1
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Jones NT, Wagner L, Hahn MCP, Scarlett CO, Wenthur CJ. In vivo validation of psilacetin as a prodrug yielding modestly lower peripheral psilocin exposure than psilocybin. Front Psychiatry 2024; 14:1303365. [PMID: 38264637 PMCID: PMC10804612 DOI: 10.3389/fpsyt.2023.1303365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/17/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction The use of the psychedelic compound psilocybin in conjunction with psychotherapy has shown promising results in the treatment of psychiatric disorders, though the underlying mechanisms supporting these effects remain unclear. Psilocybin is a Schedule I substance that is dephosphorylated in vivo to form an active metabolite, psilocin. Psilacetin, also known as O-acetylpsilocin or 4-acetoxy-N,N-dimethyltryptamine (4-AcO-DMT), is an unscheduled compound that has long been suggested as an alternative psilocin prodrug, though direct in vivo support for this hypothesis has thus far been lacking. Methods This study employed liquid chromatography-tandem mass spectrometry (LC-MS/MS) to assess the time-course and plasma concentrations of psilocin following the intraperitoneal (IP) administration of psilacetin fumarate or psilocybin to male and female C57Bl6/J mice. Results Direct comparisons of the time courses for psilocin exposure arising from psilocybin and psilacetin found that psilocybin led to 10-25% higher psilocin concentrations than psilacetin at 15-min post-injection. The half-life of psilocin remained approximately 30 min, irrespective of whether it came from psilocybin or psilacetin. Overall, the relative amount of psilocin exposure from psilacetin fumarate was found to be approximately 70% of that from psilocybin. Discussion These findings provide the first direct support for the long-standing assumption in the field that psilacetin functions as a prodrug for psilocin in vivo. In addition, these results indicate that psilacetin fumarate results in lower peripheral psilocin exposure than psilocybin when dosed on an equimolar basis. Thoughtful substitution of psilocybin with psilacetin fumarate appears to be a viable approach for conducting mechanistic psychedelic research in C57Bl6/J mice.
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Affiliation(s)
- Nathan T. Jones
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Laura Wagner
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Molly C. Pellitteri Hahn
- Analytical Instrumentation Center, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Cameron O. Scarlett
- Analytical Instrumentation Center, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Cody J. Wenthur
- School of Pharmacy, Transdisciplinary Center for Research in Psychoactive Substances, University of Wisconsin-Madison, Madison, WI, United States
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2
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Glatfelter GC, Naeem M, Pham DNK, Golen JA, Chadeayne AR, Manke DR, Baumann MH. Receptor Binding Profiles for Tryptamine Psychedelics and Effects of 4-Propionoxy- N,N-dimethyltryptamine in Mice. ACS Pharmacol Transl Sci 2023; 6:567-577. [PMID: 37082754 PMCID: PMC10111620 DOI: 10.1021/acsptsci.2c00222] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Indexed: 03/12/2023]
Abstract
Analogues of 4-phosphoryloxy-N,N-dimethyltryptamine (psilocybin) are being sold on recreational drug markets and developed as potential medications for psychedelic-assisted therapies. Many of these tryptamine-based psilocybin analogues produce psychedelic-like effects in rodents and humans primarily by agonist activity at serotonin 2A receptors (5-HT2A). However, the comprehensive pharmacological target profiles for these compounds compared to psilocybin and its active metabolite 4-hydroxy-N,N-dimethyltryptamine (psilocin) are unknown. The present study determined the receptor binding profiles of various tryptamine-based psychedelics structurally related to psilocybin across a broad range of potential targets. Specifically, we examined tryptamine psychedelics with different 4-position (hydroxy, acetoxy, propionoxy) and N,N-dialkyl (dimethyl, methyl-ethyl, diethyl, methyl-propyl, ethyl-propyl, diisopropyl, methyl-allyl, diallyl) substitutions. Further, the psilocybin analogue 4-propionoxy-N,N-dimethyltryptamine (4-PrO-DMT) was administered to mice in experiments measuring head twitch response (HTR), locomotor activity, and body temperature. Overall, the present pharmacological profile screening data show that the tryptamine psychedelics target multiple serotonin receptors, including serotonin 1A receptors (5-HT1A). 4-Acetoxy and 4-propionoxy analogues of 4-hydroxy compounds displayed somewhat weaker binding affinities but similar target profiles across 5-HT receptors and other identified targets. Additionally, differential binding screen profiles were observed with N,N-dialkyl position variations across several non-5-HT receptor targets (i.e., alpha receptors, dopamine receptors, histamine receptors, and serotonin transporters), which could impact in vivo pharmacological effects of the compounds. In mouse experiments, 4-PrO-DMT displayed dose-related psilocybin-like effects to produce 5-HT2A-mediated HTR (0.3-3 mg/kg s.c.) as well as 5-HT1A-mediated hypothermia and hypolocomotion (3-30 mg/kg s.c.). Lastly, our data support a growing body of evidence that the 5-HT2A-mediated HTR induced by tryptamine psychedelics is attenuated by 5-HT1A receptor agonist activity at high doses in mice.
