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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.
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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.
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Haug NA, Wadekar R, Barry R, Sottile J. Risk for Ecstasy Use Disorder and Other Substance Use Among International Users of Recreational Ecstasy/Molly/MDMA. J Psychoactive Drugs 2024; 56:412-421. [PMID: 37384948 DOI: 10.1080/02791072.2023.2227960] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/20/2023] [Accepted: 05/26/2023] [Indexed: 07/01/2023]
Abstract
Ecstasy/Molly/MDMA is a widely used substance often taken in combination with other drugs in different contexts. The current study assessed ecstasy use patterns, concurrent substance use and the context of ecstasy use among an international sample of adults (N = 1,732). Participants were 87% white, 81% male, 42% college educated, 72% employed, with a mean age of 25.7 (SD = 8.3). Using the modified UNCOPE, risk for ecstasy use disorder was 22% overall, and significantly higher among younger individuals and those with greater frequency and quantity of use. Participants reporting risky ecstasy use endorsed significantly higher use of alcohol, nicotine/tobacco, cannabis, cocaine, amphetamine, benzodiazepines, and ketamine compared to those at lower risk. Great Britain (aOR = 1.86; 95% CI [1.24, 2.81]) and Nordic countries (aOR = 1.97; 95% CI [1.11, 3.47]) were approximately 2 times more likely to exhibit risk for ecstasy use disorder than the United States, Canada, Germany, and Australia/New Zealand. Taking ecstasy at home emerged as a common setting followed by electronic dance music events and music festivals. The UNCOPE may be a useful clinical tool for detecting problematic ecstasy use. Harm reduction interventions for ecstasy should target young people, substance co-administration, and context of use.
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Affiliation(s)
- Nancy A Haug
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Richa Wadekar
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Rachel Barry
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - James Sottile
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
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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.
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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
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da Cunha KF, Oliveira KD, Costa JL. Green analytical toxicology method for determination of synthetic cathinones in oral fluid samples by microextraction by packed sorbent and liquid chromatography-tandem mass spectrometry. Forensic Toxicol 2024; 42:18-30. [PMID: 37505359 DOI: 10.1007/s11419-023-00671-z] [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: 04/19/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE We developed and validated a method for quantitative analysis of ten synthetic cathinones in oral fluid (OF) samples, using microextraction by packed sorbent (MEPS) for sample preparation followed by liquid chromatography‒tandem mass spectrometry (LC‒MS/MS). METHOD OF samples were collected with a Quantisal™ device and 200 µL was extracted using a C18 MEPS cartridge installed on a semi-automated pipette and then analyzed using LC‒M/SMS. RESULTS Linearity was achieved between 0.1 and 25 ng/mL, with a limit of detection (LOD) of 0.05 ng/mL and a limit of quantification (LOQ) of 0.1 ng/mL. Imprecision (% relative standard deviation) and bias (%) were better than 11.6% and 7.5%, respectively. The method had good specificity and selectivity against 9 different blank OF samples (from different donors) and 68 pharmaceutical and drugs of abuse with concentrations varying between 400 and 10,000 ng/mL. No evidence of carryover was observed. The analytes were stable after three freeze/thaw cycles and when kept in the autosampler (10 °C) for up to 24 h. The method was successfully applied to quantify 41 authentic positive samples. Methylone (mean 0.6 ng/mL, median 0.2 ng/mL), N-ethylpentylone (mean 16.7 ng/mL, median 0.35 ng/mL), eutylone (mean 39.1 ng/mL, median 3.6 ng/mL), mephedrone (mean 0.5 ng/mL, median 0.5 ng/mL), and 4-chloroethcathinone (8.1 ng/mL) were quantified in these samples. CONCLUSION MEPS was an efficient technique for Green Analytical Toxicology purposes, which required only 650 µL organic solvent and 200 µL sodium hydroxide, and the BIN cartridge had a lifespan of 100 sample extractions.
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Affiliation(s)
- Kelly Francisco da Cunha
- Campinas Poison Control Center, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, 13083‑859, Brazil
- Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, 13083‑859, Brazil
| | - Karina Diniz Oliveira
- Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, 13083‑859, Brazil
| | - Jose Luiz Costa
- Campinas Poison Control Center, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, 13083‑859, Brazil.
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, São Paulo, 13083‑859, Brazil.
