] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 06/12/2023]
Abstract
The human consumption of stimulant drugs is known to increase over festive periods. In this work, four illicit stimulants: 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), cocaine and methamphetamine and three new psychoactive substances (NPS): ethylone, mephedrone and N-ethylpentylone were monitored in influent wastewater over the Christmas-New Year period in South Australia from 2016 to 2019 using liquid chromatography-mass spectrometry. The differences in Christmas - New Year consumption between years were evaluated and daily mass loads were compared to the average for that year to determine drug levels over the festive period. Although MDMA, MDA and cocaine showed year-on-year increases, the use over the New Year period was far higher than over the rest of the year, consistent with recreational drug use. These were also the drugs that were used predominantly on weekends during the year. Methamphetamine, which does not have a pattern of predominant weekend use, and the NPS showed variable trends. These results suggest that during holiday periods there are increases in the use of a limited set of drugs only and these can be predicted from patterns of use during the non-holiday periods.
Collapse
Affiliation(s)
- Richard Bade
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5000, South Australia, Australia
| | - Jason M White
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5000, South Australia, Australia
| | - Cobus Gerber
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5000, South Australia, Australia.
| |
Collapse
|
28
|
Methylenedioxymethamphetamine-like discriminative stimulus effects of seven cathinones in rats. Behav Pharmacol 2021; 31:378-384. [PMID: 31895060 DOI: 10.1097/fbp.0000000000000540] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Synthetic cathinone derivatives are commonly considered quasi-legal alternatives for stimulant drugs, such as cocaine and methamphetamine, but some derivatives are increasingly being detected in club drug formulations of Ecstasy or 'Molly' as substitutes for methylenedioxymethamphetamine (±-MDMA). Although several studies have evaluated the psychostimulant-like effects of synthetic cathinones, few cathinone compounds have been assessed for MDMA-like activity. In order to determine their likelihood of interchangeability with entactogenic club drugs, the discriminative stimulus effects of methcathinone, 4-fluoromethcathinone, 4-methylmethcathinone, 4-methylethcathinone, 3-fluoromethcathinone, pentedrone, and ethylone were assessed in Sprague-Dawley rats trained to discriminate 1.5 mg/kg racemic methylenedioxymethamphetamine (±-MDMA) from vehicle. Methamphetamine and the cathinones 4-fluoromethcathinone, 4-methylmethcathinone, 4-methylethcathinone, 3-fluoromethcathinone, pentedrone, and ethylone fully substituted for the discriminative stimulus effects of ±-MDMA. In contrast, methcathinone produced a maximum of only 43% ±-MDMA-appropriate responding and higher doses suppressed responding. Most, but not all of the cathinone compounds tested have discriminative stimulus effects similar to those of MDMA as well as psychostimulant-like effects; however, the potency of MDMA versus psychostimulant substitution varies substantially among the compounds, suggesting that a subset of synthetic cathinones are more MDMA-like than psychostimulant-like. These findings further highlight the highly-variable pharmacology of this class of compounds and suggest that those cathinones with MDMA-like effects may also have increased use as club drugs.
Collapse
|
29
|
Bade R, White JM, Nguyen L, Tscharke BJ, Mueller JF, O'Brien JW, Thomas KV, Gerber C. Determining changes in new psychoactive substance use in Australia by wastewater analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 731:139209. [PMID: 32417485 DOI: 10.1016/j.scitotenv.2020.139209] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/02/2020] [Accepted: 05/02/2020] [Indexed: 06/11/2023]
Abstract
Measuring community consumption of new psychoactive substances (NPS) is notoriously difficult to assess by traditional means such as surveys and seizure data. Previously, we used the approach to demonstrate the prevalence of NPS on a national scale. In the current study we explored the temporal resolution for the analysis of NPS in wastewater from Australia. Samples covering all States and Territories in Australia and both metropolitan and regional areas and were collected bimonthly from October 2017-June 2018 and October 2019-February 2020. A qualitative screening method was applied, screening for 201 NPS. In total, 15 substances were found from a variety of classes of NPS. The most prevalent class was synthetic cathinones, with pentylone, N-ethylpentylone and ethylone found in all periods in at least one site in the earlier sampling period, as well as the amphetamine-like paramethoxyamphetamine (PMA). In the latter period, synthetic cathinones were also the most prevalent, including eutylone, marking the first time that this compound has been detected in wastewater. This study shows the application of wastewater analysis to detect outbreaks of NPS use and temporal differences among sites.
Collapse
Affiliation(s)
- Richard Bade
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5000, South Australia, Australia
| | - Jason M White
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5000, South Australia, Australia
| | - Lynn Nguyen
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5000, South Australia, Australia
| | - Benjamin J Tscharke
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall Street Woolloongabba, 4102, Queensland, Australia
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall Street Woolloongabba, 4102, Queensland, Australia
| | - Jake W O'Brien
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall Street Woolloongabba, 4102, Queensland, Australia
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall Street Woolloongabba, 4102, Queensland, Australia
| | - Cobus Gerber
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5000, South Australia, Australia.