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Affiliation(s)
- Grant C. Glatfelter
- Designer
Drug Research Unit, National Institute on
Drug Abuse, Intramural Research Program, Baltimore, Maryland 21224 United States
| | - Marilyn Naeem
- Department
of Chemistry and Biochemistry, University
of Massachusetts Dartmouth, North Dartmouth, Massachusetts 02747, United States
| | - Duyen N. K. Pham
- Department
of Chemistry and Biochemistry, University
of Massachusetts Dartmouth, North Dartmouth, Massachusetts 02747, United States
| | - James A. Golen
- Department
of Chemistry and Biochemistry, University
of Massachusetts Dartmouth, North Dartmouth, Massachusetts 02747, United States
| | | | - David R. Manke
- Department
of Chemistry and Biochemistry, University
of Massachusetts Dartmouth, North Dartmouth, Massachusetts 02747, United States
| | - Michael H. Baumann
- Designer
Drug Research Unit, National Institute on
Drug Abuse, Intramural Research Program, Baltimore, Maryland 21224 United States
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3
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Comparison of Psychiatric and Clinical Profiles Between People Who Use Synthetic Cathinones and Methamphetamine: A Matched Case-Control Study. J Clin Psychopharmacol 2023; 43:122-130. [PMID: 36706307 PMCID: PMC9988231 DOI: 10.1097/jcp.0000000000001649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Synthetic cathinones are the most used novel psychoactive substances in Taiwan because they exhibit psychoactive effects similar to those of methamphetamine, inducing acute psychosis, violence, and self-harm. However, the differences in the clinical characteristics of patients with synthetic cathinone and methamphetamine intoxication admitted to psychiatric emergency departments (EDs) remain unclear. METHODS This study recruited patients with stimulant intoxication who were admitted to a psychiatric ED from April 2019 to May 2020. Sociodemographic, lifestyle, and psychopathological data were collected through face-to-face interviews and evaluated. Immunoassay tests and liquid chromatography-quadrupole time-of-flight mass spectrometry were performed to detect substances in urine specimens. The patients were matched by sex and age (in 5-year intervals). The associations between the 2 groups and physical complications were analyzed through logistic regression. RESULTS Twenty-four patients with synthetic cathinone intoxication were identified and matched with 48 patients with methamphetamine intoxication. The 2 groups exhibited similar clinical severity of psychotic symptoms and high risks of violence and self-harm. Both groups were predominated by unmarried patients, unemployed patients, and habitual smokers and drinkers. However, family histories of substance use and criminal records were less prevalent among the patients with synthetic cathinone intoxication, but they had a higher rate of physical complications (odds ratio, 8.55; 95% confidence interval, 2.15-34.03), compared with patients with methamphetamine intoxication. CONCLUSIONS Compared with patients intoxicated with methamphetamine, those intoxicated with synthetic cathinones may have similar tendencies toward psychosis, violence, and self-harm but higher risks of physical complications, which are prioritized in psychiatric EDs.
