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Norman C, Schwelm HM, Semenova O, Reid R, Marland V, Nic Daéid N. Detection of the synthetic cathinone N,N-dimethylpentylone in seized samples from prisons. Forensic Sci Int 2024; 361:112145. [PMID: 38991327 DOI: 10.1016/j.forsciint.2024.112145] [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: 04/25/2024] [Revised: 07/02/2024] [Accepted: 07/08/2024] [Indexed: 07/13/2024]
Abstract
Drug use is prevalent in prisons with drugs associated with depressant effects found to be more prevalent than stimulants. Synthetic cathinones (SCats; often sold as "bath salts", "ecstasy", "molly", and "monkey dust") are the second largest category of new psychoactive substances (NPS) currently monitored by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and are commonly used as substitutes for regulated stimulants, such as amphetamine, cocaine, and MDMA. N,N-dimethylpentylone (also known as dimethylpentylone, dipentylone, and bk-DMBDP) was detected for the first time in the Scottish prisons in seven powder samples seized between January and July 2023. Samples were analyzed using gas chromatography-mass spectrometry (GC-MS), ultra-high performance liquid chromatography-quadrupole time of flight mass spectrometry (UPLC-QToF-MS), and nuclear magnetic resonance imaging (NMR). Dimethylpentylone was detected alongside other drugs in four samples, including the novel benzodiazepine desalkylgidazepam (bromonordiazepam) and the synthetic cannabinoid receptor agonists (SCRAs) MDMB-INACA and MDMB-4en-PINACA.
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Affiliation(s)
- Caitlyn Norman
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK; Department of Biomedical and Clinical Science, Division of Clinical Chemistry and Pharmacology, Linköping University, Linköping, Sweden.
| | - Hannes Max Schwelm
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Olga Semenova
- Drug Discovery Unit, School of Life Sciences, University of Dundee, Dundee, UK
| | - Robert Reid
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Victoria Marland
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Niamh Nic Daéid
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
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Chiappini S, Vaccaro G, Mosca A, Miuli A, Stigliano G, Stefanelli G, Giovannetti G, Carullo R, d'Andrea G, Di Carlo F, Cavallotto C, Pettorruso M, Di Petta G, Corkery JM, Guirguis A, Stair JL, Martinotti G, Fazel S, Schifano F. New trends of drug abuse in custodial settings: A systematic review on the misuse of over-the-counter drugs, prescription-only-medications, and new psychoactive substances. Neurosci Biobehav Rev 2024; 162:105691. [PMID: 38733894 DOI: 10.1016/j.neubiorev.2024.105691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024]
Abstract
The article presents a systematic literature review on the use and the psychiatric implications of over-the-counter drugs (OTC), prescription-only-medications (POM), and new psychoactive substances (NPS) within custodial settings. The searches wer carried out on 2 November 2022 on PubMed, Scopus, and Web of Science in line with PRISMA guidelines. A total of 538 records were identified, of which 37 met the inclusion criteria. Findings showed the most prevalent NPS and OTC and POM classes reported in prisons were synthetic cannabinoids receptor agonists (SCRAs) and opioids, respectively. NPS markets were shown to be in constant evolution following the pace of legislations aimed to reduce their spread. The use of such substances heavily impacts the conditions and rehabilitation of persons in custody, with consequent physical and mental health risks. It is important to raise awareness of the use and misuse of such substances in prisons (i) from an early warning perspective for law enforcement and policy makers (ii) to prompt doctors to cautiously prescribe substances that may be misused (iii) to improve and increase access to treatment provided (iv) to add such substances to routine toxicological screening procedures (v) to improve harm reduction programmes.
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Affiliation(s)
- Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK; Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Giorgia Vaccaro
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
| | - Alessio Mosca
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy.
| | - Andrea Miuli
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Gianfranco Stigliano
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Giulia Stefanelli
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Giulia Giovannetti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Rosalba Carullo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Giacomo d'Andrea
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Francesco Di Carlo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Clara Cavallotto
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Gilberto Di Petta
- Department of Neuroscience Department of Mental Health, ASL Napoli 2, Napoli, Nord, Italy
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
| | - Amira Guirguis
- Swansea University Medical School, Grove Building, Swansea University, Singleton Park, Swansea, Wales SA28PP, UK
| | - Jacqueline L Stair
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
| | - Giovanni Martinotti
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK; Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, England
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
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3
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Gitto L, Wadsworth T, Isenschmid D, Krotulski AJ, Logan BK, Tarozzi I, Arunkumar P. MDMB-4en-PINACA-Related Deaths in Cook County Jail: Awareness and Preventive Measures. Am J Forensic Med Pathol 2024:00000433-990000000-00199. [PMID: 39018467 DOI: 10.1097/paf.0000000000000966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
ABSTRACT Since January 2023, a series of fatalities has occurred in the Cook County Jail. Upon reviewing surveillance videos, in some cases, the inmates shared paper strips, and it was followed by the onset of labored breathing and loss of consciousness. Scene investigation revealed burnt paper strips near the body in 3 cases. No trauma was observed during autopsy. The expanded toxicology panels did not detect any illegal drugs in the postmortem blood samples. However, additional analysis specifically targeting synthetic cannabinoids revealed the presence of MDMB-4en-PINACA [methyl 3,3-dimethyl-2-{[1-(pent-4-en-1-yl)-1H-indazole-3-carbonyl]amino}butanoate], a synthetic cannabinoid associated with a wide range of adverse effects, including cardiovascular complications such as tachycardia and hypertension, respiratory depression, and acute kidney injury. There is limited research on the lethality of MDMB-4en-PINACA. This case series suggests that even isolated use can potentially lead to death. This study aims to raise public awareness regarding MDMB-4en-PINACA, highlighting its unpredictable effects and potential for severe adverse reactions, and to facilitate the development of effective prevention and harm reduction strategies. Implementing screening methods in correctional facilities is crucial to prevent the circulation of potentially fatal substances.