| |
Collapse
|
30
|
Palamar JJ, Salomone A. Shifts in Unintentional Exposure to Drugs Among People Who Use Ecstasy in the Electronic Dance Music Scene, 2016-2019. Am J Addict 2020; 30:49-54. [PMID: 32813326 DOI: 10.1111/ajad.13086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/19/2020] [Accepted: 07/17/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Electronic dance music (EDM) party attendees who use ecstasy (3,4-methylenedioxymethamphetamine [MDMA], Molly) are at high risk for ingesting adulterant drugs, but little is known regarding trends in exposure. We sought to determine whether adulteration has shifted in recent years. METHODS Adults entering EDM events at nightclubs and dance festivals in NYC were surveyed in 2016 and 2019. We tested hair samples from a subsample of those reporting past-year ecstasy use using ultra-high performance liquid chromatography-tandem mass spectrometry. Differences in unreported drug exposure and suspected adulteration were compared between 2016 (n = 90) and 2019 (n = 72). RESULTS MDMA detection was stable at 72-74%. We detected decreases in unreported use of methamphetamine (from 22.2% to 5.6% [P = .003], an 74.8% decrease), new psychoactive substances (from 31.1% to 2.8% [P < .001], a 91.0% decrease), and synthetic cathinones in particular (from 27.8% to 2.8% (P < .001, an 89.9% decrease). Unreported ketamine exposure increased from 18.9% to 34.7% (P = .022, an 83.6% increase). We also detected decreases in participants' suspicion of their ecstasy being adulterated with methamphetamine (from 20.0% to 5.6% [P = .010], an 72.0% decrease) and "bath salts" (synthetic cathinones, from 8.9% to 1.4% [P = .044], an 84.3% decrease). DISCUSSION AND CONCLUSIONS Unknown exposure to adulterants among people who use ecstasy in the EDM scene is shifting. Monitoring of exposure to adulterants is needed to inform harm reduction. SCIENTIFIC SIGNIFICANCE This was among the first studies to examine unintentional exposure to drugs over time in this population and unintentional exposure to synthetic cathinones in particular appears to be declining. (Am J Addict 2021;30:49-54).
Collapse
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, New York
| | - Alberto Salomone
- Dipartimento di Chimica, Università di Torino, Torino, Italy.,Centro Regionale Antidoping e di Tossicologia, Orbassano (TO), Italy
| |
Collapse
|
31
|
Palamar JJ, Salomone A, Keyes KM. Underreporting of drug use among electronic dance music party attendees. Clin Toxicol (Phila) 2020; 59:185-192. [PMID: 32644026 DOI: 10.1080/15563650.2020.1785488] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND OBJECTIVES Electronic dance music (EDM) party attendees are at high risk for drug use. However, little is known regarding the extent of underreporting of drug use in this population, in part, because use of synthetic drugs is often associated with unknown exposure to adulterant drugs. We estimated the extent of underreported drug use in this population by comparing self-reported use to hair toxicology results. METHODS Time-space sampling was used to survey adults entering EDM events at nightclubs and dance festivals in New York City from January through August of 2019. Seven hundred ninety-four adults were surveyed and 141 provided analyzable hair samples. We queried past-year use of >90 drugs and tested hair samples using ultra-high performance liquid chromatography-tandem mass spectrometry. We compared hair test results to past-year self-reported use and adjusted prevalence estimates by defining use as reporting use or testing positive. Correlates of discordant reporting, defined as testing positive after not reporting use, were estimated. RESULTS Prevalence of drug use increased when considering positive hair tests in estimates, with 43.8% of participants testing positive for at least one drug after not reporting use. For example, based on self-report, cocaine use prevalence was 51.1%, and increased by a factor of 1.6 to a prevalence of 80.0% when adding hair test results to self-report. Younger adults (ages 18-25), black and other/mixed race participants, those reporting "other" sexuality, and those with a college degree were at significantly higher risk for testing positive for drugs not reportedly used. Those who self-reported using more types of drugs were less likely to test positive after not reporting use (adjusted prevalence ratio = 0.53, 95% confidence interval = 0.41-0.68). CONCLUSIONS We detected underreporting of drug use, particularly cocaine and ketamine. More research is needed to determine whether this is driven by intentional underreporting or unknown exposure through adulterants.
Collapse
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Alberto Salomone
- Dipartimento di Chimica, Università di Torino, Torino, Italy.,Centro Regionale Antidoping e di Tossicologia, Orbassano, Italy
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|
32
|
Gatch MB, Forster MJ. Methylenedioxymethamphetamine-like discriminative stimulus effects of pyrrolidinyl cathinones in rats. J Psychopharmacol 2020; 34:778-785. [PMID: 32536334 DOI: 10.1177/0269881120914213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Synthetic cathinone derivatives are used as alternatives both for stimulant drugs such as cocaine and methamphetamine and for club drugs such as 3,4-methylenedioxymethamphetamine (MDMA), but little is known about their MDMA-like subjective effects. METHODS In order to determine their similarity to MDMA, the discriminative stimulus effects of 10 pyrrolidinyl cathinones (α-pyrrolidinopropiophenone, 4'-methyl-α-pyrrolidinopropiophenone (4'-MePPP), α-pyrrolidinobutiophenone, 3',4'-methylenedioxy-α-pyrrolidinobutyrophenone (MD-PBP), α-pyrrolidinovalerophenone, 3,4-methylenedioxy-pyrovalerone (MDPV), α-pyrrolidinopentiothiophenone, napthylpyrovalerone (naphyrone), α-pyrrolidinohexiophenone, and 4'-methyl-α-pyrrolidinohexiophenone (4'-MePHP)) were assessed in Sprague-Dawley rats trained to discriminate 1.5 mg/kg racemic ±-MDMA from vehicle. RESULTS Compounds with no substitutions on the phenyl ring and the thiophene produced 44-67% MDMA-appropriate responding. In contrast, the substituted pyrrolidinyl cathinones produced a range of MDMA-appropriate responding dependent upon the length of the alpha side chain. 4'-MePPP, with a single carbon on the alpha position, produced 99.8% MDMA-appropriate responding, MD-PBP (two carbons) produced 83%, naphyrone (three carbons) produced 71%, MDPV (three carbons) produced, 66%, and 4'-MePHP (four carbons) produced 47%. CONCLUSIONS Many cathinone compounds have discriminative stimulus effects similar to those of MDMA. However, the pyrrolidine substitution appears to reduce serotonergic effects, with a commensurate decrease in MDMA-like effects. Substitutions on the phenyl ring appear to be able to restore MDMA-like responding, but only in compounds with short alpha side chains. These findings agree with earlier findings of increasing dopaminergic effects and stronger reinforcing effects with increasing side chain. Assessment of more compounds is necessary to establish the replicability/robustness of this phenomenon. These findings may be of use in predicting which compounds will have MDMA/club drug-like effects versus psychostimulant-like effects.