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4
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Poyatos L, Pérez-Mañá C, Hladun O, Núñez-Montero M, de la Rosa G, Martín S, Barriocanal AM, Carabias L, Kelmendi B, Taoussi O, Busardò FP, Fonseca F, Torrens M, Pichini S, Farré M, Papaseit E. Pharmacological effects of methylone and MDMA in humans. Front Pharmacol 2023; 14:1122861. [PMID: 36873994 PMCID: PMC9981643 DOI: 10.3389/fphar.2023.1122861] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
Methylone is one of the most common synthetic cathinones popularized as a substitute for 3,4-methylenedioxymethamphetamine (MDMA, midomafetamine) owing to its similar effects among users. Both psychostimulants exhibit similar chemistry (i.e., methylone is a β-keto analog of MDMA) and mechanisms of action. Currently, the pharmacology of methylone remains scarcely explored in humans. Herein, we aimed to evaluate the acute pharmacological effects of methylone and its abuse potential in humans when compared with that of MDMA following oral administration under controlled conditions. Seventeen participants of both sexes (14 males, 3 females) with a previous history of psychostimulant use completed a randomized, double-blind, placebo-controlled, crossover clinical trial. Participants received a single oral dose of 200 mg of methylone, 100 mg of MDMA, and a placebo. The variables included physiological effects (blood pressure, heart rate, oral temperature, pupil diameter), subjective effects using visual analog scales (VAS), the short form of the Addiction Research Center Inventory (ARCI), the Evaluation of Subjective Effects of Substances with Abuse Potential questionnaire (VESSPA-SSE), and the Sensitivity to Drug Reinforcement Questionnaire (SDRQ), and psychomotor performance (Maddox wing, psychomotor vigilance task). We observed that methylone could significantly increase blood pressure and heart rate and induce pleasurable effects, such as stimulation, euphoria, wellbeing, enhanced empathy, and altered perception. Methylone exhibited an effect profile similar to MDMA, with a faster overall onset and earlier disappearance of subjective effects. These results suggest that abuse potential of methylone is comparable to that of MDMA in humans. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT05488171; Identifier: NCT05488171.
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Affiliation(s)
- Lourdes Poyatos
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Clara Pérez-Mañá
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
- *Correspondence: Clara Pérez-Mañá, ; Magí Farré,
| | - Olga Hladun
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Melani Núñez-Montero
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Georgina de la Rosa
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Soraya Martín
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
| | - Ana Maria Barriocanal
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
| | - Lydia Carabias
- Department of Pharmacy, Hospital Universitari Germans Trias i Pujol (HUGTiP), Badalona, Spain
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Omayema Taoussi
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Francina Fonseca
- Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
- Addiction Program, Institut de Neuropsiquiatria i Adiccions (INAD), Barcelona, Spain
| | - Marta Torrens
- Addiction Program, Institut de Neuropsiquiatria i Adiccions (INAD), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Magí Farré
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
- *Correspondence: Clara Pérez-Mañá, ; Magí Farré,
| | - Esther Papaseit
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
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5
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Glatfelter GC, Pottie E, Partilla JS, Sherwood AM, Kaylo K, Pham DNK, Naeem M, Sammeta VR, DeBoer S, Golen JA, Hulley EB, Stove CP, Chadeayne AR, Manke DR, Baumann MH. Structure-Activity Relationships for Psilocybin, Baeocystin, Aeruginascin, and Related Analogues to Produce Pharmacological Effects in Mice. ACS Pharmacol Transl Sci 2022; 5:1181-1196. [PMID: 36407948 PMCID: PMC9667540 DOI: 10.1021/acsptsci.2c00177] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Indexed: 11/06/2022]
Abstract