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Cruz SL, Bencomo-Cruz M, Medina-Mora ME, Vázquez-Quiroz F, Fleiz-Bautista C. First drug-checking study at an electronic festival and fentanyl detection in the central region of Mexico. Harm Reduct J 2023; 20:174. [PMID: 38053148 PMCID: PMC10698886 DOI: 10.1186/s12954-023-00905-8] [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: 04/05/2023] [Accepted: 11/17/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Perception of drug adulteration has increased in Mexico, but there is little research on adulterants and toxicity. The aim of this study was to identify drug composition in an electronic music outdoor festival nearby Mexico City. METHODS The participants completed a questionnaire with demographic data, harm reduction strategies, drug-use patterns, history, and the drug they expected to find. We took a small sample of each substance and prepared it for drug checking. A two-section drug testing station was placed within the grounds of the festival. Interaction with participants occurred at the front part. Drug checking was conducted at the rear part. The service was free of charge, voluntary and confidential. Forty persons aged 22 to 48 years participated (mode = 28), of which 92.5% were male, most (82.5%) were single. Through the Substance Analysis Program of "ReverdeSer Collective," we conducted the testing with the attendants that provided 51 drug samples, following ethical and biosafety protocols. We used colorimetry, Fourier Transform Infrared Spectroscopy, and fentanyl immunoassay strips for sample analysis. RESULTS Substances of choice among attendants were psychostimulants (MDMA and other amphetamine-like drugs) and hallucinogens. Most samples contained what the users expected plus adulterants. Main adulterants were methylene-dioxy-ethyl-amphetamine, methylene-dioxy-propyl-amphetamine, hydroxyamphetamine, and the selective serotonin reuptake inhibitor venlafaxine. Fentanyl was present in 2 out of 4 cocaine samples and in 14 of the 22 confirmed MDMA samples. CONCLUSIONS Some of the adulterants found pose serious health risks, especially fentanyl, amphetamine-like substances, and venlafaxine. Therefore, it is urgent to monitor these adulterants at electronic music festivals and to implement prevention, treatment, and harm reduction public policies. Naloxone distribution and drug-assisted therapies should be part of government programs in Mexico.
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Affiliation(s)
- Silvia L Cruz
- Department of Pharmacobiology, Center for Research and Advanced Studies (Cinvestav), Mexico City, Mexico
- Opioids Working Group. Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Miguel Bencomo-Cruz
- Substance Analysis Program-Deliberar A. C. and ReverdeSer Collective A. C., Mexico City, Mexico
| | - María E Medina-Mora
- Opioids Working Group. Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
- Faculty of Psychology Director, National Autonomous University of Mexico, Mexico City, Mexico
- National Institute of Psychiatry Ramon de la Fuente Muñiz (INPRFM), Calzada México-Xochimilco 101 Col. San Lorenzo Huipulco, 14370, Mexico City, Mexico
| | - Fabiola Vázquez-Quiroz
- National Institute of Psychiatry Ramon de la Fuente Muñiz (INPRFM), Calzada México-Xochimilco 101 Col. San Lorenzo Huipulco, 14370, Mexico City, Mexico
| | - Clara Fleiz-Bautista
- Opioids Working Group. Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
- National Institute of Psychiatry Ramon de la Fuente Muñiz (INPRFM), Calzada México-Xochimilco 101 Col. San Lorenzo Huipulco, 14370, Mexico City, Mexico.
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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.
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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
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Sprega G, Di Giorgi A, Poyatos L, Papaseit E, Pérez-Mañá C, Tini A, Pichini S, Busardò FP, Lo Faro AF, Farré M. Usefulness of Oral Fluid for Measurement of Methylone and Its Metabolites: Correlation with Plasma Drug Concentrations and the Effect of Oral Fluid pH. Metabolites 2023; 13:metabo13040468. [PMID: 37110127 PMCID: PMC10143603 DOI: 10.3390/metabo13040468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
The aim of this study was to investigate methylone and its metabolites concentration in oral fluid following controlled increasing doses, focusing on the effect of oral fluid pH. Samples were obtained from a clinical trial where twelve healthy volunteers participated after ingestion of 50, 100, 150 and 200 mg of methylone. Concentration of methylone and its metabolites 4-hydroxy-3-methoxy-N-methylcathinone (HMMC) and 3,4-methylenedioxycathinone in oral fluid were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Pharmacokinetic parameters were estimated, and the oral fluid-to-plasma ratio (OF/P) at each time interval was calculated and correlated with the oral fluid pH using data from our previous study in plasma. Methylone was detected at all time intervals after each dose; MDC and HMMC were not detectable after the lowest dose. Oral fluid concentrations of methylone ranged between 88.3-503.8, 85.5-5002.3, 182.8-13,201.8 and 214.6-22,684.6 ng/mL following 50, 100, 150 and 200 mg doses, respectively, peaked between 1.5 and 2.0 h, and were followed by a progressive decrease. Oral fluid pH was demonstrated to be affected by methylone administration. Oral fluid is a valid alternative to plasma for methylone determination for clinical and toxicological studies, allowing for a simple, easy and non-invasive sample collection.
