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Świątek S, Czyrski A. Analytical Methods for Determining Psychoactive Substances in Various Matrices: A Review. Crit Rev Anal Chem 2024:1-27. [PMID: 39155524 DOI: 10.1080/10408347.2024.2388123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
Psychoactive substances pose significant challenges and dangers to society due to their impact on perception, mood, and behavior, leading to health and life disturbances. The consumption of these substances is largely influenced by their legal status, cultural norms, and religious beliefs. Continuous development and chemical modifications of psychoactive substances complicate their control, detection, and determination in the human body. This paper addresses the terminological distinctions between psychoactive and psychotropic substances and drugs. It provides a comprehensive review of analytical methods used to identify and quantify 25 psychoactive substances in various biological matrices, including blood, urine, saliva, hair, and nails. The analysis categorizes these substances into four primary groups: stimulants, neuroleptics, depressants, and hallucinogens. The study specifically focuses on chromatographic and spectrophotometric methods, as well as other novel analytical techniques. Methodology includes a review of scientific articles containing validation studies of these methods and innovative approaches to psychoactive substance determination. Articles were sourced from the PubMed database, with most research originating from the twenty first century. The paper discusses the limits of detection and quantitation for each method, along with current trends and challenges in the analytical determination of evolving psychoactive substances.
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Affiliation(s)
- Szymon Świątek
- Department of Physical Pharmacy and Pharmacokinetics, Poznań University of Medical Sciences, Poznań, Poland
- Doctoral School of Natural Sciences, Faculty of Geographical and Geological Sciences, Adam Mickiewicz University in Poznań, Poznań, Poland
| | - Andrzej Czyrski
- Department of Physical Pharmacy and Pharmacokinetics, Poznań University of Medical Sciences, Poznań, Poland
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Guerra-Ojeda S, Marchio P, Suarez A, Aldasoro M, Valles SL, Genoves P, Vila JM, Mauricio MD. Levamisole Impairs Vascular Function by Blocking α-Adrenergic Receptors and Reducing NO Bioavailability in Rabbit Renal Artery. Cardiovasc Toxicol 2024; 24:789-799. [PMID: 38877381 PMCID: PMC11300484 DOI: 10.1007/s12012-024-09879-w] [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] [Received: 01/11/2024] [Accepted: 06/04/2024] [Indexed: 06/16/2024]
Abstract
Levamisole is an anthelmintic drug restricted to veterinary use but is currently detected as the most widely used cocaine cutting agent in European countries. Levamisole-adulterated cocaine has been linked to acute kidney injury, marked by a decrease in glomerular filtration rate, which involves reduced renal blood flow, but data on the alteration of renovascular response produced by levamisole are scarce. Renal arteries were isolated from healthy rabbits and used for isometric tension recording in organ baths and protein analysis. We provide evidence that depending on its concentration, levamisole modulates renovascular tone by acting as a non-selective α-adrenergic receptor blocker and down-regulates α1-adrenoceptor expression. Furthermore, levamisole impairs the endothelium-dependent relaxation induced by acetylcholine without modifying endothelial nitric oxide synthase (eNOS) expression. However, exposure to superoxide dismutase (SOD) partially prevents the impairment of ACh-induced relaxation by levamisole. This response is consistent with a down-regulation of SOD1 and an up-regulation of NADPH oxidase 4 (Nox4), suggesting that endothelial NO loss is due to increased local oxidative stress. Our findings demonstrate that levamisole can interfere with renal blood flow and the coordinated response to a vasodilator stimulus, which could worsen the deleterious consequences of cocaine use.
