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De Luca I, Di Carlo F, Burkauskas J, Dores AR, Carvalho IP, Gómez-Martínez MÁ, Szabo A, Fujiwara H, Barbosa CM, Di Nicola M, Mazza M, Sani G, Luciani D, Pettorruso M, di Giannantonio M, Cataldo I, Esposito G, Martinotti G, Zandonai T, Rabin O, Corazza O. Profiling and assessing the risks of image- and performance-enhancing drugs use during the COVID-19 lockdown. Front Public Health 2024; 12:1386721. [PMID: 38962770 PMCID: PMC11221326 DOI: 10.3389/fpubh.2024.1386721] [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: 02/16/2024] [Accepted: 06/07/2024] [Indexed: 07/05/2024] Open
Abstract
Background Image and Performance-Enhancing Drugs (IPEDs) can enhance mental and physical capabilities and impact one's overall health. Initially confined in sport environments, IPEDs use has become increasingly widespread in a high-performing society. The present study was aimed at profiling IPEDs use during the COVID-19 lockdown among an international sample of young adults. Methods A cross-sectional observational study was carried out in eight countries (United Kingdom, Italy, Lithuania, Hungary, Portugal, Spain, Brazil, and Japan) between April and May 2020. The survey questionnaire included validated measurements such as Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI), and Self-Compassion Scale (SCS) as well as questions about the type of IPEDs, purchasing methods and socio-demographic information. Results A total of 736 IPEDs users were included in the survey. Their mean age was 33.05 years (±SD = 10.06), and 64.2% were female participants. Overall, 6.8% were found at risk of exercise addiction (EAI >24), 27.6% presented high levels of appearance anxiety, and 24.9% revealed low levels of emotional regulation's self-compassion. Most participants (55.6%) purchased IPEDs through pharmacies/specialized shops, while 41.3% purchased IPEDs on the Internet. Online IPEDs buyers were mainly men who had higher scores on the Exercise Addiction Inventory. One or more IPEDs classifiable as "potentially risky" were used by 66.3% of the sample. Users of "potentially risky IPEDs" were younger and primarily men. They showed higher scores both on the Exercise Addiction Inventory and Appearance Anxiety Inventory. Conclusion This study profiled users of IPEDs when the most restrictive COVID-19 lockdown policies were implemented in all the participating countries. More targeted post-COVID 19 prevention strategies should be implemented according to the emerged socio-demographic and psychopathological traits and cross-cultural differences emerged. Longitudinal studies will also be needed to determine the long-term effect of the COVID-19 lockdown on IPEDs consumption.
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Affiliation(s)
- Ilaria De Luca
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Francesco Di Carlo
- Department of Neuroscience, Imaging, and Clinical Science, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Julius Burkauskas
- Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Artemisa R. Dores
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- School of Health, Polytechnic of Porto, Porto, Portugal
| | - Irene P. Carvalho
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | | | - Attila Szabo
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Hironobu Fujiwara
- Department of Neuropsychiatry, Graduate School of Medicine, University of Kyoto, Kyoto, Japan
- Decentralized Big Data Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
- The General Research Division, Osaka University Research Center on Ethical, Legal and Social Issues, Osaka, Japan
| | - Cristina Monteiro Barbosa
- Department of Psychometrics, Institute of Psychology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marco Di Nicola
- Department of Psychometrics, Institute of Psychology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marianna Mazza
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriele Sani
- Department of Psychometrics, Institute of Psychology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Debora Luciani
- Department of Neuroscience, Imaging, and Clinical Science, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging, and Clinical Science, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Massimo di Giannantonio
- Department of Neuroscience, Imaging, and Clinical Science, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Ilaria Cataldo
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Gianluca Esposito
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Martinotti
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Neuroscience, Imaging, and Clinical Science, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Thomas Zandonai
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Olivier Rabin
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
- World Anti-Doping Agency, Montreal, QC, Canada
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
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Akca AA, Couchman L, Frinculescu A, Johnston A. Analysis of drug-impregnated paper samples seized in English prisons between 2018 and 2020. Forensic Sci Int 2024; 357:111991. [PMID: 38513529 DOI: 10.1016/j.forsciint.2024.111991] [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: 08/21/2023] [Revised: 03/06/2024] [Accepted: 03/16/2024] [Indexed: 03/23/2024]
Abstract
Novel psychoactive substances (NPS) in the form of impregnated papers delivered to prisoners are of particular concern in prison settings, where they are commonly used by vaping. The purpose of this study was to create a qualitative method for identifying the various emerging NPS impregnated onto paper samples sent to prisoners. It helps to demonstrate that these findings can be used to predict drug prevalence and trends in prisons. Between 2018 and 2020, 1250 non-judicial paper samples seized from 12 English prisons were analysed to determine the NPSs being circulated. Approximately 1 cm2 paper were cut and added to 50 % (v/v) methanol in LCMS-grade water. Vortex-mixing was used to prepare extracts (30 min). Q-TOF LC/MS was used to screen the extracts. This study showed that synthetic cannabinoid receptor agonist (SCRA) was the most common drug group detected in impregnated paper seizures in English prisons between 2018 and 2020, followed by cocaine, heroin type drugs (A) and amphetamine, ketamine type drugs (B). Male prisons had a higher prevalence of SCRAs, whereas female prisons had a higher prevalence of A drugs. Furthermore, lower security prisons were found to have a higher prevalence of B drugs, pregabalin, gabapentin type drugs (C), and abused and prescription drugs than higher security prisons which unveiled a higher prevalence of nicotine. The findings of this study have revealed new information about drug use in prisons. This study will also aid in the identification of drug smuggling routes into jails, keeping prison staff up to date with the trends.
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Affiliation(s)
- Asena Avci Akca
- Department of Biology, Akdeniz University, Antalya, Turkiye; Institute of Forensic Sciences, Department of Forensic Toxicology, Ankara University, Ankara, Turkiye; Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Lewis Couchman
- Analytical Services International Ltd, St. George's University of London, London, UK; Department of Analytical, Environmental and Forensic Sciences, King's College London, London, UK.
| | - Anca Frinculescu
- Department of Analytical, Environmental and Forensic Sciences, King's College London, London, UK; TICTAC Communications Ltd., St. George's University of London, London, UK.
| | - Atholl Johnston
- Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Analytical Services International Ltd, St. George's University of London, London, UK.
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Li J, Wang Y, Liu A, Liu S. Sensitive detection of synthetic cannabinoids in human blood using magnetic polydopamine molecularly imprinted polymer nanocomposites. Analyst 2023; 148:4850-4856. [PMID: 37622412 DOI: 10.1039/d3an01135f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Synthetic cannabinoids (SCs) are a series of artificial chemical substances with pharmacological properties similar to those of natural cannabinoids and their abuse poses a great risk to social security and human health. However, the highly sensitive detection of low concentrations of SCs in human serum remains a great challenge. In this work, we developed a highly sensitive, rapid and highly selective method for the detection of SCs in human serum. Magnetic molecularly imprinted polymer (MIP) nanocomposites were prepared through self-polymerization of dopamine and template molecules on the surfaces of magnetic beads. 9H-Carbazole-9-hexanol (9CH) was used as a template molecule because of its long chain structure shared with six synthetic cannabinoids and its ability to provide specific recognition sites. With these magnetic MIP nanoparticles, six SCs could be rapidly and effectively extracted from human blood. The concentrations of six SCs could be accurately determined by high-performance liquid chromatography-mass spectrometry (HPLC-MS) analysis. The limits of detection were in the range of 0.1-0.3 ng mL-1. The proposed method is characterized by high sensitivity and selectivity, and has great potential for application in the analysis of practical samples.
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Affiliation(s)
- Jiajia Li
- Jiangsu Engineering Laboratory of Smart Carbon-Rich Materials and Device (CMD), Jiangsu Province Hi-Tech Key Laboratory for Bio-medical Research, School of Chemistry and Chemical Engineering, Southeast University, Nanjing, 211189, P. R. China.
| | - Yong Wang
- Institute of Forensic Science and Technology of Nanjing Public Security Bureau, Nanjing, 210012, P. R. China
| | - Anran Liu
- Jiangsu Engineering Laboratory of Smart Carbon-Rich Materials and Device (CMD), Jiangsu Province Hi-Tech Key Laboratory for Bio-medical Research, School of Chemistry and Chemical Engineering, Southeast University, Nanjing, 211189, P. R. China.
| | - Songqin Liu
- Jiangsu Engineering Laboratory of Smart Carbon-Rich Materials and Device (CMD), Jiangsu Province Hi-Tech Key Laboratory for Bio-medical Research, School of Chemistry and Chemical Engineering, Southeast University, Nanjing, 211189, P. R. China.