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Affiliation(s)
- Giorgia Sprega
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Alessandro Di Giorgi
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Lourdes Poyatos
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallés, Spain
| | - Esther Papaseit
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), 08193 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), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallés, Spain
| | - Anastasio Tini
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Magí Farré
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallés, Spain
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Van Dyck E, Ponnet K, Van Havere T, Hauspie B, Dirkx N, Schrooten J, Waldron J, Grabski M, Freeman TP, Curran HV, De Neve J. Substance Use and Attendance Motives of Electronic Dance Music (EDM) Event Attendees: A Survey Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20031821. [PMID: 36767188 PMCID: PMC9914168 DOI: 10.3390/ijerph20031821] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/12/2023] [Accepted: 01/15/2023] [Indexed: 06/01/2023]
Abstract
EDM event attendees are a high-risk population for substance use and associated adverse effects. The aim of this study was to examine substance use at EDM events, focusing on associations between attendance motives and substance use. Sociodemographic characteristics, event specifics, past-year use, and attendance motives were assessed through an online survey. Participants were 1345 Belgian EDM event attendees (69.44% male, Mage = 22.63, SDage = 4.03). Ecstasy/MDMA/Molly (52.28%), other synthetic hallucinogens (53.68%), ketamine (42.13%), amphetamines (40.45%), and alkyl nitrites (poppers) (32.76%) were most frequently used at festivals/outdoor parties/raves. In nightclubs, cocaine (32.29%) was shown to be prevalent as well, while other synthetic hallucinogens (15.79%) were less often consumed. At events with a more private character, cannabis (68.88%) and magic mushrooms (66.44%) were most frequently used. Aside from alcohol (47.76%), substance use in pubs/bars was negligible. Overall enjoyment was demonstrated to be the key attendance motive, which was succeeded by those relating to music and socialization. A wide range of motives proved to be more important to users (e.g., dance, exploration, escapism, excitement, alcohol, drugs) than non-users, while some were associated with the use of particular substances. The prevalence of substance use was shown to be dependent on the specifics of the setting. Moreover, the idea of a three-dimensional classification of the most principal motives for music event attendance was supported. Finally, correlations were estimated between attendance motives and substance use as well as specific substances. Results could enable more tailored approaches in prevention and harm reduction efforts as well as event management strategies.
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Affiliation(s)
- Edith Van Dyck
- Institute for Psychoacoustics and Electronic Music (IPEM), Department of Art History, Musicology and Theatre Studies, Ghent University, 9000 Ghent, Belgium
| | - Koen Ponnet
- Research Group for Media, Innovation and Communication Technologies, Department of Communication Sciences, IMEC-MICT, Ghent University, 9000 Ghent, Belgium
| | - Tina Van Havere
- Substance Use and Psychosocial Risk Behaviours (SUPR-B), University of Applied Sciences and Arts, 9000 Ghent, Belgium
| | - Bert Hauspie
- Research Group for Media, Innovation and Communication Technologies, Department of Communication Sciences, IMEC-MICT, Ghent University, 9000 Ghent, Belgium
- Substance Use and Psychosocial Risk Behaviours (SUPR-B), University of Applied Sciences and Arts, 9000 Ghent, Belgium
| | - Nicky Dirkx
- Substance Use and Psychosocial Risk Behaviours (SUPR-B), University of Applied Sciences and Arts, 9000 Ghent, Belgium
| | | | - Jon Waldron
- Clinical Psychopharmacology Unit, University College London, London WC1E 7HB, UK
| | - Meryem Grabski
- Clinical Psychopharmacology Unit, University College London, London WC1E 7HB, UK
| | - Tom P. Freeman
- Clinical Psychopharmacology Unit, University College London, London WC1E 7HB, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath BA2 7AY, UK
| | - Helen Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London WC1E 7HB, UK
| | - Jan De Neve
- Department of Data-Analysis, Ghent University, 9000 Ghent, Belgium
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9
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Madia MAO, de Oliveira LO, Baccule NS, Sakurada JY, Scanferla DTP, Aguera RG, Moreira PP, Bando É, Junior MM, Marchioni C, Mossini SAG. Amphetamine, methamphetamine, and MDMA in hair samples from a rehabilitation facility: Validation and applicability of HF-LPME-GC-MS. J Pharmacol Toxicol Methods 2023; 119:107212. [PMID: 36028047 DOI: 10.1016/j.vascn.2022.107212] [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: 05/05/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION It is known that drug abuse jeopardizes economic and social development. Toxicological analyses can guide prevention and treatment strategies in rehabilitation facilities. The current greatest challenge is finding easily adaptable and less costly sensitive methods that meet the principles of green chemistry. Hair, as a biological matrix, has several advantages, and its ability to detect consumption for longer periods keeping the matrix stable and unaltered stands out. This manuscript addresses the use of a miniaturized technique in an alternative matrix, by making use of a reduced amount of solvents to quantify amphetamines, aiming to guide prevention and treatment strategies in rehabilitation facilities. METHODS A Hollow Fiber Liquid-phase Microextraction (HF-LPME) technique for extracting amphetamines from hair samples with Gas Chromatography-Mass Spectrometry (CG-MS) was validated, adapted, and applied to ten samples from patients of a rehabilitation facility. RESULTS The technique proved to be sensitive, accurate, precise, and not affected by interference from the biological matrix and the linear range for the analytes was 0.2 to 20 ng mg -1. The three analytes were quantified in the samples analyzed. It is worth stressing that the patients were young. CONCLUSION The HF-LPME-GC-MS technique complied with the principles of green chemistry, and proved to be a sensitive technique, adaptable to the routine of common laboratories. Validation in the analysis phase with authentic samples, thus, showed that it can be an important tool for preventing and controlling drug addiction.