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Affiliation(s)
- Lorenzo Gitto
- From the Cook County Medical Examiner's Office, Chicago, IL
| | | | | | - Alex J Krotulski
- The Center for Forensic Science Research and Education (CFSRE), Willow Grove, PA
| | | | - Ilaria Tarozzi
- Department of Legal Medicine and Risk Management, Local Health Agency, Modena, Italy
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Trobbiani S, Stockham P, Kostakis C. A method for the sensitive targeted screening of synthetic cannabinoids and opioids in whole blood by LC-QTOF-MS with simultaneous suspect screening using HighResNPS.com. J Anal Toxicol 2023; 47:807-817. [PMID: 37632762 DOI: 10.1093/jat/bkad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/11/2023] [Accepted: 08/25/2023] [Indexed: 08/28/2023] Open
Abstract
A sensitive method for the qualitative screening of synthetic cannabinoids and opioids in whole blood was developed and validated using alkaline liquid-liquid extraction (LLE) and liquid chromatography-time-of-flight mass spectrometry (LC-QTOF-MS). Estimated limits of detection for validated compounds ranged from 0.03 to 0.29 µg/L (median, 0.04 µg/L) for the 27 opioids and from 0.04 to 0.5 µg/L (median, 0.07 µg/L) for the 23 synthetic cannabinoids. Data processing occurred in two stages; first, a targeted screen was performed using an in-house database containing retention times, accurate masses and MS-MS spectra for 79 cannabinoids and 53 opioids. Suspect screening was then performed using a database downloaded from the crowd sourced NPS data website HighResNPS.com which contains mass, consensus MS-MS data and laboratory-specific predicted retention times for a far greater number of compounds. The method was applied to 61 forensic cases where synthetic cannabinoid or opioid screening was requested by the client or their use was suspected due to case information. CUMYL-PEGACLONE was detected in two cases and etodesnitazine, 5 F-MDMB-PICA, 4-cyano-CUMYL-BUTINACA and carfentanil were detected in one case each. These compounds were within the targeted scope of the method but were also detected through the suspect screening workflow. The method forms a solid base for expansion as more compounds emerge onto the illicit drug market.
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Affiliation(s)
- Stephen Trobbiani
- Forensic Science SA, GPO Box 2790, Adelaide, South Australia 5001, Australia
| | - Peter Stockham
- Forensic Science SA, GPO Box 2790, Adelaide, South Australia 5001, Australia
- Flinders University of South Australia, Sturt Road, Bedford Park, Adelaide, South Australia 5042, Australia
| | - Chris Kostakis
- Forensic Science SA, GPO Box 2790, Adelaide, South Australia 5001, Australia
- Flinders University of South Australia, Sturt Road, Bedford Park, Adelaide, South Australia 5042, Australia
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Meyer M, Westenberg JN, Jang KL, Choi F, Schreiter S, Mathew N, King C, Lang UE, Vogel M, Krausz RM. Shifting drug markets in North America - a global crisis in the making? Int J Ment Health Syst 2023; 17:36. [PMID: 37880722 PMCID: PMC10598952 DOI: 10.1186/s13033-023-00601-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023] Open
Abstract
Understanding drug market dynamics and their underlying driving factors is paramount to developing effective responses to the overdose crisis in North America. This paper summarises the distinct drug market trends observed locally and internationally over the past decade to extrapolate future drug market trajectories. The emergence of fentanyl on North American street markets from 2014 onwards led to a shift of street drug use patterns. Previously perceived as contaminants, novel synthetic opioids became the drugs of choice and a trend towards higher potency was observed across various substance classes. The diversification of distribution strategies as well as the regionalisation and industrialisation of production followed basic economic principles that were heavily influenced by prosecution and policy makers. Particularly, the trend towards higher potency is likely most indicative of what to expect from future illicit drug market developments. Nitazenes and fentanyl-analogues, several times more potent than fentanyl itself, are increasingly detected in toxicological testing and have the potential of becoming the drugs of choice in the future. The dynamic of drug import and local production is less clear and influenced by a multitude of factors like precursor availability, know-how, infrastructure, and the success of local drug enforcement strategies. Drug market dynamics and the current trajectory towards ultrapotent opioids need to be recognised by legislation, enforcement, and the health care system to prepare effective responses. Without significant improvements in treatment access, the implementation of preventative approaches and early warning systems, the mortality rate will continue to increase. Furthermore, there is no mechanism in place preventing the currently North American focused overdose crisis to spread to other parts of the globe, particularly Europe. A system of oversight, research, and treatment is needed to address mortality rates of historic proportions and prevent further harm.
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Affiliation(s)
- Maximilian Meyer
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada.
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland.
| | - Jean N Westenberg
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Kerry L Jang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Fiona Choi
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Stefanie Schreiter
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nickie Mathew
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Conor King
- Victoria Police Department, Victoria, Canada
| | - Undine E Lang
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Marc Vogel
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - R Michael Krausz
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
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Fujiwara R, Journey M, Al-Doori F, Bell P, Judge B, Miracle K, Ito K, Jones S. Potential neonatal toxicity of new psychoactive substances. Pharmacol Ther 2023; 248:108468. [PMID: 37290575 DOI: 10.1016/j.pharmthera.2023.108468] [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: 01/12/2023] [Revised: 05/25/2023] [Accepted: 05/31/2023] [Indexed: 06/10/2023]
Abstract
Cannabis, cocaine, 3,4-methylenedioxymethamphetamine, and lysergic acid diethylamide are psychoactive substances with a significant increase in consumption during the 21st century due to their popularity in medicinal and recreational use. New psychoactive substances (NPSs) mimic established psychoactive substances. NPSs are known as being natural and safe to consumers; however, they are neither natural nor safe, causing severe adverse reactions, including seizures, nephrotoxicity, and sometimes death. Synthetic cannabinoids, synthetic cathinones, phenethylamines, and piperazines are all examples of NPSs. As of January 2020, nearly 1000 NPSs have become documented. Due to their low cost, ease of availability, and difficulty of detection, misuse of NPSs has become a familiar and growing problem, especially in adolescents and young adults in the past decade. The use of NPSs is associated with higher risks of unplanned sexual intercourse and pregnancy. As many as 4 in 100 women seeking treatment for substance abuse are pregnant or nursing. Animal studies and human clinical case reports have shown that exposure to certain NPSs during lactation periods has toxic effects on neonates, increasing various risks, including brain damage. Nevertheless, neonatal toxicity effects of NPSs are usually unrecognized and overlooked by healthcare professionals. In this review article, we introduce and discuss the potential neonatal toxicity of NPSs, emphasizing synthetic cannabinoids. Utilizing the established prediction models, we identify synthetic cannabinoids and their highly accumulative metabolites in breast milk.
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Affiliation(s)
- Ryoichi Fujiwara
- Department of Pharmaceutical Sciences, College of Pharmacy, Northeast Ohio Medical University, Rootstown, OH, USA.
| | - Megan Journey
- Department of Pharmaceutical Sciences, College of Pharmacy, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Fatimah Al-Doori
- College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Paris Bell
- Department of Pharmaceutical Sciences, College of Pharmacy, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Brahmjot Judge
- Department of Pharmaceutical Sciences, College of Pharmacy, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Kamille Miracle
- College of Graduate Studies, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Kousei Ito
- Laboratory of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Chiba University, Chiba, Japan.