Collapse
Affiliation(s)
- Michael B Gatch
- Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, USA
| | - Michael J Forster
- Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, USA
| |
Collapse
|
33
|
Palamar JJ, Han BH, Keyes KM. Trends in characteristics of individuals who use methamphetamine in the United States, 2015-2018. Drug Alcohol Depend 2020; 213:108089. [PMID: 32531703 PMCID: PMC7371537 DOI: 10.1016/j.drugalcdep.2020.108089] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prevalence of self-reported methamphetamine use has remained relatively stable over the past decade; however, deaths and seizures involving methamphetamine have been increasing. Research is needed to determine if select subgroups in the US are at increased risk for use. METHODS We examined data from individuals ages ≥12 from the 2015-2018 National Survey on Drug Use and Health (n = 226,632), an annual nationally representative cross-sectional survey of non-institutionalized individuals in the US. Log-linear trends in past-year methamphetamine use were examined, stratified by demographic and drug use characteristics. RESULTS Methamphetamine use increased in the US from 2015 to 2018, including among those reporting past-year use of ecstasy/MDMA (6.1 % to 10.8 % [p = .018], a 78.2 % increase), cocaine (8.4 % to 11.8 % [p = .013], a 40.1 % increase), and among those reporting past-year prescription opioid misuse (5.4 % to 8.0 % [p = .019], a 49.2 % increase). Increases were particularly pronounced among those reporting past-year use of heroin (22.5 % to 37.4 % [p = .032], a 66.2 % increase) and LSD (5.1 %-= to 10.3 % [p = .002], a 100.4 % increase). Small increases were also detected among heterosexuals (0.6 % to 0.7 % [p = .044], a 16.2 % increase), those with a high school diploma or less (1.0 % to 1.2 % [p = .020], a 22.0 % increase), and among those receiving government assistance (1.4 % to 1.8 % [p = .046], a 26.2 % increase). CONCLUSIONS Methamphetamine use is increasing among people who use other drugs with sharp increases among people who use heroin or LSD in particular, and this could have serious public health consequences. Results may signal that methamphetamine use may continue to increase in the general population.
Collapse
Affiliation(s)
- Joseph J. Palamar
- New York University School of Medicine, Department of Population Health, 180 Madison Avenue, New York, NY 10016,Center for Drug Use and HIV/HCV Research, New York University College of Global Public Health, 665 Broadway, New York, NY 10012
| | - Benjamin H. Han
- New York University School of Medicine, Department of Population Health, 180 Madison Avenue, New York, NY 10016,Center for Drug Use and HIV/HCV Research, New York University College of Global Public Health, 665 Broadway, New York, NY 10012,New York University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Palliative Care, 550 First Avenue, BCD 615, New York, NY 10016
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| |
Collapse
|
34
|
Black E, Govindasamy L, Auld R, McArdle K, Sharpe C, Dawson A, Vazquez S, Brett J, Friend C, Shaw V, Tyner S, McDonald C, Koop D, Tall G, Welsby D, Habig K, Madeddu D, Cretikos M. Toxicological analysis of serious drug-related harm among electronic dance music festival attendees in New South Wales, Australia: A consecutive case series. Drug Alcohol Depend 2020; 213:108070. [PMID: 32554172 DOI: 10.1016/j.drugalcdep.2020.108070] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 04/13/2020] [Accepted: 04/27/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND A substantial increase in drug-related harm was observed during the 2018-2019 music festival season in New South Wales, Australia, including the deaths of five young people. As part of a rapid public health response, the New South Wales Ministry of Health referred samples from patients with suspected severe drug-related illness for forensic toxicological testing to identify the type and concentration of substances associated with the presentations. METHODS Cases were identified through a variety of active and passive surveillance systems, and selected consecutively based on indicators of clinical severity. Comprehensive toxicology testing of blood and urine samples was expedited for all cases. Demographic and clinical characteristics were collated, together with quantitative toxicology results. Results were analysed using descriptive statistics. RESULTS Forty cases from eleven different music festivals were included. The majority of cases (80.0%) were aged 25 years and under. There were five fatalities, and 62.5% of cases were admitted to intensive care units. MDMA was the most frequent substance, detected in 87.5% of cases. In 82.9% of cases with MDMA, blood concentrations were above thresholds that have been associated with toxicity. Multiple substances were detected in 60.0% of cases. Novel psychoactive substances were not detected. CONCLUSIONS Our findings strongly suggest that MDMA-related toxicity was a major factor in the severity of the clinical presentations among these cases. Other substances may have enhanced MDMA toxicity but appear unlikely to have caused severe toxicity in isolation. These findings have important implications for harm reduction strategies targeted to music festival settings.