4-Phosphoryloxy-N,N-dimethyltryptamine (psilocybin) is a naturally occurring tertiary amine found in many mushroom species. Psilocybin is a prodrug for 4-hydroxy-N,N-dimethyltryptamine (psilocin), which induces psychedelic effects via agonist activity at the serotonin (5-HT) 2A receptor (5-HT2A). Several other 4-position ring-substituted tryptamines are present in psilocybin-containing mushrooms, including the secondary amine 4-phosphoryloxy-N-methyltryptamine (baeocystin) and the quaternary ammonium 4-phosphoryloxy-N,N,N-trimethyltryptamine (aeruginascin), but these compounds are not well studied. Here, we investigated the structure-activity relationships for psilocybin, baeocystin, and aeruginascin, as compared to their 4-acetoxy and 4-hydroxy analogues, using in vitro and in vivo methods. Broad receptor screening using radioligand binding assays in transfected cells revealed that secondary and tertiary tryptamines with either 4-acetoxy or 4-hydroxy substitutions display nanomolar affinity for most human 5-HT receptor subtypes tested, including the 5-HT2A and the serotonin 1A receptor (5-HT1A). The same compounds displayed affinity for 5-HT2A and 5-HT1A in mouse brain tissue in vitro and exhibited agonist efficacy in assays examining 5-HT2A-mediated calcium mobilization and β-arrestin 2 recruitment. In mouse experiments, only the tertiary amines psilocin, psilocybin, and 4-acetoxy-N,N-dimethyltryptamine (psilacetin) induced head twitch responses (ED50 0.11-0.29 mg/kg) indicative of psychedelic-like activity. Head twitches were blocked by 5-HT2A antagonist pretreatment, supporting 5-HT2A involvement. Both secondary and tertiary amines decreased body temperature and locomotor activity at higher doses, the effects of which were blocked by 5-HT1A antagonist pretreatment. Across all assays, the pharmacological effects of 4-acetoxy and 4-hydroxy compounds were similar, and these compounds were more potent than their 4-phosphoryloxy counterparts. Importantly, psilacetin appears to be a prodrug for psilocin that displays substantial serotonin receptor activities of its own.
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Affiliation(s)
- Grant C. Glatfelter
- Designer
Drug Research Unit, National Institute on
Drug Abuse Intramural Research Program, Baltimore, Maryland 21224, United States
| | - Eline Pottie
- Laboratory
of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical
Sciences, Ghent University, Campus Heymans, Ottergemsesteenweg
460, 9000 Ghent, Belgium
| | - John S. Partilla
- Designer
Drug Research Unit, National Institute on
Drug Abuse Intramural Research Program, Baltimore, Maryland 21224, United States
| | | | - Kristi Kaylo
- Usona
Institute, Madison, Wisconsin 53711, United States
| | - Duyen N. K. Pham
- Department
of Chemistry & Biochemistry, University
of Massachusetts Dartmouth, North Dartmouth, Massachusetts 02747, United States
| | - Marilyn Naeem
- Department
of Chemistry & Biochemistry, University
of Massachusetts Dartmouth, North Dartmouth, Massachusetts 02747, United States
| | - Vamshikrishna Reddy Sammeta
- Department
of Chemistry & Biochemistry, University
of Massachusetts Dartmouth, North Dartmouth, Massachusetts 02747, United States
| | - Stacie DeBoer
- Department
of Chemistry, University of Wyoming, Laramie, Wyoming 82071, United States
| | - James A. Golen
- Department
of Chemistry & Biochemistry, University
of Massachusetts Dartmouth, North Dartmouth, Massachusetts 02747, United States
| | - Elliott B. Hulley
- Department
of Chemistry, University of Wyoming, Laramie, Wyoming 82071, United States
| | - Christophe P. Stove
- Laboratory
of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical
Sciences, Ghent University, Campus Heymans, Ottergemsesteenweg
460, 9000 Ghent, Belgium
| | | | - David R. Manke
- Department
of Chemistry & Biochemistry, University
of Massachusetts Dartmouth, North Dartmouth, Massachusetts 02747, United States
| | - Michael H. Baumann
- Designer
Drug Research Unit, National Institute on
Drug Abuse Intramural Research Program, Baltimore, Maryland 21224, United States
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6
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Axelsson MAB, Lövgren H, Kronstrand R, Green H, Bergström MA. Retrospective identification of new psychoactive substances in patient samples submitted for clinical drug analysis. Basic Clin Pharmacol Toxicol 2022; 131:420-434. [PMID: 36028947 DOI: 10.1111/bcpt.13786] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/30/2022]
Abstract