| | - Sabrina Jones
- Department of Physics, University of Arkansas Fayetteville, Fayetteville, AR, USA
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7
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de Oliveira MC, Vides MC, Lassi DLS, Torales J, Ventriglio A, Bombana HS, Leyton V, Périco CDAM, Negrão AB, Malbergier A, Castaldelli-Maia JM. Toxicity of Synthetic Cannabinoids in K2/Spice: A Systematic Review. Brain Sci 2023; 13:990. [PMID: 37508922 PMCID: PMC10377539 DOI: 10.3390/brainsci13070990] [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: 05/17/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Synthetic cannabinoids (SCs) are emerging drugs of abuse sold as 'K2', 'K9' or 'Spice'. Evidence shows that using SCs products leads to greater health risks than cannabis. They have been associated with greater toxicity and higher addiction potential unrelated to the primary psychoactive component of marijuana, Δ9-tetrahydrocannabinol (Δ9-THC). Moreover, early cases of intoxication and death related to SCs highlight the inherent danger that may accompany the use of these substances. However, there is limited knowledge of the toxicology of Spice ingredients. This systematic review intends to analyze the toxicity of SCs compounds in Spice/K2 drugs. (2) Methods: Studies analyzing synthetic cannabinoid toxicity and dependence were included in the present review. We searched the PubMed database of the US National Library of Medicine, Google Scholar, CompTox Chemicals, and Web of Science up to May 2022. (3) Results: Sixty-four articles reporting the effects of synthetic cannabinoids in humans were included in our review. Ten original papers and fifty-four case studies were also included. Fourteen studies reported death associated with synthetic cannabinoid use, with AB-CHMINACA and MDMB-CHMICA being the main reported SCs. Tachycardia and seizures were the most common toxicity symptoms. The prevalence of neuropsychiatric symptoms was higher in third-generation SCs. (4) Conclusion: SCs may exhibit higher toxicity than THC and longer-lasting effects. Their use may be harmful, especially in people with epilepsy and schizophrenia, because of the increased risk of the precipitation of psychiatric and neurologic disorders. Compared to other drugs, SCs have a higher potential to trigger a convulsive crisis, a decline in consciousness, and hemodynamic changes. Therefore, it is crucial to clarify their potential harms and increase the availability of toxicology data in both clinical and research settings.
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Affiliation(s)
- Mariana Campello de Oliveira
- Interdisciplinary Group of Alcohol and Drug Studies (GREA), Institute Perdizes, Department of Psychiatry Medical School, São Paulo University, São Paulo 05403-903, SP, Brazil
| | - Mariana Capelo Vides
- Interdisciplinary Group of Alcohol and Drug Studies (GREA), Institute Perdizes, Department of Psychiatry Medical School, São Paulo University, São Paulo 05403-903, SP, Brazil
| | - Dângela Layne Silva Lassi
- Interdisciplinary Group of Alcohol and Drug Studies (GREA), Institute Perdizes, Department of Psychiatry Medical School, São Paulo University, São Paulo 05403-903, SP, Brazil
| | - Julio Torales
- Department of Psychological Medicine, School of Medical Sciences, National University of Asuncion, San Lorenzo 111421, Paraguay
| | - Antonio Ventriglio
- Department of Experimental Medicine, Medical School, University of Foggia, 71122 Foggia, Italy
| | - Henrique Silva Bombana
- Department of Legal Medicine, Medical School, São Paulo University, São Paulo 05508-090, SP, Brazil
| | - Vilma Leyton
- Department of Legal Medicine, Medical School, São Paulo University, São Paulo 05508-090, SP, Brazil
| | | | - André Brooking Negrão
- Interdisciplinary Group of Alcohol and Drug Studies (GREA), Institute Perdizes, Department of Psychiatry Medical School, São Paulo University, São Paulo 05403-903, SP, Brazil
| | - André Malbergier
- Interdisciplinary Group of Alcohol and Drug Studies (GREA), Institute Perdizes, Department of Psychiatry Medical School, São Paulo University, São Paulo 05403-903, SP, Brazil
| | - João Maurício Castaldelli-Maia
- Interdisciplinary Group of Alcohol and Drug Studies (GREA), Institute Perdizes, Department of Psychiatry Medical School, São Paulo University, São Paulo 05403-903, SP, Brazil
- Department of Neuroscience, Medical School, FMABC University Center, Santo André 09060-870, SP, Brazil
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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8
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Suriaga A, Tappen RM, Aston ER, Chiang-Hanisko L, Newman D. Cannabinoids and synthetic cannabinoids as a cause of death: Trends and their healthcare implications. J Nurs Scholarsh 2023; 55:623-636. [PMID: 36250599 DOI: 10.1111/jnu.12817] [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: 03/23/2022] [Revised: 08/24/2022] [Accepted: 09/13/2022] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Cannabis remains one of the most widely used illicit substances globally, with 188 million users in 2017. In the United States, nearly 50 million people are reported to have used cannabis in 2020. More research is needed because of the dramatic increase in cannabis use and the perception that its use has minimal risk. DESIGN The researchers used a retrospective design for this study. METHODS We used the Florida Department of Law Enforcement data from 2014 to 2020 for this study. We used descriptive statistics to report the characteristics of decedents whose cause of death (COD) was associated with cannabinoid (CB) and synthetic cannabinoid (SC) use. We used a general linear model with repeated measures to examine CB and SC death rate trends. RESULTS A total of 386 decedents' COD in Florida was associated with CB and SC use. Nearly 28% of decedents were 45-54 years, male (87.8%), and non-Hispanic whites (65.3%). One hundred percent of CB-related decedents died in urban counties. In rural counties, SC decedents accounted for 28.3% of deaths. Of decedents in rural counties, 39.9% were African American. Most decedents (with CB and SC use) died from accidents (98.7%), with 12.6% of cases involving cardiovascular-related illnesses. CONCLUSION CBs and SCs as a COD pose a legitimate health problem to society. More people ages 45-54 died from CBs and SCs. Drug intoxications (from CBs and SCs) and motor vehicle collisions accounted for most of the accidents reported while under the influence of CBs and SCs. While most decedents from both CBs and SCs were non-Hispanic whites, a substantial proportion of African Americans died from SCs as a COD in rural counties. It is important that the public become aware of the risks for adverse effects of CB and SC. The public needs to be aware that CB and SC use can exacerbate cardiac-related conditions. CLINICAL RELEVANCE This study has clinical relevance to patient safety. CB and SC use contributes to motor vehicle accidents and can cause adverse effects including death.
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Affiliation(s)
- Armiel Suriaga
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
| | - Ruth M Tappen
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
| | - Elizabeth R Aston
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Lenny Chiang-Hanisko
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
| | - David Newman
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
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9
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New Psychoactive Substances: Major Groups, Laboratory Testing Challenges, Public Health Concerns, and Community-Based Solutions. J CHEM-NY 2023. [DOI: 10.1155/2023/5852315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Across communities worldwide, various new psychoactive substances (NPSs) continue to emerge, which worsens the challenges to global mental health, drug rules, and public health risks, as well as combats their usage. Specifically, the vast number of NPSs that are currently available, coupled with the rate at which new ones emerge worldwide, increasingly challenges both forensic and clinical testing strategies. The well-established NPS detection techniques include immunoassays, colorimetric tests, mass spectrometric techniques, chromatographic techniques, and hyphenated types. Nonetheless, mitigating drug abuse and NPS usage is achievable through extensive community-based initiatives, with increased focus on harm reduction. Clinically validated and reliable testing of NPS from human samples, along with community-driven solution, such as harm reduction, will be of great importance, especially in combating their prevalence and the use of other illicit synthetic substances. There is a need for continued literature synthesis to reiterate the importance of NPS, given the continuous emergence of illicit substances in the recent years. All these are discussed in this overview, as we performed another look into NPS, from differentiating the major groups and identifying with laboratory testing challenges to community-based initiatives.