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Kühnl R, Aydin D, Horn S, Olderbak S, Verthein U, Kraus L. Taking the cat-and-mouse game to the next level: different perspectives on the introduction of the German New Psychoactive Substances Act. Harm Reduct J 2022; 19:122. [PMID: 36329471 PMCID: PMC9632031 DOI: 10.1186/s12954-022-00704-7] [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: 03/25/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To counteract the spread of new psychoactive substances (NPS) and to prevent the emergence of novel substances, specifically designed as a response to the legal control of individual substances, a new law was introduced in Germany in 2016: the New Psychoactive Substances Act (NpSG). The NpSG combines a generic approach with the waiver of criminal liability for the acquisition and possession of NPS for personal use, which is a novelty in German narcotics law. The present study aimed at exploring the impact of the introduction of the NpSG from three different perspectives-NPS users, staff of addiction care facilities, and members of law enforcement authorities-to better understand the dynamics surrounding such a change in legislation and to contribute to the body of international experience in dealing with NPS. METHODS Semi-structured narrative interviews were conducted with a total of 193 representatives of the three different groups affected by the law. These interviews included questions on perceived changes associated with the introduction of the NpSG as well as questions on opinions regarding legal and criminal policy issues. The analysis was carried out using qualitative content analysis according to Mayring. RESULTS Most interviewees welcomed the non-criminalisation approach of the NpSG but also noticed that, in practice, not much has changed for users. Nevertheless, the changes in legislation have had an impact on the market. For example, novel substances have emerged circumventing the new legislation. According to users, this has led some to reduce NPS use and others to adopt more hazardous consumption patterns. Overall, most respondents did not expect the introduction of the NpSG to bring any significant changes. CONCLUSIONS Although the idea of non-criminalisation inherent to the NpSG is appreciated and the generic approach has been well implemented in the law, thus covering a wide range of substances, the introduction of the law-perhaps for that very reason-has also had unintended and negative consequences, taking the cat-and-mouse game to the next level. To end the game, or at least to defuse the game situation, a combination of different strategies will be necessary, with legislation always playing a key role.
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Affiliation(s)
- Regina Kühnl
- IFT Institut für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany.,Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89069, Ulm, Germany
| | - Darya Aydin
- IFT Institut für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany
| | - Sabine Horn
- Unit III.5 Criminal Law, Criminal Procedural Law and Criminal Politics, German Police University, Zum Roten Berge 18-24, 48165, Muenster, Germany
| | - Sally Olderbak
- IFT Institut für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany.,Psychology Department, University of Arizona, 1503 E University Blvd., Tucson, AZ, 85721, USA
| | - Uwe Verthein
- Department of Psychiatry and Psychotherapy, Centre of Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany. .,Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, 106 91, Stockholm, Sweden. .,Institute of Psychology, ELTE Eötvös Loránd University, Egyetem tér 1-3, 1053, Budapest, Hungary.
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Ceci F, Di Carlo F, Burkauskas J, Salone A, De Luca I, Cicconcelli D, Giorgetti V, La Fratta I, Todaro A, Simonato P, Martinotti G, di Giannantonio M, Corazza O. Physical Activity and Exercise Addiction During the Covid-19 Pandemic in Italy. Int J Ment Health Addict 2022; 21:1-21. [PMID: 35469185 PMCID: PMC9020546 DOI: 10.1007/s11469-022-00815-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 12/24/2022] Open
Abstract
Severe restrictive measures were implemented globally to limit the spread of the Covid-19 pandemic leading to significant lifestyle changes and impacting on both the physical and the mental health of citizens. Caught by the fear of getting sick, some individuals have adopted behaviors which favored the development of exercise addiction (EA). Our aim was to evaluate physical activity habits and the risk of EA in the general Italian population during phase 1 of the lockdown. The role of appearance anxiety (AA), self-compassion, and use of performance and image enhancing drugs (PIEDs) as predictors of EA development were investigated. A comparison between physically active subjects with the inactive ones was also included. Between April and May 2020, an online survey was conducted across Italy. Nine hundred thirty-six answers were collected. The rate of EA in the physically active sample (782 subjects) was 4.1%. The physically active group showed higher SCS scores and a greater use of PIEDs. Of the physically active participants, 84.2% reported variations in their fitness routine. Perceived benefit of exercising resulted significantly higher in those with EA. Subjects with EA reported stronger motivation in engaging in physical activity as for "physical wellness," "psychological well-being," and "sexual attractiveness and confidence in relationship." A higher level of AA, a lower level of self-compassion, and a higher perceived benefit of exercising during lockdown were all significant predictors for the presence of EA. Our findings suggest that the fear of getting sick from Covid-19, combined with radical changes in the lifestyles induced by the lockdown and individual personological characteristics, can favor the development of EA and related phenomena in the general population.
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Affiliation(s)
- Franca Ceci
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Francesco Di Carlo
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Anatolia Salone
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Ilaria De Luca
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
| | - Dorotea Cicconcelli
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
| | - Valentina Giorgetti
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
| | - Irene La Fratta
- Department of Medical and Oral Sciences and Biotechnologies, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Pierluigi Simonato
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
| | - Massimo di Giannantonio
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Ornella Corazza
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
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Guilty by Dissociation: Part A: Development of a rapid Ultra-High Performance Liquid Chromatography (UHPLC)-MS/MS methodology for the analysis of regioisomeric diphenidine-derived Novel Psychoactive Substances (NPS). J Pharm Biomed Anal 2022; 216:114798. [DOI: 10.1016/j.jpba.2022.114798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 11/15/2022]
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7
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Deen AA, Claridge H, Treble RD, Hamnett HJ, Copeland CS. Deaths from novel psychoactive substances in England, Wales and Northern Ireland: Evaluating the impact of the UK psychoactive substances act 2016. J Psychopharmacol 2021; 35:1315-1323. [PMID: 34182812 PMCID: PMC8600590 DOI: 10.1177/02698811211026645] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND 'Legal highs' began appearing in the UK in the mid-2000s. Whilst many of these substances were controlled under the 1971 Misuse of Drugs Act, novel compounds and new variants of controlled compounds were continuously being introduced to the recreational drug market. The Psychoactive Substances Act (PSA) was therefore implemented in 2016 as a blanket ban on all novel psychoactive substances (NPS). AIM To evaluate the impact of the PSA on deaths following NPS use in England, Wales and Northern Ireland. METHODS Cases reported to the National Programme on Substance Abuse Deaths where death had occurred 3 years pre- or post-implementation of the PSA were extracted. Cases with NPS detected at post-mortem were analysed and compared against cases non-NPS cases. RESULTS 293 deaths with NPS detected were identified; 91 occurring before the PSA and 202 afterwards, indicating an 222.0% post-PSA increase. Contrastingly, non-NPS drug-related death case reporting increased by only 8.0%. Synthetic cannabinoid, anxiolytic/sedative and stimulant NPS were detected in the largest proportions of deaths pre-PSA; post-PSA stimulant NPS detections reduced whilst synthetic cannabinoid and anxiolytic/sedative detections increased.Post-PSA, average decedent age increased significantly (mean age pre-PSA 34.4 ± 10.8 vs post-PSA 38.3 ± 9.4), and they were significantly more likely to have been living in deprived areas (pre-PSA 50.0% vs post-PSA 65.9%). CONCLUSIONS Reporting of deaths following NPS use has risen despite introduction of the PSA. Whilst deaths amongst younger individuals and those living in more affluent areas has reduced, additional approaches to prohibition are needed to curb their persistence in deprived demographics.
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Affiliation(s)
- Adrian A Deen
- Institute of Pharmaceutical Sciences,
King’s College London, London, United Kingdom
| | - Hugh Claridge
- Population Health Research Institute,
St George’s, University of London, London, United Kingdom
| | | | - Hilary J Hamnett
- School of Chemistry, University of
Lincoln, Lincoln, United Kingdom
| | - Caroline S Copeland
- Institute of Pharmaceutical Sciences,
King’s College London, London, United Kingdom,Population Health Research Institute,
St George’s, University of London, London, United Kingdom,Caroline S Copeland, Institute of
Pharmaceutical Sciences, King’s College London, Franklin Wilkins Building,
Stamford Street, London, SE1 9 NH, United Kingdom.