Collapse
Affiliation(s)
- Eleanor Black
- Clinical Quality and Safety, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia.
| | - Laksmi Govindasamy
- New South Wales Public Health Officer Training Program, Centre for Epidemiology and Evidence, NSW Ministry of Health, St Leonards 2065, NSW, Australia
| | - Robin Auld
- Clinical Quality and Safety, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Kylie McArdle
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, 2145, NSW, Australia
| | - Caroline Sharpe
- Office of the Chief Health Officer, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Andrew Dawson
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, 2145, NSW, Australia
| | - Santiago Vazquez
- Forensic and Analytical Science Service, New South Wales Health Pathology, Lidcombe 2141, NSW, Australia
| | - Jonathan Brett
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, 2145, NSW, Australia
| | - Caren Friend
- Western Sydney Local Health District, New South Wales Health, Sydney NSW, Australia
| | - Vanessa Shaw
- Forensic and Analytical Science Service, New South Wales Health Pathology, Lidcombe 2141, NSW, Australia
| | - Sophie Tyner
- Office of the Chief Health Officer, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Catherine McDonald
- Forensic and Analytical Science Service, New South Wales Health Pathology, Lidcombe 2141, NSW, Australia
| | - David Koop
- New South Wales Health Emergency Management Unit, NSW Ambulance, Rozelle 2039, NSW, Australia
| | - Gary Tall
- Aeromedical and Medical Retrieval Services, NSW Ambulance, 2039, Rozelle NSW, Australia
| | - Deb Welsby
- Clinical Quality and Safety, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Karel Habig
- Aeromedical and Medical Retrieval Services, NSW Ambulance, 2039, Rozelle NSW, Australia
| | - Daniel Madeddu
- Alcohol and Other Drugs, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Michelle Cretikos
- Clinical Quality and Safety, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| |
Collapse
|
35
|
Palamar JJ. Increasing Willingness to Use Synthetic Drugs if Offered among Electronic Dance Music Party Attendees, 2017-2019. J Psychoactive Drugs 2020; 52:324-333. [PMID: 32429796 DOI: 10.1080/02791072.2020.1761574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Intention and willingness to use drugs are proximal predictors of drug use; however, willingness to use requires more research to inform prevention efforts. This study examines willingness to use drugs among electronic dance music (EDM) party attendees, a population at high risk for drug use. Data were examined from a repeated cross-sectional study of 2,426 adult EDM party attendees surveyed entering nightclubs and festivals in New York City from 2017 to 2019 using time-space sampling. Trends and correlates of reporting whether participants would use ten different synthetic drugs if offered by a friend in the next thirty days were examined. Ecstasy (31.9%), powder cocaine (25.5%), LSD (20.0%), and opioids (16.4%) were most likely to be used if offered. Willingness to use powder cocaine, LSD, ketamine, amphetamine, tryptamines, and 2C series drugs significantly increased from 2017 to 2019, particularly powder cocaine (increasing from 19.1% to 34.2%, p <.001). Any or more recent use of each drug was associated with increases in willingness to use. Past drug use is a consistent predictor of willingness to use if offered, and willingness to use is increasing in this population. Findings can inform prevention efforts by allowing better targeting of those at risk for use.
Collapse
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine , New York, NY, USA
| |
Collapse
|
36
|
Palamar JJ, Le A. Self-Correction of Unreported Marijuana Use by Participants Taking a Street Intercept Survey. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 46:708-717. [PMID: 32379560 DOI: 10.1080/00952990.2020.1745219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: Due to underreporting, a major challenge associated with drug use surveys is obtaining precise estimates of drug use. Objective: This study examined reliability of self-reported lifetime marijuana use among electronic dance music (EDM) party attendees - a high-risk population for drug use. Methods: 794 adults (35.1% female) entering EDM parties were intercept-surveyed. Participants were asked about lifetime marijuana use early in the survey. Those not reporting use were asked 5-10 min later if their earlier response was correct. Participants reporting their original response was not correct were asked to check off a reason why they did not originally report use. Participants were also asked at the end of the survey how honestly they responded throughout the survey. Prevalence of lifetime marijuana use with and without corrected responses was compared and risk factors for underreporting were examined using a Poisson generalized linear model. Results: Among those not reporting marijuana use, 31.2% subsequently reported use when asked again. Prevalence of use increased from 73.7% to 81.9% after correcting responses, an 8.2% absolute increase and a 10.0% relative increase. Reporting lifetime use of ecstasy and/or LSD was associated with lower risk for underreporting marijuana use. Compared to those reporting that they answered all questions honestly, those who reportedly answered most or no questions honestly were at higher risk for underreporting. Conclusion: Asking participants to confirm previous responses can help detect underreporting of drug use on intercept surveys. Results can inform survey methods when participants are believed to be at risk for underreporting.