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Ferrari Júnior E, Leite BHM, Gomes EB, Vieira TM, Sepulveda P, Caldas ED. Fatal cases involving new psychoactive substances and trends in analytical techniques. FRONTIERS IN TOXICOLOGY 2022; 4:1033733. [PMID: 36387045 PMCID: PMC9640761 DOI: 10.3389/ftox.2022.1033733] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/07/2022] [Indexed: 11/26/2022] Open
Abstract
New psychoactive substances (NPS) are an emerging public health issue and deaths are commonly associated with polydrug abuse. Moreover, the number of new substances available is constantly increasing, causing intoxications in low doses, characteristics that impose to toxicology and forensic laboratories to keep routine methods up to date, with high detectability and constantly acquiring new analytical standards. Likewise, NPS metabolites and respective elimination pathways are usually unknown, making it difficult the detection and confirmation of the drug involved in the fatal case in an analytical routine. A literature search was performed on PubMed, Scopus and Web of Science databases for papers related to chromatographic analyses from fatal cases related to NPS use published from 2016 to 2021. A total of 96 papers were retrieved and reviewed in this study. Opioids, synthetic cathinones, phenethylamines/amphetamines and cannabinoids were the NPS classes most found in the fatal cases. In many cases, multiple compounds were detected in the biological samples, including prescription and other illegal drugs. Liquid chromatography-tandem mass spectrometry, an alternative to overcome the gas chromatography-mass spectrometry limitations for some compounds, was the analytical technique most used in the studies, and high resolution mass spectrometry was often applied to NPS metabolite investigation and structural characterization and identification of unknown compounds. Toxicological screening and quantitation methods need to be continuously updated to include new substances that are emerging on the drug market that can be fatal at very low doses.
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Affiliation(s)
- Ettore Ferrari Júnior
- Forensic Analysis Laboratory, Criminalistics Institute, The Civil Police of the Federal District, Brasília, Brazil,Laboratory of Toxicology, Department of Pharmacy, University of Brasília, Campus Darcy Ribeiro, Brasília, Brazil
| | | | - Eliude Barbosa Gomes
- Forensic Analysis Laboratory, Criminalistics Institute, The Civil Police of the Federal District, Brasília, Brazil
| | | | - Pedro Sepulveda
- Department of Pharmacy, University of Brasília, Campus Ceilândia, Brasília, Brazil
| | - Eloisa Dutra Caldas
- Laboratory of Toxicology, Department of Pharmacy, University of Brasília, Campus Darcy Ribeiro, Brasília, Brazil,*Correspondence: Eloisa Dutra Caldas,
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11
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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] [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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12
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Vaccaro G, Massariol A, Guirguis A, Kirton SB, Stair JL. NPS detection in Prison: a Systematic Literature Review of Use, Drug Form, and Analytical Approaches. Drug Test Anal 2022; 14:1350-1367. [PMID: 35355411 PMCID: PMC9545023 DOI: 10.1002/dta.3263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 02/28/2022] [Accepted: 03/25/2022] [Indexed: 11/07/2022]
Abstract
This paper presents a systematic literature review on the detection of new psychoactive substances (NPS) in prison settings. It includes the most frequently reported NPS classes, the routes and forms used for smuggling, and the methods employed to analyze biological and non-biological samples. The search was carried out using MEDLINE (EBSCO), Scopus (ELSEVIER), PubMed (NCBI) and Web of Science (Clarivate) databases, along with reports from the grey literature in line with the PRISMA-S guidelines. A total of 2708 records were identified, of which 50 met the inclusion criteria. Findings showed the most prevalent NPS class reported in prison was synthetic cannabinoids (SCs). The most frequently reported SCs in non-biological samples were 4F-MDMB-BINACA, MDMB-4en-PINACA, and 5F-ADB. These were smuggled mainly through the postal services deposited on paper or herbal matrices. Concentrations of SCs detected on seized paper ranged between 0.05-1.17 mg/cm2 . The SCs most frequently reported in biological specimens (i.e., urine, blood, saliva, and wastewater) were 5F-MDMB-PICA, 4F-MDMB-BINACA and MDMB-4en-PINACA. Concentrations of SCs reported in femoral blood and serum were 0.12-0.48 ng/ml and 34-17 ng/ml, respectively. Hyphenated techniques were predominantly employed and generally successful for the detection of NPS in biological (i.e., LC-HRMS/MS) and non-biological samples (i.e., LC-HRMS/MS and GC-MS. The on-site technique IMS showed promise for detecting SCs in various forms, however immunoassays were not recommended. Future work should focus on accurate in-field detection of SCs deposited on paper and in urine and saliva to improve real-time decision-making, as well as wastewater and air monitoring for overall drug use trends.
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Affiliation(s)
- Giorgia Vaccaro
- Department of Clinical, Pharmaceutical and Biological Science, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Anna Massariol
- Department of Clinical, Pharmaceutical and Biological Science, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Amira Guirguis
- Department of Clinical, Pharmaceutical and Biological Science, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Swansea University Medical School, The Grove, Singleton Campus, Swansea, UK
| | - Stewart B Kirton
- Department of Clinical, Pharmaceutical and Biological Science, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Jacqueline L Stair
- Department of Clinical, Pharmaceutical and Biological Science, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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13
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McMann TJ, Calac A, Nali M, Cuomo R, Maroulis J, Mackey TK. Synthetic Cannabinoids in Prisons: Content Analysis of TikToks. JMIR INFODEMIOLOGY 2022; 2:e37632. [PMID: 37113804 PMCID: PMC9987188 DOI: 10.2196/37632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 04/29/2023]
Abstract
Background Synthetic cannabinoids are a significant public health concern, especially among incarcerated populations due to increased reports of abuse. Recent news reports have highlighted the severe consequences of K2/Spice, a synthetic cannabinoid, among the prison population in the United States. Despite regulations against cell phone use, inmates use TikTok to post K2/Spice-related content. Objective This study aimed to examine TikTok posts for use and illicit distribution of psychoactive substances (eg, K2/Spice) among incarcerated populations. Methods The study collected TikTok videos associated with the #k2spice hashtag and used a data collection approach similar to snowball sampling. Inductive coding was used to conduct content analysis of video characteristics. Videos were manually annotated to generate binary classifications related to the use of K2/Spice as well as selling and buying activities associated with it. Statistical analysis was used to determine associations between a video's user engagement and an intent to buy or sell K2/Spice. Results A total of 89 TikTok videos with the hashtag #k2spice were manually coded, with 40% (n=36) identified as displaying the use, solicitation, or adverse effects of K2/Spice among the prison population. Of them, 44.44% (n=16) were in a prison-based setting documenting adverse effects including possible overdose. Videos with higher user engagement were positively correlated with comments indicating an intent to buy or sell K2/Spice. Conclusions K2/Spice is a drug subject to abuse among prison inmates in the United States, including depictions of its harmful effects being recorded and shared on TikTok. Lack of policy enforcement on TikTok and the need for better access to treatment services within the prison system may be exacerbating substance use among this highly vulnerable population. Minimizing the potential individual harm of this content on the incarcerated population should be a priority for social media platforms and the criminal justice system alike.