New psychoactive substances (NPS) are life-threatening through unpredictable toxicity and limited analytical options for clinicians. We present the retrospective identification of NPS in raw data from a liquid chromatography-high resolution mass spectrometry (LC-HRMS) based multidrug panel analysis on 14,367 clinical oral fluid samples requested during 2019 mainly by psychiatric and addiction care clinics. Retrospectively analysed NPS included 48 notified originally in 2019 by the European Union Early Warning System (EU-EWS) and 28 frequently reported in Sweden. Of 88 included NPS, 34 (mitragynine, flualprazolam, 3F/4F-α-P(i)HP, etizolam, 4F-MDMB-BINACA, cyproheptadine, 5F-MDMB-PICA, isotonitazene, isohexedrone, MDPEP, N-ethylpentedrone, tianeptine, flubromazolam, 4'-methylhexedrone, α-P(i)HP, eutylone, mephedrone, N-ethylhexedrone, 5F-MDMB-PINACA, ADB-BUTINACA, 3-methoxy PCP, 4F-furanylfentanyl, 4F-isobuturylfentanyl, acrylfentanyl, furanylfentanyl, clonazolam, norfludiazepam, 3F-phenmetrazine, 3-MMC, 4-methylpentedrone, BMDP, ethylphenidate, methylone, α-PVP) were identified as 219 findings in 84 patients. Eight NPS notified in 2019 were identified, five before EWS release. NPS occurred in 1.20% of all samples and 1.53% of samples containing traditional drugs, and in 1.87% of all patients and 2.88% of patients using traditional drugs. NPS use was more common in men and polydrug users. Legal (not scheduled) NPS were more used than comparable illegal ones. Retrospective identification could be useful when prioritizing NPS for clinical routine analysis and when studying NPS epidemiology.
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Affiliation(s)
- Magnus A B Axelsson
- Laboratory of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hanna Lövgren
- Laboratory of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Robert Kronstrand
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden.,Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
| | - Henrik Green
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden.,Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
| | - Moa Andresen Bergström
- Laboratory of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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7
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Mallaroni P, Mason NL, Vinckenbosch FRJ, Ramaekers JG. The use patterns of novel psychedelics: experiential fingerprints of substituted phenethylamines, tryptamines and lysergamides. Psychopharmacology (Berl) 2022; 239:1783-1796. [PMID: 35487983 PMCID: PMC9166850 DOI: 10.1007/s00213-022-06142-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 04/06/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Novel psychedelics (NPs) are an expanding set of compounds, presenting new challenges for drug policy and opportunities for clinical research. Unlike their classical derivatives, little is known regarding their use profiles or their subjective effects. AIMS The purpose of this study was to compile usage patterns and adverse event rates for individual NPs belonging to each of three main psychedelic structural families. Targeting the most widely used representatives for each class, we expanded on their phenomenological distinctions. METHODS A two-part survey was employed. We investigated the prevalence of novel phenethylamines, tryptamine and lysergamides in NP users (N = 1180), contrasting the type and incidence of adverse events (AEs) using a set of logistic regressions. Honing in on 2-4-Bromo-2,5-dimethoxyphenyl)ethanamine (2C-B) (48.6%), 1-propionyl-lysergic acid diethylamide (1P-LSD) (34.2%) and 4-Acetoxy-N,N-dimethyltryptamine (4-AcO-DMT) (23.1%), we examined their phenomenological separability using a gradient boosting (XGBoost) supervised classifier. RESULTS Novel phenethylamines had the highest prevalence of use (61.5%) seconded by tryptamines (43.8%) and lysergamides (42.9%). Usage patterns were identified for 32 different compounds, demonstrating variable dosages, durations and a common oral route of administration. Compared to phenethylamines, the odds for tryptamines and lysergamides users were significantly less for overall physical AEs. No significant differences in overall psychological AEs were found. Overall model area under the curve (AUC) stood at 0.79 with sensitivity (50.0%) and specificity (60.0%) for 2C-B ranking lowest. CONCLUSION NP classes may hold distinct AE rates and phenomenology, the latter potentially clouded by the subjective nature of these experiences. Further targeted research is warranted.
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Affiliation(s)
- P Mallaroni
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.
| | - N L Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - F R J Vinckenbosch
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - J G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.