Collapse
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine , New York, NY, USA
| | - Austin Le
- Department of Population Health, New York University Grossman School of Medicine , New York, NY, USA.,New York University College of Dentistry , New York, NY, USA
| |
Collapse
|
37
|
Riley AL, Nelson KH, To P, López-Arnau R, Xu P, Wang D, Wang Y, Shen HW, Kuhn DM, Angoa-Perez M, Anneken JH, Muskiewicz D, Hall FS. Abuse potential and toxicity of the synthetic cathinones (i.e., “Bath salts”). Neurosci Biobehav Rev 2020; 110:150-173. [DOI: 10.1016/j.neubiorev.2018.07.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/14/2018] [Accepted: 07/24/2018] [Indexed: 01/22/2023]
|
38
|
Leong HS, Philp M, Simone M, Witting PK, Fu S. Synthetic Cathinones Induce Cell Death in Dopaminergic SH-SY5Y Cells via Stimulating Mitochondrial Dysfunction. Int J Mol Sci 2020; 21:ijms21041370. [PMID: 32085614 PMCID: PMC7073199 DOI: 10.3390/ijms21041370] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/13/2020] [Accepted: 02/16/2020] [Indexed: 01/22/2023] Open
Abstract
Increasing reports of neurological and psychiatric complications due to psychostimulant synthetic cathinones (SCs) have recently raised public concern. However, the precise mechanism of SC toxicity is unclear. This paucity of understanding highlights the need to investigate the in-vitro toxicity and mechanistic pathways of three SCs: butylone, pentylone, and 3,4-Methylenedioxypyrovalerone (MDPV). Human neuronal cells of SH-SY5Y were cultured in supplemented DMEM/F12 media and differentiated to a neuronal phenotype using retinoic acid (10 μM) and 12-O-tetradecanoylphorbol-13-acetate (81 nM). Trypan blue and lactate dehydrogenase assays were utilized to assess the neurotoxicity potential and potency of these three SCs. To investigate the underlying neurotoxicity mechanisms, measurements included markers of oxidative stress, mitochondrial bioenergetics, and intracellular calcium (Ca2+), and cell death pathways were evaluated at two doses (EC15 and EC40), for each drug tested. Following 24 h of treatment, all three SCs exhibited a dose-dependent neurotoxicity, characterized by a significant (p < 0.0001 vs. control) production of reactive oxygen species, decreased mitochondrial bioenergetics, and increased intracellular Ca2+ concentrations. The activation of caspases 3 and 7 implicated the orchestration of mitochondrial-mediated neurotoxicity mechanisms for these SCs. Identifying novel therapeutic agents to enhance an altered mitochondrial function may help in the treatment of acute-neurological complications arising from the illicit use of these SCs.
Collapse
Affiliation(s)
- Huey Sze Leong
- Centre for Forensic Science, School of Mathematical and Physical Sciences, University of Technology Sydney, Ultimo, NSW 2007, Australia; (H.S.L.); (M.P.)
- Discipline of Pathology, Charles Perkins Centre, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia;
| | - Morgan Philp
- Centre for Forensic Science, School of Mathematical and Physical Sciences, University of Technology Sydney, Ultimo, NSW 2007, Australia; (H.S.L.); (M.P.)
| | - Martin Simone
- Discipline of Pathology, Charles Perkins Centre, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia;
| | - Paul Kenneth Witting
- Discipline of Pathology, Charles Perkins Centre, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia;
- Correspondence: (P.K.W.); (S.F.); Tel.: +61-2-9114-0524 (P.K.W.); +61-2-9514-8207 (S.F.)
| | - Shanlin Fu
- Centre for Forensic Science, School of Mathematical and Physical Sciences, University of Technology Sydney, Ultimo, NSW 2007, Australia; (H.S.L.); (M.P.)
- Correspondence: (P.K.W.); (S.F.); Tel.: +61-2-9114-0524 (P.K.W.); +61-2-9514-8207 (S.F.)
| |
Collapse
|
39
|
Salomone A, Palamar JJ, Vincenti M. Should NPS be included in workplace drug testing? Drug Test Anal 2020; 12:191-194. [PMID: 31840414 DOI: 10.1002/dta.2749] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Alberto Salomone
- Dipartimento di Chimica, Università di Torino, Turin, Italy.,Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", , Orbassano, Turin, Italy
| | - Joseph J Palamar
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Marco Vincenti
- Dipartimento di Chimica, Università di Torino, Turin, Italy.,Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", , Orbassano, Turin, Italy
| |
Collapse
|
40
|
Onigu-Otite E, Kurtzweil M, Tucci V, Moukaddam N. Substance Use in Adolescents Presenting to the Emergency Department. ADOLESCENT PSYCHIATRY 2020. [DOI: 10.2174/2210676608666181015114220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Adolescent substance use is a dynamic public health problem.
Adolescence is a unique developmental period involving overlapping biological,
psychological, and social factors which increase the rates of initiation of substance use. The
developing adolescent brain is particularly susceptible to the effects of substances and most
adults with substance use disorders began to have symptoms and problems in their
adolescent years. Yet, for various reasons, most adolescents who use, misuse, abuse, or are
addicted to substances do not perceive the need for treatment.
Objective:
Drug and alcohol use among adolescents is a common presentation in hospital
Emergency Departments (EDs) and presents in different forms including in association with
intoxication, withdrawal states, or trauma associated with drug-related events. For many
adolescents with substance use, the Emergency Department (ED) is the first point of contact
with medical personnel and thus also serves as a potential entry point into treatment.