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Affiliation(s)
- Tiana J McMann
- Global Health Program Department of Anthropology University of California San Diego La Jolla, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
- S-3 Research San Diego, CA United States
| | - Alec Calac
- Global Health Policy and Data Institute San Diego, CA United States
- Department of Anesthesiology University of California San Diego San Diego, CA United States
| | - Matthew Nali
- Global Health Policy and Data Institute San Diego, CA United States
- S-3 Research San Diego, CA United States
| | - Raphael Cuomo
- Global Health Policy and Data Institute San Diego, CA United States
- Department of Anesthesiology University of California San Diego San Diego, CA United States
| | - James Maroulis
- Global Health Policy and Data Institute San Diego, CA United States
| | - Tim K Mackey
- Global Health Program Department of Anthropology University of California San Diego La Jolla, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
- S-3 Research San Diego, CA United States
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14
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Gilbert N, Costello A, Ellison JR, Khan U, Knight M, Linnell MJ, Ralphs R, Mewis RE, Sutcliffe OB. Synthesis, characterisation, detection and quantification of a novel hexyl-substituted synthetic cannabinoid receptor agonist: (S)-N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-hexyl-1H-indazole-3-carboxamide (ADB-HINACA). Forensic Chem 2021. [DOI: 10.1016/j.forc.2021.100354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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15
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Krotulski AJ, Garibay N, Walther D, Walton SE, Mohr ALA, Logan BK, Baumann MH. Pharmacokinetics and pharmacodynamics of the synthetic cannabinoid, 5F-MDMB-PICA, in male rats. Neuropharmacology 2021; 199:108800. [PMID: 34547333 PMCID: PMC8511335 DOI: 10.1016/j.neuropharm.2021.108800] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 09/13/2021] [Accepted: 09/16/2021] [Indexed: 12/25/2022]
Abstract
5F-MDMB-PICA is a popular synthetic cannabinoid associated with analytically confirmed intoxications. In vitro studies show 5F-MDMB-PICA is a potent cannabinoid-1 receptor (CB1) agonist, but little information is available about in vivo pharmacokinetics and pharmacodynamics. To this end, the present study had three aims: 1) to develop a validated method for detection of 5F-MDMB-PICA and its metabolites in rat plasma, 2) to utilize the method for investigating pharmacokinetics of 5F-MDMB-PICA in rats, and 3) to relate 5F-MDMB-PICA pharmacokinetics to pharmacodynamic effects. 5F-MDMB-PICA and its metabolites were quantified using liquid chromatography tandem mass spectrometry (LC-MS/MS) and method validation followed forensic standards. Male Sprague-Dawley rats bearing surgically implanted jugular catheters and subcutaneous (s.c.) temperature transponders received 5F-MDMB-PICA (50, 100, or 200 μg/kg, s.c.) or its vehicle. Blood samples were drawn at 15, 30, 60, 120, 240, and 480 min post-injection, and plasma was assayed using LC-MS/MS. At each blood draw, body temperature, and catalepsy scores were recorded. Maximum plasma concentrations (Cmax) of 5F-MDMB-PICA rose linearly with increasing dose (1.72-6.20 ng/mL), and plasma half-life (t1/2) ranged from 400 to 1000 min 5F-MDMB-PICA-3,3-dimethylbutanoic acid and 5OH-MDMB-PICA were the only metabolites detected, and plasma concentrations were much lower than the parent drug. 5F-MDMB-PICA induced robust hypothermia and catalepsy-like symptoms that were significantly correlated with concentrations of 5F-MDMB-PICA. Radioligand binding in rat brain membranes revealed 5F-MDMB-PICA displays high affinity for CB1 (IC50 = 2 nM) while metabolites do not. In summary, 5F-MDMB-PICA is a potent CB1 agonist in rats whose pharmacodynamic effects are related to circulating concentrations of the parent drug and not its metabolites.
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Affiliation(s)
- Alex J Krotulski
- Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, 2300 Stratford Avenue, Willow Grove, PA, 19090, USA; College of Life Sciences, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA, 19107, USA.
| | - Nancy Garibay
- Designer Drug Research Unit, Intramural Research Program (IRP), National Institute on Drug Abuse (NIDA), National Institutes of Health, 333 Cassell Drive, Suite 4400, Baltimore, MD, 21224, USA
| | - Donna Walther
- Designer Drug Research Unit, Intramural Research Program (IRP), National Institute on Drug Abuse (NIDA), National Institutes of Health, 333 Cassell Drive, Suite 4400, Baltimore, MD, 21224, USA
| | - Sara E Walton
- Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, 2300 Stratford Avenue, Willow Grove, PA, 19090, USA; College of Life Sciences, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA, 19107, USA
| | - Amanda L A Mohr
- Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, 2300 Stratford Avenue, Willow Grove, PA, 19090, USA
| | - Barry K Logan
- Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, 2300 Stratford Avenue, Willow Grove, PA, 19090, USA; College of Life Sciences, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA, 19107, USA; NMS Labs, 200 Welsh Road, Horsham, PA, 19044, USA
| | - Michael H Baumann
- Designer Drug Research Unit, Intramural Research Program (IRP), National Institute on Drug Abuse (NIDA), National Institutes of Health, 333 Cassell Drive, Suite 4400, Baltimore, MD, 21224, USA
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16
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Gulekci Y, Efeoglu Ozseker P, Cavus Yonar F, Daglioglu N. Comparison of methods to develop fingerprints on papers impregnated with AB-PINACA and AB-FUBINACA. J Forensic Sci 2021; 67:524-533. [PMID: 34713442 DOI: 10.1111/1556-4029.14926] [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: 07/16/2021] [Revised: 10/07/2021] [Accepted: 10/12/2021] [Indexed: 11/27/2022]
Abstract
Although there have been significant advances in fingerprinting techniques, studies on how these techniques affect other criminal evidence are limited. Synthetic cannabinoids (SC), which are illegal substances frequently encountered in crime scenes and are widely used worldwide, are available in various forms in the market (pill, powder, liquid, and herbal product). These synthetic cannabinoid substances have recently been introduced to places such as prisons and rehabilitation centers, primarily via an infused piece of paper. The first seizure of the paper-impregnated form of AB-PINACA and AB-FUBINACA in Turkey was observed in 2014. This study investigates the effects of fingerprint development methods on the concentrations of these SCs impregnated on paper. Therefore, eccrine and sebaceous fingerprints of volunteers were imprinted on the papers before and after they were impregnated with AB-PINACA and AB-FUBINACA. Six different fingerprint development methods were applied. Fingerprint development methods were later checked in 384 fingerprints. AB-PINACA and AB-FUBINACA infused on papers were extracted by the liquid-extraction method, and concentrations were analyzed via LC-MS/MS. After applying Thermanin, 1,2-indandione, iodine vapor, DFO, and 5-MTN fingerprint development methods, the concentration levels of AB-FUBINACA were 26.25, 19.60, 21.43, 17.76, and 17.77 ng/cm2 , while the concentration levels of AB-PINACA were 1.1, 0.98, 1.31, 1.28, and 1.22 ng/cm2 , respectively. Finally, although the best fingerprint visualization was obtained on papers that were applied the Ninhydrin method, the method failed to detect SCs on papers.