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8
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Zhai W, Li L, Zhao J, Xiang P, Liu M, Shi Y, Dang Y. Tentative identification of in vitro metabolites of O-acetylpsilocin (psilacetin, 4-AcO-DMT) by UHPLC-Q-Orbitrap MS. Drug Test Anal 2022; 14:1300-1309. [PMID: 35312166 DOI: 10.1002/dta.3255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/17/2022] [Accepted: 03/17/2022] [Indexed: 12/13/2022]
Abstract
4-Acetoxy-N,N-dimethyltryptamine (4-AcO-DMT, psilacetin, O-acetylpsilocin) is a synthetic tryptamine with psychedelic properties. Psilacetin may also act as precursor drug of psilocin, similar to psilocybin, but little is known about its metabolism. In this study, the phase I and phase II in vitro metabolism of 4-AcO-DMT was investigated with pooled human liver microsomes, and the reaction mixture was analyzed using liquid chromatography-quadrupole/electrostatic field orbitrap mass spectrometry. Fifteen metabolites were formed after incubation of pooled human liver microsomes with 4-AcO-DMT (12 phase I metabolites and 3 phase II metabolites). The proposed metabolite structures were based on accurate mass analysis and MS/MS fragmentation patterns. The biotransformations included hydrolysis, hydroxylation, N-demethylation, oxidation, and conjugation with glucuronic acid. The hydrolysis metabolite was the most abundant compound. For the development of new methods for the identification of 4-AcO-DMT consumption, the beta-hydroxylation metabolite of 4-AcO-DMT (M2-1) is recommended as a biomarker. The data reported in this work might be applicable to metabolic transformation of 4-AcO-DMT in vivo and also forensically helpful.
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Affiliation(s)
- Wenya Zhai
- College of Medicine and Forensics, Xi'an Jiaotong University Health Science Center, Xi'an, China.,Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China
| | - Le Li
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China
| | - Junbo Zhao
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China
| | - Ping Xiang
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China
| | - Mengxi Liu
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China
| | - Yan Shi
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Academy of Forensic Science, Shanghai, China
| | - Yonghui Dang
- College of Medicine and Forensics, Xi'an Jiaotong University Health Science Center, Xi'an, China
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9
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Seaman RW, Rice KC, Collins GT. Relative reinforcing effects of cocaine and 3,4-methylenedioxypyrovalerone (MDPV) under a concurrent access self-administration procedure in rats. Drug Alcohol Depend 2022; 232:109299. [PMID: 35063839 PMCID: PMC8919706 DOI: 10.1016/j.drugalcdep.2022.109299] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/30/2021] [Accepted: 12/15/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Recent evidence suggesting that polysubstance use is the norm rather than the exception highlights the need for a better understanding of interactions amongst the abuse-related effects of commonly co-abused drugs. Synthetic cathinones remain one of the most popular families of novel psychoactive substances and are typically used in preparations containing multiple stimulants. Evaluating the reinforcing effects of drugs under both single-operant procedures and procedures in which alternatives are available can provide a more complete characterization of their reinforcing effects and economic interactions. METHODS These studies utilized a drug-versus-drug choice procedure in 18 male Sprague-Dawley rats to evaluate economic interactions between the synthetic cathinone, MDPV, and cocaine in addition to how a history of concurrent access impacts reinstatement behavior. RESULTS When equi-effective doses of MDPV and cocaine were made concurrently available, approximately half of the subjects responded exclusively on the MDPV-reinforced lever whereas the other half responded exclusively on the cocaine-reinforced lever. Allocation of responding was reversed when the cost of the preferred drug increased, or the cost of the non-preferred drug decreased. Drug-paired cues and MDPV, cocaine, and methamphetamine pretreatments reinstated responding on both drug levers, regardless of preference. CONCLUSION These data demonstrate that MDPV and cocaine act as economic substitutes and suggest that measures of reinforcing effectiveness determined under a progressive ratio schedule of reinforcement can predict drug choice. These data also suggest that environmental stimuli associated with a particular drug might stimulate class-specific drug-seeking, however, further studies are needed to test the generality of this claim.
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Affiliation(s)
- Robert W Seaman
- Department of Pharmacology, The University of Texas Health Science Center at San Antonio, USA; South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Kenner C Rice
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, NIDA and NIAAA, Bethesda, MD, USA
| | - Gregory T Collins
- Department of Pharmacology, The University of Texas Health Science Center at San Antonio, USA; South Texas Veterans Health Care System, San Antonio, TX, USA.