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Affiliation(s)
- Mariana A O Madia
- Program on Bioscience and Physiopathology, State University of Maringá, Maringá - Paraná, Brazil, Avenida Colombo, 5790, Bloco I90 - sala 102B. Jardim Universitário, 87020-900 Maringá - Paraná, Brazil.
| | - Luís O de Oliveira
- Program on Bioscience and Physiopathology, State University of Maringá, Maringá - Paraná, Brazil, Avenida Colombo, 5790, Bloco I90 - sala 102B. Jardim Universitário, 87020-900 Maringá - Paraná, Brazil; State University of Maringá, Maringá - Paraná, Brazil, Avenida Colombo, 5790, Bloco I90 - sala 102B. Jardim Universitário, 87020-900 Maringá - Paraná, Brazil
| | - Nicole S Baccule
- State University of Maringá, Maringá - Paraná, Brazil, Avenida Colombo, 5790, Bloco I90 - sala 102B. Jardim Universitário, 87020-900 Maringá - Paraná, Brazil
| | - Jéssica Y Sakurada
- State University of Maringá, Maringá - Paraná, Brazil, Avenida Colombo, 5790, Bloco I90 - sala 102B. Jardim Universitário, 87020-900 Maringá - Paraná, Brazil
| | - Deborah T P Scanferla
- Program on Bioscience and Physiopathology, State University of Maringá, Maringá - Paraná, Brazil, Avenida Colombo, 5790, Bloco I90 - sala 102B. Jardim Universitário, 87020-900 Maringá - Paraná, Brazil
| | - Raul G Aguera
- Program on Bioscience and Physiopathology, State University of Maringá, Maringá - Paraná, Brazil, Avenida Colombo, 5790, Bloco I90 - sala 102B. Jardim Universitário, 87020-900 Maringá - Paraná, Brazil
| | - Paula P Moreira
- Program on Bioscience and Physiopathology, State University of Maringá, Maringá - Paraná, Brazil, Avenida Colombo, 5790, Bloco I90 - sala 102B. Jardim Universitário, 87020-900 Maringá - Paraná, Brazil
| | - Érika Bando
- Laboratory of Toxicology. Department of Basic Health Sciences, State University of Maringá, Maringá - Paraná, Brazil, Avenida Colombo, 5790, Bloco I90 - sala 102B. Jardim Universitário, 87020-900 Maringá - Paraná, Brazil
| | - Miguel Machinski Junior
- Laboratory of Toxicology. Department of Basic Health Sciences, State University of Maringá, Maringá - Paraná, Brazil, Avenida Colombo, 5790, Bloco I90 - sala 102B. Jardim Universitário, 87020-900 Maringá - Paraná, Brazil
| | - Camila Marchioni
- Department of Pathology, Federal University of Santa Catarina, Florianopolis - Santa Catarina, Brazil, R. Eng. Agronômico Andrei Cristian Ferreira, s/n - Trindade, 88040-900 Florianópolis - Santa Catarina, Brazil
| | - Simone A G Mossini
- Program on Bioscience and Physiopathology, State University of Maringá, Maringá - Paraná, Brazil, Avenida Colombo, 5790, Bloco I90 - sala 102B. Jardim Universitário, 87020-900 Maringá - Paraná, Brazil; State University of Maringá, Maringá - Paraná, Brazil, Avenida Colombo, 5790, Bloco I90 - sala 102B. Jardim Universitário, 87020-900 Maringá - Paraná, Brazil
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10
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Sottile JE, Macia KS, Wickham RE, Haug NA. Development and initial validation of an MDMA/Ecstasy motives assessment. Addict Behav 2023; 136:107494. [PMID: 36162335 DOI: 10.1016/j.addbeh.2022.107494] [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: 05/16/2022] [Revised: 08/11/2022] [Accepted: 09/14/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE MDMA/Ecstasy motives differ from those of other substances such as alcohol, cannabis, and methamphetamine. Previous literature on alcohol and cannabis use identified social, expansion, enhancement, coping, and conformism as primary motives for use. MDMA/Ecstasy users also report using the drug for increases in self-awareness and energy. The development of an MDMA/Ecstasy use motives assessment has potential to inform treatment interventions and public policy on harm reduction. METHOD An MDMA/Ecstasy use motives assessment was developed from alcohol and cannabis motives measures and qualitative feedback from MDMA/Ecstasy users. Participants included an international sample of adults (N = 1754) who completed an online questionnaire regarding their motives for using recreational MDMA/Ecstasy. RESULTS Exploratory and confirmatory factor analysis supported a 4-factor MDMA/Ecstasy motives scale. The four motive scales showed good internal consistency reliabilitySocial (α = 0.88) Expansion (α = 0.81), Coping (α = 0.82), and Energy (α = 0.75). Conformity and Enhancement did not emerge as significant factors. Analyses demonstrated convergent and discriminant validity with relevant constructs including quantity/frequency of use, MDMA use disorder, sensation seeking personality, and positive and negative consequences of use. CONCLUSIONS MDMA/Ecstasy use motives differ from those of other substances due to the distinctly stimulating, emotional, and empathic effects sought by users. By identifying salient MDMA/Ecstasy motives, this study highlights the unique aspects of recreational MDMA/Ecstasy use. This research has utility for informing clinical practice and contributing to public health harm reduction efforts.