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8
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Bade R, White JM, Chen J, Baz-Lomba JA, Been F, Bijlsma L, Burgard DA, Castiglioni S, Salgueiro-Gonzalez N, Celma A, Chappell A, Emke E, Steenbeek R, Wang D, Zuccato E, Gerber C. International snapshot of new psychoactive substance use: Case study of eight countries over the 2019/2020 new year period. WATER RESEARCH 2021; 193:116891. [PMID: 33582495 DOI: 10.1016/j.watres.2021.116891] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
There is considerable concern around the use of new psychoactive substances (NPS), but still little is known about how much they are really consumed. Analysis by forensics laboratories of seized drugs and post-mortem samples as well as hospital emergency rooms are the first line of identifying both 'new' NPS and those that are most dangerous to the community. However, NPS are not necessarily all seized by law enforcement agencies and only substances that contribute to fatalities or serious afflictions are recorded in post-mortem and emergency room samples. To gain a better insight into which NPS are most prevalent within a community, complementary data sources are required. In this work, influent wastewater was analysed from 14 sites in eight countries for a variety of NPS. All samples were collected over the 2019/2020 New Year period, a time which is characterized by celebrations and parties and therefore a time when more NPS may be consumed. Samples were extracted in the country of origin following a validated protocol and shipped to Australia for final analysis using two different mass spectrometric strategies. In total, more than 200 were monitored of which 16 substances were found, with geographical differences seen. This case study is the most comprehensive wastewater analysis study ever carried out for the identification of NPS and provides a starting point for future, ongoing monitoring of these substances.
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Affiliation(s)
- Richard Bade
- Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5001, South Australia, Australia
| | - Jason M White
- Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5001, South Australia, Australia
| | - Jingjing Chen
- Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5001, South Australia, Australia
| | | | - Frederic Been
- KWR Water Research Institute, 3433 PE Nieuwegein, the Netherlands
| | - Lubertus Bijlsma
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Avda, Sos Baynat s/n, E-12071 Castellón, Spain
| | - Daniel A Burgard
- Department of Chemistry, University of Puget Sound, Tacoma, WA 98416, United States
| | - Sara Castiglioni
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Sciences, Via Mario Negri 2, 20156, Milan Italy
| | - Noelia Salgueiro-Gonzalez
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Sciences, Via Mario Negri 2, 20156, Milan Italy
| | - Alberto Celma
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Avda, Sos Baynat s/n, E-12071 Castellón, Spain
| | - Andrew Chappell
- Institute of Environmental Science and Research Limited (ESR), Christchurch Science Centre: 27 Creyke Road, Ilam, Christchurch 8041, New Zealand
| | - Erik Emke
- KWR Water Research Institute, 3433 PE Nieuwegein, the Netherlands
| | - Ruud Steenbeek
- KWR Water Research Institute, 3433 PE Nieuwegein, the Netherlands
| | - Degao Wang
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, P. R. China, 116026
| | - Ettore Zuccato
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Sciences, Via Mario Negri 2, 20156, Milan Italy
| | - Cobus Gerber
- Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5001, South Australia, Australia.
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Dolgova OB, Grekhov IA. [Method for determination the action of psychoactive agents on the central nervous system based on the molecular docking method]. Sud Med Ekspert 2021; 64:47-52. [PMID: 34264581 DOI: 10.17116/sudmed20216404147] [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] [Indexed: 06/13/2023]
Abstract
A large number of narcotic substances are currently being synthesized. In 2018, at least one drug with a new chemical formula was created and distributed around the world every week. In a number of countries, it became necessary to change legislation to optimize the regulation of drug trafficking to speed up and simplify the procedure for adding chemical compounds to the list of drugs. The new global legal and regulatory terminology has made it possible to approach the definition of «psychoactive substance» from a legal and medical point of view. The legislative definitions of medical organizations have been clarified that have determined the main features of new psychoactive substances: the possibility of influencing the human nervous system and the ability to form addictive behavior. The problem in the production of forensic medical examination is the answer to the question about the state of drug intoxication (poisoning) of a person from the action of a new psychoactive substance in the absence of information about the clinical picture of intoxication (poisoning). The proposed method of molecular docking allows confirming the possibility of a chemical substance acting on the human nervous system to determine the similarity with the effects of drugs and to consider the properties of a chemical compound as the properties of a "new psychoactive substance". Molecular docking - modeling the interaction of a bio-target - a human receptor protein sensitive to a drug with a ligand - a drug. The method allows to determine the fundamental possibility of a chemical reaction between molecules, as well as to estimate the reaction energy for the isolation of the most chemically active ligands.
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Affiliation(s)
- O B Dolgova
- Ural State Medical University, Yekaterinburg, Russia
| | - I A Grekhov
- Ural State Medical University, Yekaterinburg, Russia
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10
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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
- Clinical Toxicology, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Derek K. Tracy
- Consultant Psychiatrist, Oxleas NHS Foundation Trust, London, UK
- Department of Psychosis Studies, the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, DeCrespigny Park, London, SE5 8AF, UK
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11
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Moeller K, Svensson B, Munksgaard R. Fentanyl analogs on the Swedish webforum flashback: Interest and impact of scheduling. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 87:103013. [PMID: 33181448 DOI: 10.1016/j.drugpo.2020.103013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/11/2020] [Accepted: 10/13/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Sweden regulates new psychoactive substances, including fentanyl analogs, individually. This reactive scheduling procedure enabled the existence of a recreational market for unscheduled fentanyl analogs sold from surface webshops. We measure the interest in 24 named fentanyl analogs and the impact of scheduling. METHODS We scraped posts in threads on named fentanyl analogs from the Swedish internet forum Flashback.org, 2012-2019. The sample consists of 24 threads with a total of 8761 posts. We construct five measures of interest based on duration of threads, number of posts, and number of distinct posters, and fit a non-seasonal ARMA model to test if there was a change in mean activity after scheduling. RESULTS Across the five measures, there was most interest in acryl fentanyl, butyr fentanyl, and acetyl fentanyl. The number of daily posts was significantly reduced in nine out of 13 threads after scheduling. CONCLUSION The scheduling of fentanyl analogs impacted interest on Flashback.org. The biggest effect sizes were from the narcotics scheduling of 2-Me-MAF, acryl, and acetyl fentanyl, while furanyl fentanyl saw the biggest reduction after health scheduling. The reductions were bigger for narcotics scheduling compared to health scheduling.
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Affiliation(s)
- Kim Moeller
- Department of Criminology, Malmö University, Sweden.
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12
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El Balkhi S, Monchaud C, Herault F, Géniaux H, Saint-Marcoux F. Designer benzodiazepines' pharmacological effects and potencies: How to find the information. J Psychopharmacol 2020; 34:1021-1029. [PMID: 31971477 DOI: 10.1177/0269881119901096] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Scientific data on the psychopharmacological effects of new psychoactive substances (NPSs) are scarce. Web fora contain a wealth of information posted by users as trip reports (TRs), but the reliability of the reports remains questionable because of the nature of the used molecule and the potential for dose inaccuracies. We focused on the TRs of designer benzodiazepine (DBZD) users since their psychopharmacological effects are similar to prescription benzodiazepines (BZDs). Moreover, the impact of functional groups on the BZD rings with regards to the potency has been fairly/quite studied, allowing structural analysis. METHODS DBZDs offering more than 15 TRs with at least two accounts on experienced effects were included. Data were analyzed with the empirical phenomenological psychological method. Reported effects were analyzed and the pharmacological potencies of DBZDs were compared by calculating a 'potency score'. RESULTS In total, 197 TRs for clonazolam, deschloroetizolam, diclazepam, etizolam, flubromazepam, flubromazolam, meclonazepam, metizolam, nifoxipam and pyrazolam were analyzed. Effects similar to prescription BZDs were reported for all the selected DBZDs. Pyrazolam was reported to be the most anxiolytic DBZD, flubromazolam the most hypnotic, etizolam the most euphoric and flubromazolam and clonazolam as the most amnesic DBZDs. Diclazepam and pyrazolam were not reported to induce euphoria. Flubromazepam, flubromazolam, clonazolam and meclonazepam were the most potent and deschloroetizolam, nifoxipam, metizolam and pyrazolam the least potent. The chemical structure of the different DBZDs and the functional groups on the BZD rings confirmed this ranking, except for nifoxipam. CONCLUSIONS When information on NPSs obtained from Internet fora are abundant, it could be considered as an appreciable data source.