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Affiliation(s)
- Sol Guerra-Ojeda
- Department of Physiology, School of Medicine, University of Valencia, Blasco Ibañez, 15, 46010, Valencia, Spain
- INCLIVA, Institute of Health Research, Valencia, Spain
| | - Patricia Marchio
- Department of Physiology, School of Medicine, University of Valencia, Blasco Ibañez, 15, 46010, Valencia, Spain
| | - Andrea Suarez
- Department of Physiology, School of Medicine, University of Valencia, Blasco Ibañez, 15, 46010, Valencia, Spain
- INCLIVA, Institute of Health Research, Valencia, Spain
| | - Martin Aldasoro
- Department of Physiology, School of Medicine, University of Valencia, Blasco Ibañez, 15, 46010, Valencia, Spain
- INCLIVA, Institute of Health Research, Valencia, Spain
| | - Soraya L Valles
- Department of Physiology, School of Medicine, University of Valencia, Blasco Ibañez, 15, 46010, Valencia, Spain
| | - Patricia Genoves
- Department of Physiology, School of Medicine, University of Valencia, Blasco Ibañez, 15, 46010, Valencia, Spain
- INCLIVA, Institute of Health Research, Valencia, Spain
- Center for Biomedical Research Network on Cardiovascular Diseases (CIBER-CV), Madrid, Spain
| | - Jose M Vila
- Department of Physiology, School of Medicine, University of Valencia, Blasco Ibañez, 15, 46010, Valencia, Spain
- INCLIVA, Institute of Health Research, Valencia, Spain
| | - Maria D Mauricio
- Department of Physiology, School of Medicine, University of Valencia, Blasco Ibañez, 15, 46010, Valencia, Spain.
- INCLIVA, Institute of Health Research, Valencia, Spain.
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Claudet I, Caula C, Gallart JC, Tourniaire G, Lerouge-Bailhache M, Michard-Lenoir AP, Tran A, Maleterre A, Huet F, Dufour D, Billaud N, David A, Di Patrizio M, Granjon M, Benoist G, Laguille C, Guitteny MA, Balençon M, Vrignaud B, Basmaci R, Dampfhoffer M, Dubos F, Chappuy H, Minodier P, Médiamolle N, Bréhin C. A French study of cocaine intoxication/exposure in children (2010-2020). Clin Toxicol (Phila) 2023; 61:370-378. [PMID: 37183679 DOI: 10.1080/15563650.2023.2188143] [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: 12/19/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND AND OBJECTIVE In the European Union, the record of cocaine-related seizures indicates an expanding supply. The purity has also been increasing. The health impact of these trends remains poorly documented, in particular, the changes and clinical manifestations of intoxication in young children. We attempted to evaluate the trend in French pediatric admissions for cocaine intoxication/exposure over an 11-year period (2010-2020). METHODS A retrospective, national, multicenter, study of a pediatric cohort. All children less than 15 years of age admitted to a tertiary-level pediatric emergency unit for proven cocaine intoxication (compatible symptoms and positive toxicological screening) during the reference period were included. RESULTS Seventy-four children were included. Forty-six percent were less than 6 years old. Annual admissions increased by a factor of 8 over 11 years (+700%) and 57% of all cases were admitted in the last two years. The main clinical signs were neurologic (59%) followed by cardiovascular symptoms (34%). Twelve patients were transferred to the pediatric intensive care unit. Factors significantly associated with the risk of being transferred to the pediatric intensive care unit were initial admission to the pediatric resuscitation area (P < 0.001), respiratory impairment (P < 0.01), mydriasis (P < 0.01), cardiovascular symptoms (P = 0.014), age of less than 2 years (P = 0.014). Blood and/or urine toxicological screening isolated eighteen other substances besides cocaine in 46 children (66%). CONCLUSION Children are collateral victims of the changing trends in cocaine availability, use and purity. Admissions of intoxicated children to pediatric emergency departments are more frequent and there is an increase in severe presentations. Therefore, this is a growing public health concern.