Methods:
This article reviews the common ways drug and alcohol problems present in the
ED, clinical assessment of the patient and family, screening, laboratory testing, brief
interventions in the ED, and referral to treatment beyond the ED.
Conclusion:
Guidelines on how to manage the shifting terrain of adolescent substance use
presenting in EDs across the nation continue to evolve. We highlight that considerable
further research is needed to inform effective ED protocols to address this important
individual and public health safety concern. Systems of care models which include
collaborative teams of diverse stake holders are needed to effectively manage adolescents
with substance use disorders.
Collapse
Affiliation(s)
- Edore Onigu-Otite
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Miju Kurtzweil
- Merit Health Wesley Emergency Medicine Residency, Hattiesburg, MS, United States
| | - Veronica Tucci
- Merit Health Wesley Emergency Medicine Residency, Hattiesburg, MS, United States
| | - Nidal Moukaddam
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| |
Collapse
|
41
|
Combination of pressurized liquid extraction with dispersive liquid liquid micro extraction for the determination of sixty drugs of abuse in hair. J Chromatogr A 2019; 1605:360348. [DOI: 10.1016/j.chroma.2019.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 02/06/2023]
|
42
|
Palamar JJ, Acosta P, Sutherland R, Shedlin MG, Barratt MJ. Adulterants and altruism: A qualitative investigation of "drug checkers" in North America. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 74:160-169. [PMID: 31610451 DOI: 10.1016/j.drugpo.2019.09.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/25/2019] [Accepted: 09/27/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND "Drug checking" has become a common harm reduction method used to test illicit substances, such as ecstasy, for purity and/or the presence of adulterants. Formal drug-checking services have been operating for decades, and the use of personal reagent test kits appears to be relatively common; however, little attention has been devoted to understanding the role and broader experiences of 'drug-checkers' (i.e., people who test their own and/or other people's substances). As such, it remains unknown who is engaging in this practice, their motivations for drug-checking, and what barriers they may experience. We addressed this research gap by interviewing people who check drugs about their experiences, with a goal of better understanding drug checking practices. METHODS We conducted in-depth interviews with 32 adults in North America who reported testing drugs. Coding was conducted in an inductive manner and thematic analysis was used to identify relevant themes. RESULTS Over half (56.2%) of our sample was affiliated with a drug checking organization. Among non-affiliated checkers (43.8%), the majority (57.1%) tested for friends, 21.4% tested only for themselves, and 21.4% were people who sold drugs and tested for their clients. Motivations were driven largely by altruism, described by checkers as wanting to protect their peers from exposure to adulterants. People interviewed who sold drugs were altruistic in the same manner. Barriers to checking-particularly at nightclubs and festivals-included perceived illegality of test kits and denied approval to test drugs at venues, although many checkers circumvented this barrier by checking drugs without such approval. CONCLUSIONS Drug checkers in North America seek to educate people who use drugs about the risk of exposure to unexpected substance types, but they face various barriers. Policy change could help ensure that these potentially life-saving services can be provided without fear of fines and/or criminal prosecution.
Collapse
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University School of Medicine, 180 Madison Avenue, Room 1752, New York, NY 10016, USA; Center for Drug Use and HIV/HCV Research, NYU College of Global Public Health, New York, NY, USA.
| | - Patricia Acosta
- Department of Population Health, New York University School of Medicine, 180 Madison Avenue, Room 1752, New York, NY 10016, USA
| | - Rachel Sutherland
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Michele G Shedlin
- Center for Drug Use and HIV/HCV Research, NYU College of Global Public Health, New York, NY, USA
| | - Monica J Barratt
- Social and Global Studies Centre, RMIT University, Melbourne, Australia; National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| |
Collapse
|
43
|
Palamar JJ. Commentary on Ondersma et al. (2019): Will better self-report screening instruments be enough to detect drug use during pregnancy? Addiction 2019; 114:1694-1695. [PMID: 31301078 PMCID: PMC7046169 DOI: 10.1111/add.14717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 06/19/2019] [Indexed: 11/30/2022]
Abstract
Better screening instruments to detect drug use during pregnancy are needed, but under-reporting of use in this population will probably continue as long as many pregnant women who use drugs fear social and/or legal repercussions..
Collapse
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| |
Collapse
|
44
|
Palamar JJ, Acosta P, Le A, Cleland CM, Nelson LS. Adverse drug-related effects among electronic dance music party attendees. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 73:81-87. [PMID: 31349134 DOI: 10.1016/j.drugpo.2019.07.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/20/2019] [Accepted: 07/02/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Drug use is prevalent among electronic dance music (EDM) party attendees, but research is needed to determine the extent of adverse drug-related outcomes in this population in order to better inform prevention and harm reduction efforts. METHOD 1029 adults were surveyed entering EDM parties in New York City in 2018. Those reporting past-year use of a drug were asked if they experienced a harmful or very unpleasant effect after use in which they were concerned about their immediate safety. They were also asked about co-use of other drugs and whether they sought help. RESULTS We estimate that a third (33.5%) of EDM party attendees have experienced a drug-related adverse effect in the past year. Two-thirds (67.8%) of adverse effects involved use of alcohol. Relative to use, adverse effects most commonly resulted from use of opioids (e.g., prescription opioid misuse, 41.2%) or alcohol (33.9%). Among those reporting an adverse effect, concomitant use of other drugs was common, particularly among users of LSD (56.5%), ketamine (56.3%), cocaine (55.7%), and ecstasy/MDMA/Molly (47.7%). Adverse effects resulting from synthetic cathinone ("bath salt") use were most likely to result in a hospital visit (57.1%). CONCLUSION Adverse effects from drug use are common among those in the EDM party scene and polydrug use appears to be a common risk factor. More research is needed, however, to determine the extent of event-specific adverse outcomes. Results can inform prevention and harm reduction efforts in this population.