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Affiliation(s)
- Yakup Gulekci
- Forensic Sciences Department, Faculty of Engineering and Natural Sciences, Kütahya University of Health Sciences, Kütahya, Turkey
| | - Pınar Efeoglu Ozseker
- Department of Forensic Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Fatma Cavus Yonar
- Institute of Forensic Sciences & Legal Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Nebile Daglioglu
- Department of Forensic Medicine, Cukurova University, Faculty of Medicine, Adana, Turkey
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17
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Cytotoxicity, metabolism, and isozyme mapping of the synthetic cannabinoids JWH-200, A-796260, and 5F-EMB-PINACA studied by means of in vitro systems. Arch Toxicol 2021; 95:3539-3557. [PMID: 34453555 PMCID: PMC8492589 DOI: 10.1007/s00204-021-03148-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/19/2021] [Indexed: 12/16/2022]
Abstract
Intake of synthetic cannabinoids (SC), one of the largest classes of new psychoactive substances, was reported to be associated with acute liver damage but information about their hepatotoxic potential is limited. The current study aimed to analyze the hepatotoxicity including the metabolism-related impact of JWH-200, A-796260, and 5F-EMB-PINACA in HepG2 cells allowing a tentative assessment of different SC subclasses. A formerly adopted high-content screening assay (HCSA) was optimized using a fully automated epifluorescence microscope. Metabolism-mediated effects in the HCSA were additionally investigated using the broad CYP inhibitor 1-aminobenzotriazole. Furthermore, phase I metabolites and isozymes involved were identified by in vitro assays and liquid chromatography–high-resolution tandem mass spectrometry. A strong cytotoxic potential was observed for the naphthoylindole SC JWH-200 and the tetramethylcyclopropanoylindole compound A-796260, whereas the indazole carboxamide SC 5F-EMB-PINACA showed moderate effects. Numerous metabolites, which can serve as analytical targets in urine screening procedures, were identified in pooled human liver microsomes. Most abundant metabolites of JWH-200 were formed by N-dealkylation, oxidative morpholine cleavage, and oxidative morpholine opening. In case of A-796260, most abundant metabolites included an oxidative morpholine cleavage, oxidative morpholine opening, hydroxylation, and dihydroxylation followed by dehydrogenation. Most abundant 5F-EMB-PINACA metabolites were generated by ester hydrolysis plus additional steps such as oxidative defluorination and hydroxylation. To conclude, the data showed that a hepatotoxicity of the investigated SC cannot be excluded, that metabolism seems to play a minor role in the observed effects, and that the extensive phase I metabolism is mediated by several isozymes making interaction unlikely.
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18
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Rodrigues TB, Souza MP, de Melo Barbosa L, de Carvalho Ponce J, Júnior LFN, Yonamine M, Costa JL. Synthetic cannabinoid receptor agonists profile in infused papers seized in Brazilian prisons. Forensic Toxicol 2021; 40:119-124. [DOI: 10.1007/s11419-021-00586-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/12/2021] [Indexed: 01/30/2023]
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19
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Norman C, McKirdy B, Walker G, Dugard P, NicDaéid N, McKenzie C. Large-scale evaluation of ion mobility spectrometry for the rapid detection of synthetic cannabinoid receptor agonists in infused papers in prisons. Drug Test Anal 2021; 13:644-663. [PMID: 33058556 DOI: 10.1002/dta.2945] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 11/10/2022]
Abstract
Synthetic cannabinoid receptor agonists (SCRAs), colloquially known as "spice," are commonly used in prisons and enter establishments via the mail in the form of infused papers. Many prisons use benchtop ion mobility spectroscopy (IMS) instruments to screen mail and seized materials for the presence of SCRAs and other controlled substances. The selectivity and sensitivity of Rapiscan Itemiser® 3E and Itemiser® 4DN Ion Trap Mobility Spectroscopy™ (ITMS™) systems were evaluated using 21 SCRA reference standards. Some differences in the SCRA reduced mobility (K0 ) values were observed between this study and those reported previously using IMS detection systems, particularly for cumyl and quinolinyl SCRAs (e.g., 5F-PB-22, Cumyl-4CN-BINACA, and 5F-Cumyl-PEGACLONE), although this was found to have little effect at an operational level. Operational reliability of the systems was evaluated by analyzing 392 paper and card samples with known drug content. ITMS™ system results (e.g., detect or nondetect) were in agreement with gas chromatography-mass spectrometry (GC-MS) analysis in up to 95% of samples tested. Overall, this study found the ITMS™ systems tested to be effective instruments when deployed for the rapid detection of SCRA-infused papers. Used effectively and with up-to-date substance libraries, they will help reduce the supply of SCRAs into prisons and identify emerging threats as they arise. Several emerging SCRAs (5F-MPP-PICA, 5F-EMB-PICA, and 4F-MDMB-BICA) were detected for the first time in Scottish prisons between May and August 2020 as a result of routine monitoring, and all were detected using the ITMS™ systems tested.