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Affiliation(s)
- Isabelle Claudet
- Service d'accueil des Urgences Pédiatriques, Hôpital des Enfants, CHU Toulouse, France
- UMR 1295, Inserm, Paul Sabatier University, UPS, Toulouse, France
| | - Caroline Caula
- Urgences pédiatriques, Hôpital Robert-Debré, AP-HP, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Martine Balençon
- Urgences pédiatriques, Pédiatrie-Médecine légale, CHU Rennes, France
| | | | - Romain Basmaci
- Urgences pédiatriques, Hôpital Louis Mourier, AP-HP, France
| | | | | | | | | | | | - Camille Bréhin
- Service d'accueil des Urgences Pédiatriques, Hôpital des Enfants, CHU Toulouse, France
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Darke S, Duflou J, Peacock A, Chrzanowska A, Farrell M, Lappin J. Clinical characteristics of fatal cocaine toxicity in Australia, 2000-2021. Drug Alcohol Rev 2023; 42:582-591. [PMID: 36423902 DOI: 10.1111/dar.13581] [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: 07/19/2022] [Revised: 09/27/2022] [Accepted: 11/02/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION With increased use, the number of cocaine-related deaths has increased. We aimed to determine: (i) the toxicological profile of cocaine, metabolites and adulterants amongst three groups of cocaine-related fatalities in which cocaine and/or metabolites were present in blood: (a) fatal toxicity, where cocaine only (CO) was present (n = 48), (b) multiple drug toxicity (MDT) where other drugs were present (n = 604), and (c) a comparison group of death from traumatic injury (TI, n = 232); (ii) the acute clinical presentation by group; and (iii) cardiovascular disease by group. METHODS Retrospective study of cocaine-related deaths in Australia, 2000-2021, from the National Coronial Information System. RESULTS The parent drug cocaine was significantly more common, and had a higher median concentration, amongst the CO group (97.9%, 1.550 mg/L) than the MDT (68.9%, 0.09 mg/L) and TI (70.7%, 0.05 mg/L) groups respectively. Similarly large ratios between CO, MDT and TI were seen for benzoylecgonine (2.100, 0.510, 0.240 mg/L), methylecgonine (1.350, 0.140, 0.070 mg/L), lignocaine (1.200, 0.200, 0.150 mg/L) and levamisole (0.230, 0.045, 0.025 mg/L). The two toxicity groups had significantly higher proportions than the TI group for reports of sudden collapse, seizure, acute psychosis, hyperthermia and vomiting. In addition, CO had higher proportions than MDT and TI of sudden collapse. CO had significantly higher proportions of cardiomegaly and coronary artery disease than the TI group. DISCUSSION AND CONCLUSIONS Compared to MDT and TI cases, CO cases had higher cocaine concentrations, higher concentrations of adulterants, higher levels of cardiovascular disease and were more likely to suddenly collapse.
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Affiliation(s)
- Shane Darke
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Johan Duflou
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
- Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Agata Chrzanowska
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Julia Lappin
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
- School of Psychiatry, UNSW Sydney, Sydney, Australia
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Darke S, Duflou J, Peacock A, Chrzanowska A, Farrell M, Lappin J. Rates, characteristics and toxicology of cocaine-related deaths in Australia, 2000-2021. Addiction 2023; 118:297-306. [PMID: 36164848 DOI: 10.1111/add.16055] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/09/2022] [Indexed: 01/05/2023]
Abstract
AIMS To (i) assess the population mortality rates of cocaine-related deaths in Australia, 2000 to 2021; (ii) determine the circumstances of death and case characteristics; and (iii) determine their toxicological profile. DESIGN Retrospective study of cocaine-related deaths in Australia, 2000 to 2021, retrieved from the National Coronial Information System. SETTING Australia-wide. CASES A total of 884 cases, mean age = 33.8 (SD, 10.0) years and 86.5% (n = 765) male. MEASUREMENTS Information was collected on characteristics, manner of death and toxicology. Only cases in which the presence of blood cocaine and/or metabolites were included. FINDINGS Population rates did not significantly