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Affiliation(s)
- Souleiman El Balkhi
- Department of Pharmacology, Toxicology and Pharmacovigilance, Limoges University Hospital, Limoges, France.,INSERM, 1248 UMR, Limoges, France
| | - Caroline Monchaud
- Department of Pharmacology, Toxicology and Pharmacovigilance, Limoges University Hospital, Limoges, France.,INSERM, 1248 UMR, Limoges, France
| | | | - Hélène Géniaux
- Department of Pharmacology, Toxicology and Pharmacovigilance, Limoges University Hospital, Limoges, France
| | - Franck Saint-Marcoux
- Department of Pharmacology, Toxicology and Pharmacovigilance, Limoges University Hospital, Limoges, France.,INSERM, 1248 UMR, Limoges, France.,University of Limoges, Faculty of Pharmacy, Limoges, France
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13
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Bade R, Abbate V, Abdelaziz A, Nguyen L, Trobbiani S, Stockham P, Elliott S, White JM, Gerber C. The complexities associated with new psychoactive substances in influent wastewater: The case of 4-ethylmethcathinone. Drug Test Anal 2020; 12:1494-1500. [PMID: 32621345 DOI: 10.1002/dta.2890] [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] [Received: 03/26/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 11/07/2022]
Abstract
Consumption of new psychoactive substances (NPS) is an international problem for health, policing, forensic, and analytical laboratories. The transience of these substances in the community, combined with continual slight structural changes to evade legislation makes the elucidation of NPS an analytical challenge. This is amplified in a matrix as complex as wastewater. For that reason, suspect and non-target methodologies, employing high resolution mass spectrometry are the most appropriate current tool to facilitate the identification of new and existing compounds. In the current work, a qualitative screening method of influent wastewater using liquid chromatography-high resolution mass spectrometry showed a strong signal at m/z 192.1382 - identical to that of two NPS standards that were in our method (pentedrone and 4-methylethcathinone), and with identical fragment ions, but the retention times did not match. This work shows the methodology followed to identify this compound, highlighting the challenges of the identifying "new" compounds in influent wastewater.
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Affiliation(s)
- Richard Bade
- UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, University of South Australia, Adelaide, South Australia, Australia
| | - Vincenzo Abbate
- King's Forensics, Department of Analytical, Environmental and Forensic Sciences, King's College London, London, UK
| | - Ahmed Abdelaziz
- UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, University of South Australia, Adelaide, South Australia, Australia
| | - Lynn Nguyen
- UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, University of South Australia, Adelaide, South Australia, Australia
| | | | - Peter Stockham
- Forensic Science SA, GPO Box 2790, Adelaide, Australia.,College of Science and Engineering, Flinders University, Bedford Park, South Australia
| | - Simon Elliott
- King's Forensics, Department of Analytical, Environmental and Forensic Sciences, King's College London, London, UK.,Elliott Forensic Consulting, Birmingham, UK
| | - Jason M White
- UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, University of South Australia, Adelaide, South Australia, Australia
| | - Cobus Gerber
- UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, University of South Australia, Adelaide, South Australia, Australia
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14
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Hamilton I. Role of non-specialist nurses in supporting people who misuse drugs. Nurs Stand 2020; 35:61-66. [PMID: 32323931 DOI: 10.7748/ns.2020.e11522] [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] [Accepted: 01/28/2020] [Indexed: 06/11/2023]
Abstract
In their practice, nurses are likely to encounter people who misuse drugs, but they may find it daunting to support these patients. While specialist drug treatment services have an important role in providing substitution treatment and talking therapies, referral is not always appropriate for some patients. Non-specialist nurses are well placed to use techniques such as brief interventions and motivational interviewing to engage patients in discussions about their drug misuse and prompt them to consider how they could reduce it. This article defines drug misuse, describes the contributing factors that can lead to it and its associated health issues. It also discusses how non-specialist nurses can manage and provide optimal support for patients who misuse drugs.
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15
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Grigg J, Killian JJ, Matthews S, Scott D, Arunogiri S, Manning V, Taylor DA, Crossin R, Smith K, Lubman DI. The impact of legislation on acute synthetic cannabinoid harms resulting in ambulance attendance. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 79:102720. [PMID: 32279004 DOI: 10.1016/j.drugpo.2020.102720] [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: 09/20/2019] [Revised: 02/28/2020] [Accepted: 03/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Synthetic cannabinoid receptor agonists (SCRAs) have been challenging current drug policy due to the rapid emergence of new variants, and their propensity for acute harm. In Australia, as in other parts of the world, multiple regulatory changes have occurred in response to these new psychoactive compounds, and population surveys indicate use is declining. This suggests that related harms would also be declining. We examined the impact of drug legislative changes on acute SCRA-related harms resulting in ambulance attendance. Secondary aims were to describe patient and attendance characteristics. METHODS A retrospective analysis of coded ambulance attendance data from Victoria, Australia (January 2014-December 2018). Interrupted time-series was used to analyse the trajectories of SCRA-related attendances relative to legislative changes. RESULTS During the study period, 3727 SCRA-related ambulance attendances were identified. There was an upward trend in attendances following legislation scheduling specific SCRAs in Victoria in October 2016 (slope = 1.31, 95% CI 1.17, 1.45). A downward trend in attendances followed 'blanket' legislation targeting all new psychoactive substances, implemented in Victoria in November 2017 (slope = -1.87, 95% CI -2.27, -1.46). Patient median age was 33 years, 80.5% were male, co-occurring substance use was identified in 30.4% cases, and 15.2% had >1 SCRA-related attendance. Overall, 69.4% cases were transported to hospital, with the odds of transport to hospital increasing each year from 2016. CONCLUSION This study represents a population-level examination of the impact of drug policy on acute SCRA-related harms resulting in ambulance attendance. Scheduling of specific SCRAs was associated with a spike in attendances, likely due to the introduction of more harmful variants in the drug market. Blanket legislation was associated with a reduction in SCRA-related attendances, however, a corresponding increase in cases transported to hospital indicates a greater severity of harm that may have been inadvertently promoted by this policy.
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Affiliation(s)
- Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia.
| | - Jessica J Killian
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Sharon Matthews
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Debbie Scott
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | | | - Rose Crossin
- Turning Point, Eastern Health, Melbourne, Australia
| | - Karen Smith
- Centre for Research and Evaluation, Ambulance Victoria, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
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16
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Hill RG. Understanding the UK Psychoactive Substances Act. Br J Clin Pharmacol 2020; 86:499-504. [PMID: 31749206 PMCID: PMC7080622 DOI: 10.1111/bcp.14168] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/04/2019] [Accepted: 10/17/2019] [Indexed: 11/28/2022] Open
Abstract
This review paper is based on a talk given at the British Pharmaceutical Society Winter Meeting in 2018 derived from the Home Office Report on the workings of the UK Psychoactive Substances Act (PSA) published in November 2018. The review deals with the context in which the PSA 2016 arose and how this piece of legislation differs from other UK drug regulations. It attempts to put the PSA in context with other control schemes being instituted around the world and to assess the success of the Act in its first 2 years of implementation. For more details the reader is referred to Review of the Psychoactive Substances Act 2016, Home Office, November 2018.