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Affiliation(s)
- James E Sottile
- Department of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304 USA
| | - Kathryn S Macia
- National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025 USA
| | - Robert E Wickham
- Department of Psychological Sciences, Northern Arizona University, S San Francisco Street, Flagstaff, AZ 86011 USA
| | - Nancy A Haug
- Department of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304 USA.
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11
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Risky Party and Nightclub Attendance during the COVID-19 Nightlife Shutdown in New York City. J Urban Health 2022; 99:900-908. [PMID: 35672545 PMCID: PMC9172973 DOI: 10.1007/s11524-022-00657-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 11/22/2022]
Abstract
From March 2020 through May 2021, nightlife venues were shut down and large gatherings were deemed illegal in New York City (NYC) due to COVID-19. This study sought to determine the extent of risky party attendance during the COVID-19 shutdown among people who attend electronic dance music parties in NYC. During the first four months that venues were permitted to reopen (June through September 2021), time-space sampling was used to survey adults (n = 278) about their party attendance during the first year of the shutdown (March 2020-March 2021). We examined prevalence and correlates of attendance and mask-wearing at such parties. A total of 43.9% attended private parties with more than 10 people, 27.3% attended nightclubs, and 20.5% attended other parties such as raves. Among those who attended any, 32.3% never wore a mask and 19.3% reported attending parties in which no one wore a mask. Past-year ecstasy use was associated with increased risk for attending private (aPR = 1.51, 95% CI: 1.00-2.28) or other parties (aPR = 2.75, 95% CI: 1.48-5.13), and use of 2C series drugs was associated with increased risk for attending nightclubs (aPR = 2.67, 95% CI: 1.24-5.77) or other parties (aPR = 2.50, 95% CI: 1.06-5.87). Attending >10 parties was associated with increased risk for never wearing a mask (aPR = 2.74, 95% CI: 1.11-6.75) and for no other attendees wearing masks (aPR = 4.22, 95% CI: 1.26-14.07). Illegal dance parties continued in NYC during the COVID-19 shutdown. Prevention and harm reduction efforts to mitigate risk of COVID-19 transmission during such shutdowns are sorely needed.
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12
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Scanferla DTP, Sano Lini R, Marchioni C, Mossini SAG. Drugs of abuse: A narrative review of recent trends in biological sample preparation and chromatographic techniques. Forensic Chem 2022. [DOI: 10.1016/j.forc.2022.100442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Mohr ALA, Logan BK, Fogarty MF, Krotulski AJ, Papsun DM, Kacinko SL, Huestis MA, Ropero-Miller JD. Reports of Adverse Events Associated with Use of Novel Psychoactive Substances, 2017-2020: A Review. J Anal Toxicol 2022; 46:e116-e185. [PMID: 35445267 PMCID: PMC9282356 DOI: 10.1093/jat/bkac023] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/17/2022] [Accepted: 04/20/2022] [Indexed: 12/15/2022] Open
Abstract
An important role of modern forensic and clinical toxicologists is to monitor the adverse events of novel psychoactive substances (NPS). Following a prior review from 2013 to 2016, this critical literature review analyzes and evaluates published case reports for NPS from January 2017 through December 2020. The primary objective of this study is to assist in the assessment and interpretation of these cases as well as provide references for confirmation methods. Chemistry, pharmacology, adverse events and user profiles (e.g., polypharmacy) for NPS are provided including case history, clinical symptoms, autopsy findings and analytical results. Literature reviews were performed in PubMed and Google Scholar for publications using search terms such as NPS specific names, general terms (e.g., 'designer drugs' and 'novel psychoactive substances'), drug classes (e.g., 'designer stimulants') and outcome-based terms (e.g., 'overdose' and 'death'). Government and website drug surveillance databases and abstracts published by professional forensic science organizations were also searched. Toxicological data and detailed case information were extracted, tabulated, analyzed and organized by drug category. Case reports included overdose fatalities (378 cases), clinical treatment and hospitalization (771 cases) and driving under the influence of drugs (170 cases) for a total of 1,319 cases providing details of adverse events associated with NPS. Confirmed adverse events with associated toxidromes of more than 60 NPS were reported including synthetic cannabinoid, NPS stimulant, NPS hallucinogen, NPS benzodiazepine and NPS opioid cases. Fifty of these NPS were reported for the first time in January 2017 through December 2020 as compared to the previous 4 years surveyed. This study provides insight and context of case findings described in the literature and in digital government surveillance databases and websites during a recent 4-year period. This review will increase the awareness of adverse events associated with NPS use to better characterize international emerging drug threats.