increase during 2001-2011 (annual percentage change [APC] = 1.5; CI, -3.2, 6.5), but from 2012, there was a marked acceleration (APC = 20.0, 95% CI, 15.5, 25.3). Circumstances of death were unintentional drug toxicity (70.7%, n = 625), intentional self-harm (17.8%, n = 157), traumatic accident (11.5%, n = 102). The proportion of cases constituted by unintentional toxicity declined across the study period (APC = -2.6; CI, -3.1, -2.1). There was a substantial decline in the proportion of cases with a history of injecting drug use (APC = -5.7; CI, -6.5, -4.9) and with a history of substance use problems (APC = -3.2; CI, -3.9, -2.5). Both cocaine (0.100 vs 0.050 mg/L, P < 0.001) and benzoylecgonine (0.590 vs 0.240 mg/L, P < 0.001) concentrations were higher amongst toxicity cases than in cases of death from traumatic injury. Cocaethylene was present in 26.4% (n = 233), levamisole in 18.6% (n = 164) and lignocaine in 11.5% (n = 102). Psychoactive drugs in addition to cocaine were present in 92.9% (n = 821), most commonly opioids (50.5%, n = 446), alcohol (47.1%, n = 416), hypnosedatives (43.2%, n = 382) and psychostimulants (30.3%, n = 268). There was a steady decline in the proportion of opioid positive cases (APC = -5.4; CI, -6.3, -4.5). CONCLUSIONS There was a large increase in cocaine-related deaths across Australia from 2000 to 2021. This was accompanied by changes in case profiles, with histories of injecting drug use and substance use problems, as well as recent opioid use, becoming less prominent.
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Affiliation(s)
- Shane Darke
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Johan Duflou
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Agata Chrzanowska
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Julia Lappin
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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Midthun KM, Nelson BN, Strathmann FG, Browne T, Logan BK. Analysis of umbilical cord tissue as an indicator of in utero exposure to toxic adulterating substances. Front Pediatr 2023; 11:1127020. [PMID: 37025298 PMCID: PMC10070803 DOI: 10.3389/fped.2023.1127020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/27/2023] [Indexed: 04/08/2023] Open
Abstract
In utero drug exposure is a significant public health threat to the well-being and normal development of the neonate. Recently, testing of umbilical cord tissue (UCT) has been employed to measure illicit drug exposure, as drugs used by the mother during the third trimester may be retained in the UCT. Focus has also been given to potential adverse health effects among drug users, resulting from exposure to pharmacologically active adulterants and cutting agents in the street drug supply. The in utero effects of these substances have not been well studied in humans, nor has their presence been demonstrated as a means for assessing adverse health effects in the neonate. Here, we describe the application of a novel test method to analyze UCT for the presence of more than 20 common adulterating/cutting substances via LC/Q-TOF. In total, 300 de-identified UCT samples were analyzed-all had previously tested positive for cocaine or opiates. Generally, the positivity rates of individual compounds were similar between the Cocaine and Opiates Subgroups, apart from levamisole, xylazine, dipyrone (metabolites), and promethazine. Many of the adulterants used in the street drug supply do have legitimate medicinal/therapeutic uses, including several of the compounds most frequently detected in this study. Caffeine and lidocaine were the most frequently identified compounds both individually (>70% each) and in combination with each other. Alternatively, levamisole, an adulterant with no legitimate therapeutic use, was present in 12% of cases. Importantly, this data demonstrates that the detection of traditional drugs of abuse may serve as indicators of potential in utero exposure to toxic adulterating substances during gestation. While there is cause for concern with respect to any unintentional drug exposure, illicit drug use during pregnancy, including uncontrolled dosing, poly-adulterant consumption, and the interactions of these drug mixtures, produces a significant public health threat to the neonate which warrants further study.