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Affiliation(s)
- Caitlyn Norman
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Brian McKirdy
- HMP Inverness, Scottish Prison Service, Inverness, UK
| | - Gillian Walker
- Public Protection Unit, Scottish Prison Service, Edinburgh, UK
| | - Pat Dugard
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Niamh NicDaéid
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Craig McKenzie
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
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20
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Antonides LH, Cannaert A, Norman C, NicDáeid N, Sutcliffe OB, Stove CP, McKenzie C. Shape matters: The application of activity-based in vitro bioassays and chiral profiling to the pharmacological evaluation of synthetic cannabinoid receptor agonists in drug-infused papers seized in prisons. Drug Test Anal 2020; 13:628-643. [PMID: 33161649 DOI: 10.1002/dta.2965] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/01/2020] [Accepted: 11/01/2020] [Indexed: 12/19/2022]
Abstract
Synthetic cannabinoid receptor agonists (SCRAs) elicit many of their psychoactive effects via type-1 human cannabinoid (CB1 ) receptors. Enantiomer pairs of eight tert-leucinate or valinate indole- and indazole-3-carboxamide SCRAs were synthesized and their CB1 potency and efficacy assessed using an in vitro β-arrestin recruitment assay in a HEK239T stable cell system. A chiral high-performance liquid chromatography method with photodiode array and/or quadrupole time-of-flight-mass spectrometry detection (HPLC-PDA and HPLC-PDA-QToF-MS) was applied to 177 SCRA-infused paper samples seized in Scottish prisons between 2018 and 2020. In most samples, SCRAs were almost enantiopure (S)-enantiomer (>98% of total chromatographic peak area), although in some (n = 18), 2% to 16% of the (R)-enantiomer was detected. (S)-enantiomers are consistently more potent than (R)-enantiomers and often more efficacious. The importance of SCRA-CB1 receptor interactions in the "head" or "linked group" moiety is demonstrated, with the conformation of the "bulky" tert-leucinate group greatly affecting potency (by up to a factor of 374), significantly greater than the difference observed between valinate SCRA enantiomers. (S)-MDMB-4en-PINACA, (S)-4F-MDMB-BINACA, and (S)-5F-MDMB-PICA are currently the most prevalent SCRAs in Scottish prisons, and all have similar high potency (EC50 , 1-5 nM) and efficacy. Infused paper samples were compared using estimated intrinsic efficacy at the CB1 receptor (EIECB1 ) to evaluate samples with variable SCRA content. Given their similar potency and efficacy, any variation in CB1 receptor-mediated psychoactive effects are likely to derive from variation in dose, mode of use, pharmacokinetic differences, and individual factors affecting the user, rather than differences in the specific SCRA present.
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Affiliation(s)
- Lysbeth H Antonides
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Annelies Cannaert
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Caitlyn Norman
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Niamh NicDáeid
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Oliver B Sutcliffe
- Department of Natural Sciences, Manchester Metropolitan University, Manchester, UK
| | - Christophe P Stove
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Craig McKenzie
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
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Presley BC, Castaneto MS, Logan BK, Jansen-Varnum SA. Metabolic profiling of synthetic cannabinoid 5F-ADB and identification of metabolites in authentic human blood samples via human liver microsome incubation and ultra-high-performance liquid chromatography/high-resolution mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2020; 34:e8908. [PMID: 32710798 DOI: 10.1002/rcm.8908] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 06/11/2023]
Abstract
RATIONALE Indazole carboxamide synthetic cannabinoids, a prevalent class of recreational drugs, are a major clinical, forensic and public health challenge. One such compound, 5F-ADB, has been implicated in fatalities worldwide. Understanding its metabolism and distribution facilitates the development of laboratory assays to substantiate its consumption. Synthetic cannabinoid metabolites have been extensively studied in urine; studies identifying metabolites in blood are limited and no data on the metabolic stability (half-life, clearance and extraction ratio) of 5F-ADB have been published prior to this report. METHODS The in vitro metabolism of 5F-ADB was elucidated via incubation with human liver microsomes for 2 h at 37°C. Samples were collected at multiple time points to determine its metabolic stability. Upon identification of metabolites, authentic forensic human blood samples underwent liquid-liquid extraction and were screened for metabolites. Extracts were analyzed via ultra-high-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UHPLC/QTOFMS) operated in positive electrospray ionization mode. RESULTS Seven metabolites were identified including oxidative defluorination (M1); carboxypentyl (M2); monohydroxylation of the fluoropentyl chain (M3.1/M3.2) and indazole ring system (M4); ester hydrolysis (M5); and ester hydrolysis with oxidative defluorination (M6). The half-life (3.1 min), intrinsic clearance (256.2 mL min-1 kg-1 ), hepatic clearance (18.6 mL min-1 kg-1 ) and extraction ratio (0.93) were determined for the first time. In blood, M1 was present in each sample as the most abundant substance; two samples contained M5; one contained 5F-ADB, M1 and M5. CONCLUSIONS 5F-ADB is rapidly metabolized in HLM. 5F-ADB, M1 and M5 are pharmacologically active at the cannabinoid receptors (CB1 /CB2 ) and M1 and M5 may contribute to a user's impairment profile. The results demonstrate that it is imperative that synthetic cannabinoid assays screen for pharmacologically active metabolites, especially for drugs with short half-lives. The authors propose that M1 and M5 are appropriate markers to include in laboratory blood tests screening for 5F-ADB.
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Affiliation(s)
- Brandon C Presley
- Department of Chemistry, Temple University, 1901 N. 13 St., Philadelphia, PA, 19122, USA
| | - Marisol S Castaneto
- Department of Pathology, Tripler Army Medical Center, 1 Jarrett White Rd., Honolulu, HI, 96859, USA
| | - Barry K Logan
- The Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, PA, 19090, USA
| | - Susan A Jansen-Varnum
- Department of Chemistry, Temple University, 1901 N. 13 St., Philadelphia, PA, 19122, USA
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Jurásek B, Čmelo I, Svoboda J, Čejka J, Svozil D, Kuchař M. New psychoactive substances on dark web markets: From deal solicitation to forensic analysis of purchased substances. Drug Test Anal 2020; 13:156-168. [PMID: 32678972 DOI: 10.1002/dta.2901] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 02/02/2023]
Abstract
The dark web scene has been drawing the attention of law enforcement agencies and researchers alike. To date, most of the published works on the dark web are based on data gained by passive observation. To gain a more contextualized perspective, a study was conducted in which three vendors were selected on the "Dream Market" dark web marketplace, from whom subsequently several new psychoactive substances (NPS) were ordered. All transactions were documented from the initial drug deal solicitation to the final qualitative analysis of all received samples. From the selected vendors, a total of nine NPS samples was obtained, all of which were analyzed by NMR, HRMS, LC-UV, and two also by x-ray diffraction. According to our analyses, four of the five substances offered under already known NPS names contained a different NPS. The selected vendors therefore either did not know about their product, or deliberately deceived the buyers. Furthermore, two of three obtained samples of purportedly novel NPS were identified as already documented substances sold under a different name. However, the third characterized substance sold as "MPF-47700" was a novel, yet uncharacterized, NPS. Finally, we received a single undeclared substance, later identified as 5F-ADB. In addition to chemical analysis of the nine obtained NPS samples, the methodology used also yielded contextual information about the accessibility of NPS on the dark web, the associated purchase process, and the modus operandi of three NPS vendors. Direct participation in dark web marketplaces seems to provide additional layers of information useful for forensic studies.