Collapse
Affiliation(s)
- Joseph J Palamar
- New York University School of Medicine, Department of Population Health, New York, NY, United States; Center for Drug Use and HIV/HCV Research, New York University College of Global Public Health, New York, NY, United States.
| | - Patricia Acosta
- New York University School of Medicine, Department of Population Health, New York, NY, United States
| | - Austin Le
- New York University School of Medicine, Department of Population Health, New York, NY, United States; New York University College of Dentistry, New York, NY, United States
| | - Charles M Cleland
- New York University School of Medicine, Department of Population Health, New York, NY, United States; Center for Drug Use and HIV/HCV Research, New York University College of Global Public Health, New York, NY, United States
| | - Lewis S Nelson
- Rutgers University, School of Public Health, Rutgers University, Newark, NJ, United States
| |
Collapse
|
45
|
Palamar JJ, Le A, Guarino H, Mateu-Gelabert P. A comparison of the utility of urine- and hair testing in detecting self-reported drug use among young adult opioid users. Drug Alcohol Depend 2019; 200:161-167. [PMID: 31146203 PMCID: PMC6588496 DOI: 10.1016/j.drugalcdep.2019.04.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Biological testing can be used to validate or detect underreported drug use. Since hair testing is increasingly used in survey research, we examined how the utility of hair testing compares to a more common method-urine testing. METHODS 532 adults (ages 18-29) reporting past-month heroin use and/or nonmedical prescription opioid use were surveyed about past-month use of various drugs. Participants were urine-tested and the majority (79.3%) provided a hair sample for analysis. We examined the utility of urine vs. hair-testing in detecting past-month use of various drugs. RESULTS Compared to hair testing, urine testing was able to confirm higher proportions of self-reported use of heroin/opioids (85.5% vs. 80.9%), marijuana (73.9% vs. 22.9%), benzodiazepines (51.3% vs. 15.1%), and methadone (77.0% vs. 48.7%), while hair testing was more likely to detect reported cocaine use (66.3% vs. 48.0%) (Ps<.01). Compared to hair testing, urine testing was more likely to detect unreported use of marijuana (11.3% vs. 0.9%), and benzodiazepines (14.4% vs. 5.4%), and hair testing was more likely to detect unreported use of cocaine (27.0% vs. 5.8%) and oxycodone (19.7% vs. 1.4%) (Ps<.001). When added to urine testing, hair testing increased detection of reported and non-reported use of cocaine and oxycodone ranging from 14 to 22%. CONCLUSIONS While hair testing is efficacious in detecting drug use in wide window periods (e.g., past-year use), it is less efficacious than urine testing when testing for past-month use of select drugs among opiate/opioid users. However, hair testing is particularly efficacious in detecting unreported use of cocaine and/or oxycodone.
Collapse
Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University Langone Medical Center, New York, NY, USA,Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing, 433 1st Avenue, New York, NY, USA
| | - Austin Le
- Department of Population Health, New York University Langone Medical Center, New York, NY, USA,New York University College of Dentistry, 345 E. 24th Street, 1st Avenue, New York, NY, USA
| | - Honoria Guarino
- Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing, 433 1st Avenue, New York, NY, USA,National Development and Research Institutes, 71 W 23rd St, New York, NY, USA
| | - Pedro Mateu-Gelabert
- Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing, 433 1st Avenue, New York, NY, USA,National Development and Research Institutes, 71 W 23rd St, New York, NY, USA
| |
Collapse
|
46
|
Freni F, Bianco S, Vignali C, Groppi A, Moretti M, Osculati AMM, Morini L. A multi-analyte LC–MS/MS method for screening and quantification of 16 synthetic cathinones in hair: Application to postmortem cases. Forensic Sci Int 2019; 298:115-120. [DOI: 10.1016/j.forsciint.2019.02.036] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 02/17/2019] [Accepted: 02/19/2019] [Indexed: 10/27/2022]
|
47
|
Salomone A, Palamar JJ, Bigiarini R, Gerace E, Di Corcia D, Vincenti M. Detection of Fentanyl Analogs and Synthetic Opioids in Real Hair Samples. J Anal Toxicol 2019; 43:259-265. [PMID: 30462247 PMCID: PMC6460334 DOI: 10.1093/jat/bky093] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/17/2018] [Accepted: 10/23/2018] [Indexed: 11/13/2022] Open
Abstract
Novel synthetic opioids include various analogs of fentanyl and emerging non-fentanyl compounds with different chemical structures, such as AH-7921, MT-45 and U-47700. In recent years, these drugs have rapidly emerged on the drug market, and their abuse has been increasing worldwide. The motivations for use of these new compounds include their legal status, ready availability, low cost, users' curiosity or preference for their particular pharmacological properties and the intention to avoid detection. Furthermore, more common drugs like heroin are now increasingly being replaced or cut with fentanyl or new designer opioids; thus, many drug users are unintentionally or unknowingly using synthetic fentanyl analogs. In this scenario, the detection of new psychoactive substances in hair can provide insight into their current diffusion among the population and social characteristics of these synthetic drug users. In this manuscript, we describe a simple, fast, specific and sensitive UHPLC-MS-MS method able to detect 13 synthetic opioids (including fentanyl analogs) and metabolites in hair samples. Furthermore, the method includes the detection of 4-anilino-N-phenethyl-piperidine (4-ANPP), which is considered both a precursor and a metabolite of several fentanyl analogs. The method was applied to 34 real hair samples collected in New York City from subjects who had reported past-year non-medical opioid and/or heroin use. In total, 17 samples tested positive for at least one target analyte, with oxycodone (nine samples) and tramadol (eight samples) being the most common. Among these, the method was able to quantify furanyl-fentanyl and fentanyl in the pg/mg range in two samples. Simultaneously, also 4-ANPP was detected, giving evidence for the first time that this compound can be selected as a marker of fentanyl analogs use via hair testing. In conclusion, this study confirmed the increasing diffusion of new synthetic opioids and "fentalogs" with high potency among non-medical opioid users.