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Affiliation(s)
- Kari M. Midthun
- NMS Labs, Horsham, PA, United States
- Correspondence: Kari M. Midthun
| | | | | | - Thom Browne
- Colombo Plan Secretariat, Colombo, Sri Lanka
| | - Barry K. Logan
- NMS Labs, Horsham, PA, United States
- Center for Forensic Science Research and Education (CFSRE) at the Fredric Rieders Family Foundation, Willow Grove, PA, United States
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Hesse M, Thomsen KR, Thylstrup B, Andersen CU, Reitzel LA, Worm-Leonhard M, Lindholst C. Purity of street-level cocaine across Denmark from 2006 to 2019: Analysis of seized cocaine. Forensic Sci Int 2021; 329:111050. [PMID: 34736046 DOI: 10.1016/j.forsciint.2021.111050] [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: 05/12/2021] [Revised: 09/29/2021] [Accepted: 10/05/2021] [Indexed: 10/20/2022]
Abstract
Cocaine-related emergency department admissions are increasing, and cocaine seizures are at an all-time high in Europe. Our aim was to investigate the trends in purity and adulterants over time in cocaine available to cocaine users at street level in Denmark. We used a representative sample of cocaine seized at street level and analyzed by the national departments of forensic medicine between 2006 and 2019 (n = 1460). Latent profile analysis was used to classify the samples based on cocaine, levamisole, and phenacetin content. Low purity cocaine comprised most of the cocaine seizures in early years, but its share began to decline in 2013, and from 2016 to 2019, the high purity profile was dominant. While the total number of samples containing adulterants decreased, levamisole remained a common and dangerous adulterant. The findings underline the need to inform the public, medical doctors, and service providers for people with drug use disorders about the higher potency of street cocaine.
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Affiliation(s)
- Morten Hesse
- Aarhus University, Center for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark.
| | - Kristine Rømer Thomsen
- Aarhus University, Center for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark.
| | - Birgitte Thylstrup
- Aarhus University, Center for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark.
| | - Charlotte Uggerhøj Andersen
- Aarhus University, Department of Forensic Medicine, Palle Juul-Jensens Boulevard 99, Building Z, 3.017, 8200 Aarhus N, Denmark.
| | | | | | - Christian Lindholst
- Aarhus University, Department of Forensic Medicine, Palle Juul-Jensens Boulevard 99, Building Z, 3.017, 8200 Aarhus N, Denmark.
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Yao J, Xu X, Liu L, Kuang H, Wang Z, Xu C. Simultaneous detection of phenacetin and paracetamol using ELISA and a gold nanoparticle-based immunochromatographic test strip. Analyst 2021; 146:6228-6238. [PMID: 34528034 DOI: 10.1039/d1an01173a] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We have developed a sensitive and rapid gold nanoparticle-based immunochromatographic strip (GNP-ICS) for the detection of phenacetin (PNCT) and paracetamol (PAP) using an anti-PNCT monoclonal antibody (mAb). The sensitive anti-PNCT mAb (2D6) had a half maximal inhibitory concentration (IC50) and limit of detection (LOD) of 3.51 and 0.21 ng mL-1, respectively. Additionally, its cross-reactivity with PAP was approximately 10.1%. The developed GNP-ICS assay based on GNP-labeled mAb was sensitive for the detection of PNCT with vLOD and cut-off values of 2.5 and 50 ng mL-1 respectively and a vLOD value of 25 ng mL-1 for PAP. Furthermore, the developed icELISA and GNP-ICS assays were applied to determine PNCT-spiked beverage samples without pretreatment, in addition to a kind of PAP-containing drug. The recoveries were validated using high performance liquid chromatography (HPLC). The results revealed that the developed GNP-ICS assay was reliable for the detection of PNCT in practical samples.
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Affiliation(s)
- Jingjing Yao
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. .,International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Xinxin Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. .,International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Liqiang Liu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. .,International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Hua Kuang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. .,International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Zhengyou Wang
- Standards & Quality Center of National Food and Strategic Reserves Administration, Xicheng District, 100037 Beijing, China
| | - Chuanlai Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. .,International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
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Bouvarel T, Delaunay N, Pichon V. Selective extraction of cocaine from biological samples with a miniaturized monolithic molecularly imprinted polymer and on-line analysis in nano-liquid chromatography. Anal Chim Acta 2020; 1096:89-99. [DOI: 10.1016/j.aca.2019.10.046] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
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