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Affiliation(s)
- Raymond G. Hill
- Faculty of MedicineImperial CollegeCommonwealth Building, Hammersmith Campus, Du Cane RdLondonUK
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17
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Al-Banaa I, Hawkins L, Hill SL, Lupton DJ, Jackson G, Sandilands EA, Bradberry SM, Thompson JP, Rushton S, Thomas SHL. Effect of the UK Psychoactive Substances Act 2016 on episodes of toxicity related to new psychoactive substances as reported to the National Poisons Information Service. A time series analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 77:102672. [PMID: 32032867 DOI: 10.1016/j.drugpo.2020.102672] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND There have been recent increases in use of new psychoactive substances (NPS) associated with acute health harms including hospital presentations due to toxicity and increasing numbers of deaths. In response, the UK Government enacted generic legislation on 26th May 2016 (the Psychoactive Substances Act) making it an offence to produce, possess with intent to supply, supply, import or export, or possess within a custodial setting a psychoactive substance. We studied the impact of this Act on monthly frequency of enquiries made by health professionals to the UK National Poisons Information Service (NPIS) about NPS. We also studied five commonly used 'conventional' drugs of misuse that had been controlled prior to January 2009. METHOD Anonymised clinical enquiries to the NPIS and accesses to the poisons information database TOXBASE were reviewed retrospectively from January 2009 to December 2018 to ascertain the trends in reported toxicity for NPS, cocaine, heroin, cannabis, amphetamines and MDMA. Data were analysed using interrupted time series analysis with the date of the PSA used as an independent predictor. RESULTS Over the period of study there were 3,866 NPIS telephone enquiries and 79,271 TOXBASE user accesses made by UK health professionals concerning NPS. There were increases in monthly TOXBASE accesses (t = 7.408, P < 0.0001) and telephone enquiries (t = 4.74, P < 0.001) over the pre-specified period January 2009 to May 2016. Comparing the period after the PSA with that before, there were significant reductions in TOXBASE accesses (t = -3.327, P < 0.001) and telephone enquiries (t = -6.97, P < 0.001), although reductions started before May 2016. There were no significant changes for the five conventional drugs. There were significant reductions in telephone enquiries (t = -3.418, P < 0.001) and non-significant reductions in TOXBASE accesses (t = -1.713, P = 0.089) for NPS between June 2016 and December 2018. Increases in telephone enquiries for cocaine and reductions TOXBASE accesses for MDMA were also observed over that period. CONCLUSIONS There have been significant recent reductions in NPIS enquiry activity relating to NPS; although these began before enactment of the PSA in May 2016.
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Affiliation(s)
- I Al-Banaa
- Health Protection Research Unit for Chemical and Radiation Threats and Hazards, Newcastle University, Newcastle NE2 4HH, United Kingdom; College of Pharmacy, Department of Pharmacology and Toxicology, University of Mosul, Iraq.
| | - L Hawkins
- National Poisons Information Service (Newcastle Unit), Newcastle upon Tyne Hospitals NHS Foundation Trust, Wolfson Unit, Claremont Place, Newcastle upon Tyne, NE2 4HH, United Kingdom
| | - S L Hill
- National Poisons Information Service (Newcastle Unit), Newcastle upon Tyne Hospitals NHS Foundation Trust, Wolfson Unit, Claremont Place, Newcastle upon Tyne, NE2 4HH, United Kingdom
| | - D J Lupton
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - G Jackson
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - E A Sandilands
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - S M Bradberry
- National Poisons Information Service (Birmingham Unit), City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom
| | - J P Thompson
- National Poisons Information Service, Cardiff Unit, University Hospital Llandough, Penlan Road, Penarth, Vale of Glamorgan CF64 2XX, United Kingdom
| | - S Rushton
- School of Natural and Environmental Sciences, Newcastle University, Newcastle NE2 4HH, United Kingdom
| | - S H L Thomas
- Health Protection Research Unit for Chemical and Radiation Threats and Hazards, Newcastle University, Newcastle NE2 4HH, United Kingdom
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18
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Smyth BP, Daly A, Elmusharaf K, McDonald C, Clarke M, Craig S, Cullen W. Legislation targeting head shops selling new psychoactive substances and changes in drug-related psychiatric admissions: A national database study. Early Interv Psychiatry 2020; 14:53-60. [PMID: 30945460 DOI: 10.1111/eip.12807] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/04/2019] [Accepted: 02/17/2019] [Indexed: 11/26/2022]
Abstract
AIM New psychoactive substance (NPS) use can negatively impact mental health and may result in drug-related psychiatric admissions (DRPA). Irish youth reported very high rates of NPS use by international standards, the most common being synthetic cannabinoids and cathinones. This occurred in the context of a rapid expansion in specialist high street shops, called head shops, selling NPS in 2010. Government responded to public protests about head shops by enacting legislation in May and August 2010 to end this trade. Many academics argued that such actions were futile. We sought to determine if changes in head shop activity coincided with changes in DRPA. METHOD The national database on psychiatric admissions was examined focusing on young adults admitted from 2008 to 2012. Joinpoint regression analysis was utilized to examine for the presence of trend changes in DRPA. RESULTS The monthly rate of DRPA was higher in 2010 than 2008, 2009 and 2012 (P < 0.01). Joinpoint regression analysis identified a significant downward trend change which occurred in July 2010 (95% CI Feb 2010 to April 2011). Young males aged 18 to 24 years showed evidence of greatest change, DRPA falling by 1.4% per month (95% CI 0.7 to 3.7% decline) from May 2010 to December 2012. CONCLUSIONS Cessation of NPS sale by head shops coincided with a reversal in the upward trend of DRPA, this change being most evident in young men. While correlation does not imply causation, legislation which successfully targets the sale of NPS may result in reduced drug-related mental disorders.
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Affiliation(s)
- Bobby P Smyth
- Department of Public Health & Primary Care, Trinity College Dublin, Ireland.,Graduate Entry Medical School, University of Limerick, Limerick, Ireland.,HSE Addiction Service, Bridge House, Cherry Orchard Hospital, Dublin, Ireland
| | - Antoinette Daly
- National Health Information Systems, Health Research Board, Dublin, Ireland
| | - Khalifa Elmusharaf
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | | | - Mary Clarke
- School of Medicine, University College Dublin, Ireland
| | - Sarah Craig
- National Health Information Systems, Health Research Board, Dublin, Ireland
| | - Walter Cullen
- School of Medicine, University College Dublin, Ireland
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19
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Peacock A, Bruno R, Gisev N, Degenhardt L, Hall W, Sedefov R, White J, Thomas KV, Farrell M, Griffiths P. New psychoactive substances: challenges for drug surveillance, control, and public health responses. Lancet 2019; 394:1668-1684. [PMID: 31668410 DOI: 10.1016/s0140-6736(19)32231-7] [Citation(s) in RCA: 150] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 06/05/2019] [Accepted: 08/08/2019] [Indexed: 12/30/2022]
Abstract
The rapid emergence since the mid-2000s of a large and diverse range of substances originally designed as legal alternatives to more established illicit drugs (pragmatically clustered and termed new psychoactive substances; [NPS]) has challenged traditional approaches to drug monitoring, surveillance, control, and public health responses. In this section of the Series, we describe the emergence of NPS and consider opportunities for strengthening the detection, identification, and responses to future substances of concern. First, we explore the definitional complexity of the term NPS. Second, we describe the origins and drivers surrounding NPS, including motivations for use. Third, we summarise evidence on NPS availability, use, and associated harms. Finally, we use NPS as a case example to explore challenges and opportunities for future drug monitoring, surveillance, control, and public health responses. We posit that the current means of responding to emerging substances might no longer be fit for purpose in a world in which different substances can be rapidly introduced, and where people who use drugs can change preferences on the basis of market availability.
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Affiliation(s)
- Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia; School of Psychology, University of Tasmania, Hobart, TAS, Australia.
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia; School of Psychology, University of Tasmania, Hobart, TAS, Australia
| | - Natasa Gisev
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Wayne Hall
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia; Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Roumen Sedefov
- European Monitoring Centre on Drugs and Drug Addiction, Lisbon, Portugal
| | - Jason White
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Paul Griffiths
- European Monitoring Centre on Drugs and Drug Addiction, Lisbon, Portugal
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20
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Understanding and managing the new psychoactive substances phenomenon: a holistic approach. J Public Health Policy 2019; 40:217-235. [PMID: 30504846 DOI: 10.1057/s41271-018-0156-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The new psychoactive substances (NPS) phenomenon has emerged as a global threat that challenges public health and institutions. There are important qualitative differences between the NPS and traditional drugs phenomena. We discuss these differences and explore the complex structure of the NPS phenomenon. We analyse the entire phenomenon with a global, holistic approach. We present an original framework to help policy makers, healthcare practitioners, and community workers understand the NPS phenomenon's structure and to plan comprehensive policy responses and prevention strategies. We discuss fundamental characteristics, driving forces, routes of information, and social and individual health risks of the phenomenon. We conclude that a holistic approach integrating all aspects of the framework is essential for addressing this emerging threat. We give practical examples of interventions likely to be effective.