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Affiliation(s)
- Amanda L A Mohr
- Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, PA 19090, USA
| | - Barry K Logan
- Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, PA 19090, USA
- NMS Labs, 200 Welsh Rd, Horsham, PA 19044, USA
| | - Melissa F Fogarty
- Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, PA 19090, USA
| | - Alex J Krotulski
- Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, PA 19090, USA
| | | | | | - Marilyn A Huestis
- Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, PA 19090, USA
- Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Jeri D Ropero-Miller
- RTI International, Center for Forensic Sciences, 3040 East Cornwallis Rd, Research Triangle Park, NC 27709, USA
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14
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Pascual-Caro S, Borrull F, Calull M, Aguilar C. Recent chromatographic and electrophoretic based methods for determining drugs of abuse in urine and oral fluid: A review from 2018 to June 2021. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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15
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Nakamura M, Takaso M, Takeda A, Hitosugi M. A fatal case of intoxication from a single use of eutylone: clinical symptoms and quantitative analysis results. Leg Med (Tokyo) 2022; 58:102085. [DOI: 10.1016/j.legalmed.2022.102085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/26/2022]
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16
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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.
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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
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17
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Glatfelter GC, Walther D, Evans-Brown M, Baumann MH. Eutylone and Its Structural Isomers Interact with Monoamine Transporters and Induce Locomotor Stimulation. ACS Chem Neurosci 2021; 12:1170-1177. [PMID: 33689284 DOI: 10.1021/acschemneuro.0c00797] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Synthetic cathinones are a class of new psychoactive substances that induce psychostimulant effects and pose risk for hospitalizations, overdose, and death. At the present time, derivatives of the synthetic cathinone, methylone, are being confiscated in nonmedical (i.e., recreational) drug markets worldwide. In particular, eutylone is a newly emerging methylone analog that possesses ethyl groups at the α-carbon and amine positions. Little information is available about the pharmacological effects of eutylone, but based on its structure, we surmised that the compound interacts with monoamine transporters in the brain. To test this hypothesis, we compared the effects of eutylone and its structural isomers, dibutylone and pentylone, using in vitro transporter assays in rat brain synaptosomes and in vivo locomotor activity assessments in mice. All drugs displayed dose-related inhibition of [3H]neurotransmitter uptake at dopamine transporters (DAT) and norepinephrine transporters (NET), but effects at DAT were 10-fold more potent (IC50 = 120 nM). Eutylone and pentylone inhibited uptake at serotonin transporters (SERT), while dibutylone did not. Additionally, eutylone and pentylone displayed weak partial releasing actions at SERT which achieved 50% of maximal response. All drugs stimulated dose-related locomotion in mice, and eutylone was most potent and efficacious in this regard (ED50 = 2 mg/kg, sc). Our results demonstrate that eutylone is a hybrid transporter compound with uptake inhibition properties at DAT and NET but substrate activity at SERT. The effects of eutylone are similar to those produced by pentylone, which suggests that eutylone will exhibit abuse liability and pose risks for psychostimulant side-effects in human users.
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Affiliation(s)
- Grant C. Glatfelter
- Designer Drug Research Unit, National Institute on Drug Abuse Intramural Research Program, 333 Cassell Drive, Baltimore, Maryland 21224, United States
| | - Donna Walther
- Designer Drug Research Unit, National Institute on Drug Abuse Intramural Research Program, 333 Cassell Drive, Baltimore, Maryland 21224, United States
| | - Michael Evans-Brown
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), 1249-289 Lisbon, Portugal
| | - Michael H. Baumann
- Designer Drug Research Unit, National Institute on Drug Abuse Intramural Research Program, 333 Cassell Drive, Baltimore, Maryland 21224, United States
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18
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Scott IA, Scott RJ. Pill testing at music festivals: is it evidence-based harm reduction? Intern Med J 2021; 50:395-402. [PMID: 31908122 DOI: 10.1111/imj.14742] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 12/19/2019] [Accepted: 12/29/2019] [Indexed: 01/12/2023]
Abstract
Recent pill-related deaths of young people at music festivals in Australia have led to a concerted push for on-site pill testing as a means for preventing such events. However, whether pill testing (also termed 'safety checking') is an effective harm reduction strategy remains uncertain. This narrative review concludes that pill testing currently lacks evidence of efficacy sufficient to justify publicly funded national roll-out of on-site pill-testing programmes. Australian governments, addiction specialists and public health experts should collaborate in conducting properly designed field studies aimed at confirming clear benefits from such programmes in reducing pill-related harm.