Collapse
Affiliation(s)
- Alberto Salomone
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
| | - Joseph J Palamar
- Department of Population Health, New York University Langone Medical Center
- Center for Drug Use and HIV/HCV Research, New York University College of Nursing New York, NY, USA
| | | | - Enrico Gerace
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
| | - Daniele Di Corcia
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
- Dipartimento di Chimica, Università di Torino, Turin, Italy
| |
Collapse
|
48
|
Richeval C, Dumestre-Toulet V, Wiart JF, Vanhoye X, Humbert L, Nachon-Phanithavong M, Allorge D, Gaulier JM. New psychoactive substances in oral fluid of drivers around a music festival in south-west France in 2017. Forensic Sci Int 2019; 297:265-269. [DOI: 10.1016/j.forsciint.2019.02.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/08/2019] [Accepted: 02/16/2019] [Indexed: 11/29/2022]
|
49
|
Oliver CF, Palamar JJ, Salomone A, Simmons SJ, Philogene-Khalid HL, Stokes-McCloskey N, Rawls SM. Synthetic cathinone adulteration of illegal drugs. Psychopharmacology (Berl) 2019; 236:869-879. [PMID: 30338489 PMCID: PMC6472990 DOI: 10.1007/s00213-018-5066-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/03/2018] [Indexed: 01/28/2023]
Abstract
RATIONALE Current prevalence estimates of synthetic cathinone ("bath salt") use may be underestimates given that traditional metrics (e.g., surveys, urinalysis) often fail to capture the emergent issue of synthetic cathinone adulteration of more common illegal drugs, such as ecstasy (3,4-methylenedioxymethamphetamine). OBJECTIVES This review examines the evolution of synthetic cathinones and prevalence of use over the past decade in the United States. We also review methods of self-report and biological testing of these compounds as well as adverse outcomes associated with adulterated drug use. RESULTS Synthetic cathinone use emerged in the United States by 2009 with use associated with tens of thousands of poisonings. Reported poisonings and self-reported use have substantially decreased over the past five years. However, our review suggests that current estimates of use are underestimates due to underreporting stemming primarily from unknown or unintentional use of adulterated formulations of relatively popular illegal drugs, such as ecstasy. CONCLUSIONS While intentional synthetic cathinone use has decreased in recent years, evidence suggests that prevalence of use is underestimated. Testing of drugs and/or biological specimens can improve the accuracy of synthetic cathinone use estimates. Furthermore, we advocate that researchers and clinicians should become better aware that exposure to these potent compounds (e.g., as adulterants) often occurs unknowingly or unintentionally. To improve our understanding of synthetic cathinone adulteration, research utilizing a combinatorial approach (survey and biological testing) will help more accurately estimate the prevalence and impact of this public health issue.
Collapse
Affiliation(s)
- Chicora F Oliver
- Center for Substance Abuse Research, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, 882A, Philadelphia, PA, 19140, USA.
| | - Joseph J Palamar
- Department of Population Health, 180 Madison Avenue Room 1752, New York, NY, 10016, USA
| | - Alberto Salomone
- Centro Regionale Antidoping "A. Bertinaria", Regione Gonzole 10/1, 10043, Orbassano, Torino, Italy
| | - Steven J Simmons
- Center for Substance Abuse Research, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, 882A, Philadelphia, PA, 19140, USA
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia Research Institute, Philadelphia, PA, 19104, USA
| | - Helene L Philogene-Khalid
- Center for Substance Abuse Research, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, 882A, Philadelphia, PA, 19140, USA
- Department of Psychiatry, 100 E. Lehigh Ave, Philadelphia, PA, 19125, USA
| | - Nick Stokes-McCloskey
- Center for Substance Abuse Research, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, 882A, Philadelphia, PA, 19140, USA
| | - Scott M Rawls
- Center for Substance Abuse Research, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, 882A, Philadelphia, PA, 19140, USA
| |
Collapse
|
50
|
Emerging threats in addiction: will novel psychoactive substances contribute to exacerbating the ongoing drug overdose epidemic? Psychopharmacology (Berl) 2019; 236:839-843. [PMID: 31119328 DOI: 10.1007/s00213-019-05271-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|