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21
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Corazza O, Simonato P, Demetrovics Z, Mooney R, van de Ven K, Roman-Urrestarazu A, Rácmolnár L, De Luca I, Cinosi E, Santacroce R, Marini M, Wellsted D, Sullivan K, Bersani G, Martinotti G. The emergence of Exercise Addiction, Body Dysmorphic Disorder, and other image-related psychopathological correlates in fitness settings: A cross sectional study. PLoS One 2019; 14:e0213060. [PMID: 30943200 PMCID: PMC6447162 DOI: 10.1371/journal.pone.0213060] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/15/2019] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION In a society that perpetuates the strive for a perfect appearance, a fit body has become synonymous with success, but simultaneously hard to achieve. This represents a fertile ground for the development of Exercise Addiction (EA) alongside other disorders, such as Body Dysmorphic Disorder (BDD). This study aims to explore the diffusion of EA in fitness settings in the United Kingdom, Italy, Netherlands, Hungary and the previously unexplored association with appearance anxiety, BDD, self-esteem and the use of fitness supplements. METHODS A large cross-sectional sample (N = 1711) was surveyed in fitness settings using the Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI) and Rosenberg's Self Esteem Scale (RSE) in addition to questions surrounding the use of fitness supplements. RESULTS Compulsive exercise, appearance anxiety and low self-esteem were present in this sample according to the psychometric measures used (EAI, AAI, RSE). 11.7% scored over the cut off for EA, with alarming peaks in the Netherlands (20.9%) and the United Kingdom (16.1%). 38.5% were found at risk of BDD, mainly female (47.2%). 39.8% used fitness enhancing supplements without medical consultation (95.5%). This cohort of supplement users scored higher in both EAI and AAI. The logistic regression model revealed a strong association between the consumption of sport products and the level of EA across the sample with an odds ratio (OR) of 3.03. Other co-variable factors among female were appearance anxiety (AAI; OR 1.59) and to a lesser extent self-esteem (RSE) (OR 1.08). CONCLUSIONS This study identified a high risk of EA, appearance anxiety and BDD amongst a cohort of gym users internationally. The previously-unexplored association between these disorders and the unsupervised use of a variety of fitness products, including illicit drugs, highlights the need for informed and integrated responses targeting such vulnerable individuals.
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Affiliation(s)
- Ornella Corazza
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Pierluigi Simonato
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Dual-Diagnosis Unit, Clinic Parco dei Tigli, Padova, Italy
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addiction, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Roisin Mooney
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Katinka van de Ven
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
| | - Andres Roman-Urrestarazu
- Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
- Department of International Health, Maastricht University, Maastricht, Netherlands
| | - Lili Rácmolnár
- Department of Clinical Psychology and Addiction, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Ilaria De Luca
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Eduardo Cinosi
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, United Kingdom
| | - Rita Santacroce
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Neuroscience, Imaging, and Clinical Science, University of Chieti Pescara, Chieti, Italy
| | - Massimo Marini
- Department of Psychiatry, University of Padua, Padua, Italy
| | - David Wellsted
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Keith Sullivan
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Giuseppe Bersani
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Giovanni Martinotti
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Neuroscience, Imaging, and Clinical Science, University of Chieti Pescara, Chieti, Italy
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X-Ray powder diffraction – A non-destructive and versatile approach for the identification of new psychoactive substances. Talanta 2019; 195:414-418. [DOI: 10.1016/j.talanta.2018.11.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/12/2018] [Accepted: 11/19/2018] [Indexed: 02/05/2023]
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McAuley A, Yeung A, Taylor A, Hutchinson SJ, Goldberg DJ, Munro A. Emergence of Novel Psychoactive Substance injecting associated with rapid rise in the population prevalence of hepatitis C virus. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 66:30-37. [PMID: 30690222 DOI: 10.1016/j.drugpo.2019.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Novel Psychoactive Substance (NPS) use has increased in recent years and generated significant concern within public health. People who inject drugs (PWID) are at increased risk of blood borne viruses, in particular Hepatitis C virus (HCV). However, little is known about the extent of NPS injecting at a national level and its association with HCV. This study provides one of the first epidemiological analyses of the association between NPS injecting and HCV among a population level sample of PWID. METHODS Five cross sectional surveys of almost 13,000 PWID attending services providing injecting equipment across Scotland between 2008 and 2016 were analysed. Logistic regression was used to determine associations between NPS injecting and HCV. RESULTS The proportion of PWID reporting that they had injected NPS in the previous six months increased from 0.2% in 2008-09 to 11.0% in 2015-16. Those who reported injecting NPS were considerably more likely to be resident in the Lothian NHS Board area at the time of the study (AOR 5.6 (95% CI 4.1-7.5)) and to have had recent experience of homelessness (AOR 1.4 (95% CI 1.0-1.9)). People who injected NPS were also significantly more likely to be HCV positive (AOR 1.7 (95% CI 1.2-2.4)). In Lothian, HCV prevalence rose from around 30% between 2008 and 2012 to 41% and then 48% in 2013-14 and 2015-16 respectively. Increases in prevalent HCV infection in Lothian may be partly attributed to increases in NPS injecting. CONCLUSION In Scotland, people who had injected Novel Psychoactive Substances were at increased risk of hepatitis C virus. Novel Psychoactive Substance injecting poses a threat to HCV elimination strategies.
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Affiliation(s)
- Andrew McAuley
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, Meridian Court, Cadogan St, Glasgow, UK.
| | - Alan Yeung
- Health Protection Scotland, Meridian Court, Cadogan St, Glasgow, UK
| | - Avril Taylor
- School of Media, Culture and Society, University of the West of Scotland, Paisley, UK
| | - Sharon J Hutchinson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, Meridian Court, Cadogan St, Glasgow, UK
| | - David J Goldberg
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, Meridian Court, Cadogan St, Glasgow, UK
| | - Alison Munro
- Scottish Improvement Science Collaborating Centre, University of Dundee, UK
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MONAGHAN MARK, WINCUP EMMA, WICKER KATE. Experts, Expertise and Drug Policymaking. ACTA ACUST UNITED AC 2018. [DOI: 10.1111/hojo.12265] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- MARK MONAGHAN
- Mark Monaghan is Lecturer in Criminology and Social Policy, Department of Social Sciences; Loughborough University
| | - EMMA WINCUP
- Emma Wincup is Senior Lecturer, School of Law; University of Leeds
| | - KATE WICKER
- Kate Wicker is Doctoral Student, School of Sociology and Social Policy; University of Leeds
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25
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Hall W. The future of the international drug control system and national drug prohibitions. Addiction 2018; 113:1210-1223. [PMID: 28884869 DOI: 10.1111/add.13941] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/21/2017] [Accepted: 07/10/2017] [Indexed: 01/17/2023]
Abstract
A major impediment to any nation abandoning the policy of drug prohibition has been the fact that international drug treaties to which the majority of United Nations (UN) member states are signatory prohibit the non-medical use of amphetamines, cannabis, cocaine and heroin. The future of these treaties is now uncertain because of decisions by Uruguay, eight US states and Canada to legalize cannabis use. This paper: (1) provides a brief account of the international drug control treaties; (2) outlines the major criticisms of the treaties; (3) analyses critically proposals for treaty reform; and (4) provides a personal view on policies that nation states could adopt to minimize the harms from the use of cannabis, party drugs and hallucinogens, opioids, stimulants and new psychoactive substances. It is argued that: a major risk of cannabis legalization in the United States is promotion of heavy use and increased harm by a weakly regulated industry; some cautious national experiments with the regulation of party drugs and hallucinogens would be informative; a strong case remains for prohibiting the nonmedical use of opioids while mitigating the adverse effects that this policy has on opioid-dependent people; stimulant legalization will probably increase problem use but prohibition is difficult to enforce, highlighting the urgency of finding better ways to reduce demand for these drugs and respond to problem users; and that it is unclear what the best approach is to reducing possible harms that may arise from the use of new psychoactive substances.