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Affiliation(s)
- Ian A Scott
- Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Russ J Scott
- Prison Mental Health Services, Queensland Health, Brisbane, Queensland, Australia
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19
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Krotulski AJ, Papsun DM, Chronister CW, Homan J, Crosby MM, Hoyer J, Goldberger BA, Logan BK. Eutylone Intoxications-An Emerging Synthetic Stimulant in Forensic Investigations. J Anal Toxicol 2021; 45:8-20. [PMID: 33325503 DOI: 10.1093/jat/bkaa113] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/14/2020] [Accepted: 08/19/2020] [Indexed: 11/13/2022] Open
Abstract
Synthetic stimulants are the largest class of novel psychoactive substances identified each year by forensic laboratories internationally. While hundreds of these drugs appear in drug powders, only a few proliferate in use among forensically relevant populations and eventually emerge in postmortem and clinical investigations. Beta-keto-methylenedioxyamphetamines (i.e., novel psychoactive substances with names ending in "ylone") are currently the most popular subclass of synthetic stimulants. Leading up to its federal scheduling in 2018, N-ethyl pentylone was the most encountered synthetic stimulant. The popularity of N-ethyl pentylone declined once it was scheduled, but it was quickly replaced by eutylone (bk-EBDB), a structurally related analog from the same family. In cases encountered between January 2019 and April 2020, eutylone was quantitatively confirmed in 83 forensic investigations, including postmortem cases and driving under the influence of drugs cases. Matrix types included blood, urine and tissue. Eutylone was identified in cases submitted from 13 states, demonstrating proliferation around the United States; Florida accounted for 60% of the positive cases. The mean concentration of eutylone in postmortem blood was 1,020 ng/mL (standard deviation = ±2,242 ng/mL; median = 110 ng/mL, range = 1.2-11,000 ng/mL, n = 67). The mean concentration of eutylone in blood from driving under the influence of drugs cases was 942 ng/mL (standard deviation = ±1,407 ng/mL; median = 140 ng/mL, range = 17-3,600 ng/mL, n = 7). This report includes cause and manner of death data for 22 postmortem cases. Further analysis of authentic human specimens revealed the presence of three eutylone metabolites, including one unique biomarker and one metabolite in common with butylone. Laboratories should be aware that eutylone may be present in cases of suspected Ecstasy, "Molly" and/or methylenedioxymethamphetamine use, causing or contributing to impairment or death.
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Affiliation(s)
- Alex J Krotulski
- Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, Willow Grove, PA 19090, USA
| | | | - Chris W Chronister
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA
| | - Joseph Homan
- NMS Labs, Toxicology Department, Horsham, PA 19044, USA
| | - Michele M Crosby
- Department of Chemistry, Biochemistry and Physics, University of Tampa, Tampa, FL 33606, USA
| | - Jennifer Hoyer
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA
| | - Bruce A Goldberger
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA
| | - Barry K Logan
- NMS Labs, Toxicology Department, Horsham, PA 19044, USA
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20
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Palamar JJ, Salomone A, Rutherford C, Keyes KM. Extensive Underreported Exposure to Ketamine Among Electronic Dance Music Party Attendees. J Gen Intern Med 2021; 36:235-237. [PMID: 31997140 PMCID: PMC7858731 DOI: 10.1007/s11606-020-05672-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/12/2019] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
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, TO, Italy
| | - 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
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21
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Palamar JJ, Acosta P. Virtual raves and happy hours during COVID-19: New drug use contexts for electronic dance music partygoers. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 93:102904. [PMID: 32861536 PMCID: PMC7448780 DOI: 10.1016/j.drugpo.2020.102904] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 01/22/2023]
Abstract
Background The popularity of virtual raves and happy hours has increased during the COVID-19 pandemic. While nightlife settings are often associated with drug use, it is unknown whether virtual events are associated with use. Methods Electronic dance music (EDM) partygoers who live in New York and reported recent drug use were recruited online and screened for eligibility throughout April and May 2020. Eligible adults (n = 128) were asked about virtual rave and happy hour attendance during the COVID-19 crisis. We examined prevalence and correlates of drug use during such events. Results 55.5% of participants attended virtual raves and 69.5% attended virtual happy hours. 40.9% used illegal drugs during virtual raves and the most frequently used drugs were cannabis (29.6%), ecstasy/MDMA/Molly (8.5%), LSD (7.0%), and cocaine (4.2%). 33.7% used illegal drugs during virtual happy hours and the most frequently used drugs were cannabis (29.2%), cocaine (3.4%), and ketamine (3.4%). Older participants were more likely to use illegal drugs during virtual raves, and those reporting past-year use of more drugs were more likely to use drugs during virtual raves and/or happy hours (ps<0.05). Conclusions EDM partygoers are at risk for using drugs during virtual events. Results can inform prevention and harm reduction efforts.
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Affiliation(s)
- Joseph J Palamar
- New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, Room 1752, New York 10016, NY, USA.
| | - Patricia Acosta
- New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, Room 1752, New York 10016, NY, USA
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22
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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).
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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
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23
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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.
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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
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Abstract
PURPOSE OF REVIEW Drug checking services invite drug consumers to anonymously submit drug samples for chemical analysis and provide feedback of results. Drugs are tested for strength/dose and/or presence of adulterants. Drug checking appears to be more common in recent years in response to increases in fentanyl-related deaths and the proliferation of new psychoactive substances (NPS). We aim to provide information regarding the current state of drug checking in relation to analysis methods, adulteration rates, and behavioral responses to results. RECENT FINDINGS Various technologies are being used to detect the presence of fentanyl, its analogs, and other NPS in drug samples. Proxy drug checking, which we define as biospecimen testing for drug exposure postconsumption, is also becoming common. However, there appears to a dichotomy between research focusing on populations at high risk for fentanyl exposure and to exposure to NPS such as synthetic cathinones. SUMMARY Drug checking research and services largely focus on opioid consumers and nightclub and dance festival attendees, but more focus may be needed on the general population. Drug checking results can inform surveillance efforts, and more research is needed to overcome barriers to drug checking and to focus on whether test results indeed affect behavior change.
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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.