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Affiliation(s)
- Bronislav Jurásek
- Forensic Laboratory of Biologically Active Substances, University of Chemistry and Technology Prague, Technická 5, Prague, Czech Republic.,Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Technická 5, Prague, Czech Republic
| | - Ivan Čmelo
- CZ-OPENSCREEN:National Infrastructure for Chemical Biology, Department of Informatics and Chemistry, Faculty of Chemical Technology, University of Chemistry and Technology Prague, Technická 5, Prague, Czech Republic
| | - Jan Svoboda
- Department of Organic Technology, University of Chemistry and Technology Prague, Technická 3, Prague, Czech Republic
| | - Jan Čejka
- Department of Solid State Chemistry, University of Chemistry and Technology Prague, Technická 3, Prague, Czech Republic
| | - Daniel Svozil
- CZ-OPENSCREEN:National Infrastructure for Chemical Biology, Department of Informatics and Chemistry, Faculty of Chemical Technology, University of Chemistry and Technology Prague, Technická 5, Prague, Czech Republic
| | - Martin Kuchař
- Forensic Laboratory of Biologically Active Substances, University of Chemistry and Technology Prague, Technická 5, Prague, Czech Republic.,Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Technická 5, Prague, Czech Republic
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23
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Presley BC, Castaneto MS, Logan BK, Jansen-Varnum SA. Assessment of synthetic cannabinoid FUB-AMB and its ester hydrolysis metabolite in human liver microsomes and human blood samples using UHPLC-MS/MS. Biomed Chromatogr 2020; 34:e4884. [PMID: 32415732 DOI: 10.1002/bmc.4884] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/15/2020] [Accepted: 05/11/2020] [Indexed: 12/18/2022]
Abstract
FUB-AMB, an indazole carboxamide synthetic cannabinoid recreational drug, was one of the compounds most frequently reported to governmental agencies worldwide between 2016 and 2019. It has been implicated in intoxications and fatalities, posing a risk to public health. In the current study, FUB-AMB was incubated with human liver microsomes (HLM) to assess its metabolic fate and stability and to determine if its major ester hydrolysis metabolite (M1) was present in 12 authentic forensic human blood samples from driving under the influence of drug cases and postmortem investigations using UHPLC-MS/MS. FUB-AMB was rapidly metabolized in HLM, generating M1 that was stable through a 120-min incubation period, a finding that indicates a potential long detection window in human biological samples. M1 was identified in all blood samples, and no parent drug was detected. The authors propose that M1 is a reliable marker for inclusion in laboratory blood screens for FUB-AMB; this metabolite may be pharmacologically active like its precursor FUB-AMB. M1 frequently appears in samples in which the parent drug is undetectable and can point to the causative agent. The results suggest that it is imperative that synthetic cannabinoid laboratory assay panels include metabolites, especially known or potential pharmacologically active metabolites, particularly for compounds with short half-lives.
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Affiliation(s)
- Brandon C Presley
- Department of Chemistry, Temple University, Philadelphia, Pennsylvania, USA
| | | | - Barry K Logan
- The Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, Willow Grove, Pennsylvania, USA
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24
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Jurásek B, Bartůněk V, Huber Š, Fagan P, Setnička V, Králík F, Dehaen W, Svozil D, Kuchař M. Can X-Ray Powder Diffraction Be a Suitable Forensic Method for Illicit Drug Identification? Front Chem 2020; 8:499. [PMID: 32656182 PMCID: PMC7325198 DOI: 10.3389/fchem.2020.00499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/14/2020] [Indexed: 11/13/2022] Open
Abstract
New psychoactive substances (NPSs) are associated with a significant number of intoxications. With the number of readily available forms of these drugs rising every year, there are even risks for the general public. Consequently, there is a high demand for methods sufficiently sensitive to detect NPSs in samples found at the crime scene. Infrared (IR) and Raman spectroscopies are commonly used for such detection, but they have limitations; for example, fluorescence in Raman can overlay the signal and when the sample is a mixture sometimes neither Raman nor IR is able to identify the compounds. Here, we investigate the potential of X-ray powder diffraction (XRPD) to analyse samples seized on the black market. A series of psychoactive substances (heroin, cocaine, mephedrone, ephylone, butylone, JWH-073, and naphyrone) was measured. Comparison of their diffraction patterns with those of the respective standards showed that XRPD was able to identify each of the substances. The same samples were analyzed using IR and Raman, which in both cases were not able to detect the compounds in all of the samples. These results suggest that XRPD could be a valuable addition to the range of forensic tools used to detect these compounds in illicit drug samples.
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Affiliation(s)
- Bronislav Jurásek
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Prague, Czechia
| | - Vilém Bartůněk
- Department of Inorganic Chemistry, University of Chemistry and Technology Prague, Prague, Czechia
| | - Štěpán Huber
- Department of Inorganic Chemistry, University of Chemistry and Technology Prague, Prague, Czechia
| | - Patrik Fagan
- Department of Analytical Chemistry, University of Chemistry and Technology Prague, Prague, Czechia
| | - Vladimír Setnička
- Department of Analytical Chemistry, University of Chemistry and Technology Prague, Prague, Czechia
| | - František Králík
- Department of Analytical Chemistry, University of Chemistry and Technology Prague, Prague, Czechia
| | - Wim Dehaen
- CZ-OPENSCREEN: National Infrastructure for Chemical Biology, Department of Informatics and Chemistry, Faculty of Chemical Technology, University of Chemistry and Technology Prague, Prague, Czechia
| | - Daniel Svozil
- CZ-OPENSCREEN: National Infrastructure for Chemical Biology, Department of Informatics and Chemistry, Faculty of Chemical Technology, University of Chemistry and Technology Prague, Prague, Czechia
| | - Martin Kuchař
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Prague, Czechia
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Shafi A, Berry AJ, Sumnall H, Wood DM, Tracy DK. New psychoactive substances: a review and updates. Ther Adv Psychopharmacol 2020; 10:2045125320967197. [PMID: 33414905 PMCID: PMC7750892 DOI: 10.1177/2045125320967197] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/26/2020] [Indexed: 12/19/2022] Open
Abstract
New psychoactive substances (NPS) are a heterogeneous group of substances. They are associated with a number of health and social harms on an individual and societal level. NPS toxicity and dependence syndromes are recognised in primary care, emergency departments, psychiatric inpatient and community care settings. One pragmatic classification system is to divide NPS into one of four groups: synthetic stimulants, synthetic cannabinoids, synthetic hallucinogens and synthetic depressants (which include synthetic opioids and benzodiazepines). We review these four classes of NPS, including their chemical structures, mechanism of action, modes of use, intended intoxicant effects, and their associated physical and mental health harms. The current challenges faced by laboratory testing for NPS are also explored, in the context of the diverse range of NPS currently available, rate of production and emergence of new substances, the different formulations, and methods of acquisition and distribution.
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Affiliation(s)
- Abu Shafi
- East London Foundation Trust, London, UK
| | - Alex J Berry
- Division of Psychiatry, University College London, UK
| | | | - David M Wood
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Derek K Tracy
- Consultant Psychiatrist, Oxleas NHS Foundation Trust, London, UK
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