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Affiliation(s)
- Wayne Hall
- National Addiction Centre, Institute of Psychiatry, Psychiatry and Neuroscience, King's College, London, London, UK.,The Centre for Youth Substance Abuse Research, The University of Queensland, Herston, QLD, Australia.,National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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26
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Chatwin C, Blackman S, O’Brien KL. Intersections in (New) drug research. DRUGS-EDUCATION PREVENTION AND POLICY 2018. [DOI: 10.1080/09687637.2018.1466867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Caroline Chatwin
- SSPSSR, University of Kent, Canterbury, United Kingdom of Great Britain and Northern Ireland
| | - Shane Blackman
- Media, Canterbury Christ Church University, Canterbury, United Kingdom of Great Britain and Northern Ireland
| | - Kate Louise O’Brien
- SASS, Durham University, Durham, United Kingdom of Great Britain and Northern Ireland
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27
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Rychert M, Wilkins C. A critical analysis of the implementation of a legal regulated market for new psychoactive substances (“legal highs”) in New Zealand. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018. [DOI: 10.1016/j.drugpo.2018.02.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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28
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Boateng BO, Fever M, Edwards D, Petersson P, Euerby MR, Sutcliffe OB. Chromatographic retention behaviour, modelling and optimization of a UHPLC-UV separation of the regioisomers of the Novel Psychoactive Substance (NPS) methoxphenidine (MXP). J Pharm Biomed Anal 2018. [PMID: 29514124 DOI: 10.1016/j.jpba.2018.02.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A detailed investigation into the chromatographic retention behaviour and separation of the three regioisomers of the Novel Psychoactive Substance (NPS) methoxphenidine (i.e. 2-, 3- and 4-MXP isomers) has revealed the ionization state of the analyte and stationary phase, to be the controlling factor in dictating which retention mechanism is in operation. At low pH, poor separation and retention was observed. In contrast, at intermediate pH, enhanced retention and separation of the three MXP isomers was obtained; it appeared that there was a synergistic effect between the electrostatic and hydrophobic mechanisms. At high pH, the MXP isomers were retained by hydrophobic retention. Accurate retention time predictions (<0.5%) were achievable using non-linear retention models (3 × 3). This allowed the optimization of the gradient separation of the MXP isomers using a two-dimensional gradient and temperature design space. Prediction errors for peak width and resolution were, in most cases, lower than 5%. The use of linear models (2 × 2) still afforded retention time and resolution accuracies of <2.3 and 11% respectively. A rapid and highly sensitive LC-MS friendly method (i.e. Rsmin > 5 within 4 min) was predicted and verified. The developed methodology should be highly suitable for the rapid, specific and sensitive detection and control of MXP regioisomers.
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Affiliation(s)
- Bernard O Boateng
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde,161 Cathedral Street, Glasgow, G4 0RE, UK
| | - Mark Fever
- Hichrom Ltd, 1 The Markham Centre, Station Road, Theale, Reading Berkshire, RG7 4PE, UK
| | - Darren Edwards
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde,161 Cathedral Street, Glasgow, G4 0RE, UK
| | | | - Melvin R Euerby
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde,161 Cathedral Street, Glasgow, G4 0RE, UK; Hichrom Ltd, 1 The Markham Centre, Station Road, Theale, Reading Berkshire, RG7 4PE, UK.
| | - Oliver B Sutcliffe
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), School of Science and the Environment, Faculty of Science and Engineering, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD, UK.
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29
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Corkery JM, Guirguis A, Papanti DG, Orsolini L, Schifano F. Synthetic Cathinones—Prevalence and Motivations for Use. CURRENT TOPICS IN NEUROTOXICITY 2018. [DOI: 10.1007/978-3-319-78707-7_9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Health and Social Problems Associated with Recent Novel Psychoactive Substance (NPS) Use Amongst Marginalised, Nightlife and Online Users in Six European Countries. Int J Ment Health Addict 2017; 16:480-495. [PMID: 29674947 PMCID: PMC5897487 DOI: 10.1007/s11469-017-9824-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Continued diversification and use of new psychoactive substances (NPS) across Europe remains a public health challenge. The study describes health and social consequences of recent NPS use as reported in a survey of marginalised, nightlife and online NPS users in the Netherlands, Hungary, Portugal, Ireland, Germany and Poland (n = 3023). Some respondents were unable to categorise NPS they had used. Use of ‘herbal blends’ and ‘synthetic cannabinoids obtained pure’ was most reported in Germany, Poland and Hungary, and use of ‘branded stimulants’ and ‘stimulants/empathogens/nootropics obtained pure’ was most reported in the Netherlands. Increased heart rate and palpitation, dizziness, anxiety, horror trips and headaches were most commonly reported acute side effects. Marginalised users reported substantially more acute side effects, more mid- and long-term mental and physical problems, and more social problems. Development of country-specific NPS awareness raising initiatives, health and social service needs assessments, and targeted responses are warranted.
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31
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Khanra S, Munda SK, Khess CRJ, Maity M. New psychoactive substances: Can there be any effective legal enforcement? Asian J Psychiatr 2017; 30:165-166. [PMID: 29073586 DOI: 10.1016/j.ajp.2017.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 10/13/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Sourav Khanra
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi 834006, India.
| | - Sanjay Kumar Munda
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi 834006, India.
| | | | - Manosij Maity
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi 834006, India.
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32
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Addison M, Stockdale K, McGovern R, McGovern W, McKinnon I, Crowe L, Hogan L, Kaner E. Exploring the intersections between novel psychoactive substances (NPS) and other substance use in a police custody suite setting in the north east of England. DRUGS-EDUCATION PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1378620] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Michelle Addison
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Kelly Stockdale
- School of Psychological and Social Sciences, York St John University, North Yorkshire, York, United Kingdom of Great Britain and Northern Ireland
| | - Ruth McGovern
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - William McGovern
- School of Social Work and Communities, Northumbria University, Allendale House, Coach Lane Campus (West), Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Iain McKinnon
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
- Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Lisa Crowe
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Lisa Hogan
- Northumbria Police, Newcastle City Centre Police Station, Newcastle Upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
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33
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Yeung A, Weir A, Austin H, Morrison K, Inverarity D, Sherval J, Henderson N, Joshi S, Ure R, McAuley A. Assessing the impact of a temporary class drug order on ethylphenidate-related infections among people who inject drugs in Lothian, Scotland: an interrupted time-series analysis. Addiction 2017; 112:1799-1807. [PMID: 28600805 DOI: 10.1111/add.13898] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/02/2017] [Accepted: 06/02/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS In April 2015, the UK government enacted a temporary class drug order (TCDO) on ethylphenidate in response to reported harms associated with its use, in particular an outbreak of infections among people who inject drugs (PWID) in Lothian, Scotland. This study assesses the effect that the TCDO had on reducing the most common infections identified during the outbreak: Streptococcus pyogenes and Staphylococcus aureus. DESIGN The outbreak was split into a pre-intervention period (35 weeks) and a post-intervention period (26 weeks) based around the date of the TCDO. Segmented negative binomial regression models were used to compare trends in weekly counts of infections between the pre- and post-intervention periods. SETTING AND PARTICIPANTS PWID in the Lothian region of Scotland. MEASUREMENTS Cases of S. pyogenes and S. aureus infections reported within the National Health Service, Lothian. FINDINGS There were 251 S. pyogenes and/or S. aureus infections recorded among 211 PWID between February 2014 and December 2015: 171 infections in the pre-intervention period and 51 in the post-intervention period. Significant trend changes in weekly S. pyogenes and/or S. aureus infections following the TCDO were found [relative risk (RR) = 0.88, 95% confidence interval (CI) = 0.82-0.94]. PWID who self-reported using novel psychoactive substances (NPS) were at higher risk of acquiring these infections (RR = 1.81, 95% CI = 1.12-2.93), particularly when comparing the risk of infection with NPS use for a specific strain, S. pyogenes emm76.0, against the risk of infection with NPS use for S. pyogenes (emm types other than emm76.0) (RR = 3.49, 95% CI = 1.32-9.21). CONCLUSIONS The UK government's 2015 temporary class drug order on ethylphenidate was effective in reducing infections among people who inject drugs during an outbreak situation in Lothian, Scotland.