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Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine , New York, NY, USA
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26
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Palamar JJ, Keyes KM. Trends in drug use among electronic dance music party attendees in New York City, 2016-2019. Drug Alcohol Depend 2020; 209:107889. [PMID: 32050110 PMCID: PMC7127946 DOI: 10.1016/j.drugalcdep.2020.107889] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Electronic dance music (EDM) party attendees are a high-risk population for drug use and associated adverse effects. We examined trends in past-year drug use within this population to better inform prevention and harm reduction efforts. METHODS Each summer from 2016 through 2019, we used time-space sampling to survey a cross-section of adults entering EDM parties at randomly selected nightclubs and at dance festivals in New York City. Ns ranged from 504 (2019) to 1,087 (2016). We estimated log-linear trends in past-year use of 16 different synthetic drugs or drug classes. RESULTS Between 2016 and 2019, estimated past-year prevalence of use of ketamine increased from 5.9% to 15.3% (a 157.6% relative increase; P = .007), LSD use increased from 9.9% to 16.6% (a 67.7% relative increase, P < .001), powder cocaine use increased from 17.3% to 35.2% (a 103.5% relative increase, P < .001), and GHB use increased from 1.0% to 4.2% (a 311.8% relative increase; P = .002). Past-year use of >3 drugs increased from 12.7% to 20.5% (a 61.4% relative increase; P = .013); however, estimated past-year use of unknown powders decreased from 2.0% to 1.1% (a relative 44.7% decrease; P = .038) and ecstasy/MDMA/Molly use was stable across years (at 25.0 to 28.5 %; P = .687). CONCLUSIONS Reports of powder cocaine, LSD, ketamine, and GHB are becoming more prevalent among EDM party attendees. Prevention and harm reduction efforts are needed to address increasing use. Research is also needed to examine whether increasing media coverage of medical use of ketamine and other psychedelics affects prevalence of recreational use.
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Affiliation(s)
- Joseph J. Palamar
- New York University School of Medicine, Department of Population Health, New York, NY
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
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27
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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
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28
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Quadrupole Time-of-Flight Mass Spectrometry: A Paradigm Shift in Toxicology Screening Applications. Clin Biochem Rev 2019; 40:135-146. [PMID: 31530964 DOI: 10.33176/aacb-19-00023] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The screening of biological samples for the presence of illicit or legal substances is an important frontline tool in both clinical and forensic toxicology. In the clinical setting, drug screening is a useful tool for the clinician in improving patient care and guiding treatment. Analytical approaches for the screening of drugs in biological samples are extensive and well documented, though many rapid screening techniques often lack appropriate sensitivity and specificity, requiring careful clinical interpretation. The continuous emergence of new psychoactive substances presents a considerable analytical challenge in maintaining up-to-date methods for the detection of relevant drugs. Adapting and validating methods for the detection of new substances can be a complicated and costly undertaking. There is also a considerable lag time between the emergence of new drugs and the release of commercial assays for detection. Quadrupole time-of-flight mass spectrometry (Q-TOF-MS) has gained considerable attention over the last decade as an analytical technique that is capable of meeting the challenges of a rapidly changing drug landscape. Exhibiting both high sensitivity and specificity in drug detection, Q-TOF-MS also allows methods to be rapidly updated for newly emerging psychoactive agents. The coupling of Q-TOF-MS with techniques such as liquid or gas chromatography can provide both rapid and comprehensive screening solutions that are gaining popularity in the clinical laboratory setting.
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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]
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"Flakka" use among high school seniors in the United States. Drug Alcohol Depend 2019; 196:86-90. [PMID: 30709657 PMCID: PMC6377311 DOI: 10.1016/j.drugalcdep.2018.12.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Use of synthetic cathinones, commonly referred to as "bath salts", has been associated with tens of thousands of emergency department visits in the US; however, few national studies have estimated prevalence of use and we know very little about use among adolescents. In this study we estimate prevalence and correlates of use of "Flakka" (alpha-PVP), a highly-potent "bath salt" associated with at least 80 deaths in the US. METHODS We analyzed data from the 2016/2017 Monitoring the Future study, which surveyed a nationally representative sample of high school seniors in the US (n = 3786). Bivariable and multivariable models were used to determine demographic and drug-related correlates of use. RESULTS Overall, 0.8% (95% CI: 0.5-1.2) of high school seniors in 2016/2017 is estimated to have used Flakka in the past year. Students whose parents have less than a high school education were at higher odds for use (aOR = 4.12, 95% CI: 1.00-16.94). Flakka users reported high prevalence of use of other drugs, particularly synthetic cannabinoids (85.6%), ketamine (72.3%), marijuana (59.1%), and GHB (47.5%). Flakka use was also associated with use of a higher number of other drugs and higher frequency of use of other drugs, with 51.7% using 4-12 other drugs and 22.4% using 4-12 other drugs >6 times. CONCLUSIONS Students who use multiple drugs are elevated risk for Flakka use, suggesting synthetic cathinone use alone is rare and the use of multiple substances may compound adverse effects of these drugs. Socio-economic disparities are concerning given reduced access to prevention and intervention.
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