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Affiliation(s)
- Alan Yeung
- Blood-borne Viruses and Sexually Transmitted Infections Section, Health Protection Scotland, Glasgow, UK
| | - Amanda Weir
- Blood-borne Viruses and Sexually Transmitted Infections Section, Health Protection Scotland, Glasgow, UK
| | - Hannah Austin
- Department of Public Health, NHS Lothian, Edinburgh, UK
| | | | - Donald Inverarity
- Department of Microbiology, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Jim Sherval
- Department of Public Health, NHS Lothian, Edinburgh, UK
| | - Naomi Henderson
- Department of Microbiology, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Shruti Joshi
- Department of Microbiology, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Roisin Ure
- Scottish Haemophilus Legionella Meningococcus Pneumococcus Reference Laboratory, NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, Glasgow, UK
| | - Andrew McAuley
- Blood-borne Viruses and Sexually Transmitted Infections Section, Health Protection Scotland, Glasgow, UK.,School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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34
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Smyth BP. New psychoactive substances in Ireland following the criminal justice (psychoactive substances) act-why all the pessimism? Addiction 2017; 112:1686. [PMID: 28778119 DOI: 10.1111/add.13804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 02/20/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Bobby P Smyth
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
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35
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Mdege ND, Meader N, Lloyd C, Parrott S, McCambridge J. The Novel Psychoactive Substances in the UK Project: empirical and conceptual review work to produce research recommendations. PUBLIC HEALTH RESEARCH 2017. [DOI: 10.3310/phr05040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BackgroundAlthough illegal drug use has largely been declining in the UK over the past decade, this period has witnessed the emergence of a range of novel psychoactive substances (NPS) (‘legal highs’). These are new, mostly synthetic, substances that mimic the effects of existing drugs). Despite there being many causes for concern in relation to NPS, there has been little prior study of the burden associated with their use in public health terms. Clarity is lacking on research priorities in this rapidly developing literature.ObjectivesTo inform the development of public health intervention research on NPS by reviewing existing data on their use, associated problems and potential responses to such problems.DesignA scoping review and narrative synthesis of selected bodies of evidence was undertaken to summarise and evaluate what is known about NPS use and the related harms of, and responses to, such use. Relevant literature was identified from electronic databases (covering January 2006 to June 2016 inclusive), Google (Google Inc., Mountain View, CA, USA), relevant websites and online drug forums and by contacting experts. Articles were included if they were primary studies, secondary studies involving the analysis and interpretation of primary research or discussion papers. A conceptual framework postulating an evidence-informed public health approach to NPS use in the UK was developed through a pragmatic literature review, the iterative development of concepts and finalisation in light of the results from the empirical review work. The process also involved feedback from various stakeholders. Research recommendations were developed from both strands of work.ResultsA total of 995 articles were included in the scoping review, the majority of which related to individual-level health-related adverse effects attributable to NPS use. The prevalence of lifetime NPS use varied widely between (e.g. with higher prevalence in young males) and within population subgroups. The most commonly reported adverse effects were psychiatric/other neurological, cardiovascular, renal and gastrointestinal manifestations, and there is limited evidence available on responses. In these and other respects, available evidence is at an early stage of development. Initial evidence challenges the view that NPS should be treated differently from other illicit drugs. The conceptual framework indicated that much of the evidence that would be useful to inform public health responses does not yet exist. We propose a systems-based prevention approach that develops existing responses, is multilevel and life course informed in character, and emphasises commonalities between NPS and other legal and illegal drug use. We make 20 recommendations for research, including nine key recommendations.LimitationsScoping reviews do not interrogate evidence in depth, and the disjunction between the scoping review and the conceptual framework findings is worthy of careful attention.ConclusionsKey research recommendations build on those that have previously been made and offer more evidence-based justification and detail, as previous recommendations have not yet been acted on. The case for decision-making on commissioning new research based on these recommendations is both strong and urgent.Future workThe validity of recommendations generated through this project could be enhanced via further work with research commissioners, policy-makers, researchers and the public.Study registrationThe systematic review element of this study is registered as PROSPERO CRD42016026415.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Noreen D Mdege
- Department of Health Sciences, University of York, York, UK
| | - Nick Meader
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Charlie Lloyd
- Department of Health Sciences, University of York, York, UK
| | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
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Sutherland R, Bruno R, Peacock A, Lenton S, Matthews A, Salom C, Dietze P, Butler K, Burns L, Barratt MJ. Motivations for new psychoactive substance use among regular psychostimulant users in Australia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 43:23-32. [DOI: 10.1016/j.drugpo.2016.12.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 12/22/2016] [Accepted: 12/31/2016] [Indexed: 10/20/2022]
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37
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Smyth BP, Lyons S, Cullen W. Decline in new psychoactive substance use disorders following legislation targeting headshops: Evidence from national addiction treatment data. Drug Alcohol Rev 2017; 36:609-617. [DOI: 10.1111/dar.12527] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/13/2016] [Accepted: 12/13/2016] [Indexed: 01/10/2023]
Affiliation(s)
- Bobby P. Smyth
- Department of Public Health and Primary Care; Trinity College Dublin; Dublin Ireland
- Graduate Entry Medical School; University of Limerick; Limerick Ireland
| | | | - Walter Cullen
- Academic General Practice, School of Medicine; University College Dublin; Dublin Ireland
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38
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Wadsworth E, Drummond C, Deluca P. The adherence to UK legislation by online shops selling new psychoactive substances. DRUGS-EDUCATION PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1284417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Elle Wadsworth
- National Addiction Centre, King’s College London, London, UK
| | - Colin Drummond
- National Addiction Centre, King’s College London, London, UK
| | - Paolo Deluca
- National Addiction Centre, King’s College London, London, UK
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39
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Rychert M, Wilkins C, Witten K. “Lost in translation”: Issues with the establishment of a legal market for “low risk” psychoactive products (“legal highs”) in New Zealand. DRUGS-EDUCATION PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1282422] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Marta Rychert
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Chris Wilkins
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Karen Witten
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
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40
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Evans-Brown M, Sedefov R. New psychoactive substances: driving greater complexity into the drug problem. Addiction 2017; 112:36-38. [PMID: 27546297 DOI: 10.1111/add.13528] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 07/05/2016] [Accepted: 07/05/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Michael Evans-Brown
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | - Roumen Sedefov
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
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41
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Rychert M, Wilkins C. Thirty-one psychoactive plants exempted from New Zealand's Psychoactive Substances Act 2013. Addiction 2017; 112:181-182. [PMID: 27549982 DOI: 10.1111/add.13526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 07/14/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Marta Rychert
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Chris Wilkins
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
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42
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Uchtenhagen A. Which policy for new psychoactive drugs? Addiction 2017; 112:32-33. [PMID: 27418117 DOI: 10.1111/add.13478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 05/31/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Ambros Uchtenhagen
- Research Institute for Public Health and Addiction, Zurich University, Konradstr. 32, Zurich CH-8031, Switzerland
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43
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Wilkins C, Rychert M. Recent developments with the New Zealand regulated market approach to 'low-risk' psychoactive products. Addiction 2017; 112:34-36. [PMID: 27457711 DOI: 10.1111/add.13495] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/09/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Chris Wilkins
- SHORE and Whariki Research Centre, College of Health, Massey University, New Zealand
| | - Marta Rychert
- SHORE and Whariki Research Centre, College of Health, Massey University, New Zealand
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44
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Krajewski K. The unbearable lightness of simplicity. Addiction 2017; 112:33-34. [PMID: 27514364 DOI: 10.1111/add.13488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 06/15/2016] [Accepted: 06/15/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Krzysztof Krajewski
- Department of Criminology, Jagiellonian University, Olszewskiego 2, 31-007, Krakow, Poland
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45
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Pardo B, Reuter P. A chorus of pessimism surrounding the new psychoactive substances problem. Addiction 2017; 112:38-39. [PMID: 27753224 DOI: 10.1111/add.13596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/03/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Bryce Pardo
- School of Public Policy, University of Maryland, MD, USA
| | - Peter Reuter
- School of Public Policy and Department of Criminology, University of Maryland, MD, USA
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Guilty by dissociation—development of gas chromatography–mass spectrometry (GC-MS) and other rapid screening methods for the analysis of 13 diphenidine-derived new psychoactive substances (NPSs). Anal Bioanal Chem 2016; 408:8467-8481. [DOI: 10.1007/s00216-016-9969-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/24/2016] [Accepted: 09/22/2016] [Indexed: 12/28/2022]
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