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10
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Tirri M, Bilel S, Arfè R, Corli G, Marchetti B, Bernardi T, Boccuto F, Serpelloni G, Botrè F, De-Giorgio F, Golembiowska K, Marti M. Effect of -NBOMe Compounds on Sensorimotor, Motor, and Prepulse Inhibition Responses in Mice in Comparison With the 2C Analogs and Lysergic Acid Diethylamide: From Preclinical Evidence to Forensic Implication in Driving Under the Influence of Drugs. Front Psychiatry 2022; 13:875722. [PMID: 35530025 PMCID: PMC9069068 DOI: 10.3389/fpsyt.2022.875722] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/09/2022] [Indexed: 11/25/2022] Open
Abstract
In the last decade, the market for new psychoactive substances has been enriched by numerous psychedelic phenethylamines, which mimic the psychoactive effect of lysergic acid diethylamide (LSD). In particular, the -NBOMe series, which are more potent than their 2C compounds analogs, are considered worthy substitutes for LSD by users. The purpose of this study was to assess the effects of 25H-NBOMe and its halogenated derivatives (25I-NBOMe and 25B-NBOMe) in comparison to their 2C compounds analogs and LSD on the sensorimotor (visual, acoustic, and overall tactile), reaction time, spontaneous (total distance traveled) and stimulated (drag, accelerod test) motor activity, grip strength test, and prepulse inhibition (PPI) responses in mice. Systemic administration of -NBOMe, 2C compounds analogs, and LSD (0.001-10 mg/kg) differently impaired the sensorimotor, reaction time, motor, and PPI responses in mice. In particular, halogenated (25I and 25B)-NBOMe derivatives appear to be more effective than the entire class of 2C compounds analogs in altering visual and acoustic responses, affecting reaction time, and motor and sensory gating in PPI test. In fact, the specific rank order of compounds potency for nearly all of the experiments showed that (25I and 25B)-NBOMe were more potent than 2C compounds analogs and LSD. -NBOMe and 2C compounds analogs impaired not only the reception of incoming sensory stimuli (visual and acoustic), but their correct brain processing (PPI) in an equal and sometimes stronger way than LSD. This sensory impairment directly affected the spontaneous motor response and reaction time of mice, with no change in performance in stimulated motor activity tests. These aspects should be carefully considered to better understand the potential danger that psychedelic phenethylamines, in particular -NBOMe, may pose to public health, with particular reference to decreased performance in driving and hazardous works that require special sensorimotor skills.
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Affiliation(s)
- Micaela Tirri
- Section of Legal Medicine and Laboratory for Advanced Therapy Technologies (LTTA) Centre, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Sabrine Bilel
- Section of Legal Medicine and Laboratory for Advanced Therapy Technologies (LTTA) Centre, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Raffaella Arfè
- Section of Legal Medicine and Laboratory for Advanced Therapy Technologies (LTTA) Centre, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Giorgia Corli
- Section of Legal Medicine and Laboratory for Advanced Therapy Technologies (LTTA) Centre, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Beatrice Marchetti
- Section of Legal Medicine and Laboratory for Advanced Therapy Technologies (LTTA) Centre, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Tatiana Bernardi
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Federica Boccuto
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Serpelloni
- Neuroscience Clinical Center and Transcranial Magnetic Stimulation (TMS) Unit, Verona, Italy
| | - Francesco Botrè
- Institute of Sport Science University of Lausanne (ISSUL), Lausanne, Switzerland
| | - Fabio De-Giorgio
- Section of Legal Medicine, Department of Health Care Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Krystyna Golembiowska
- Department of Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakòw, Poland
| | - Matteo Marti
- Section of Legal Medicine and Laboratory for Advanced Therapy Technologies (LTTA) Centre, Department of Translational Medicine, University of Ferrara, Ferrara, Italy.,Department of Anti-Drug Policies, Collaborative Center for the Italian National Early Warning System, Presidency of the Council of Ministers, Rome, Italy
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11
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Novel Phenethylamines and Their Potential Interactions With Prescription Drugs: A Systematic Critical Review. Ther Drug Monit 2021; 42:271-281. [PMID: 32022784 DOI: 10.1097/ftd.0000000000000725] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The novel phenethylamines 4-fluoroamphetamine (4-FA) and 2,5-dimethoxy-4-bromophenethylamine (2C-B) fall in the top 10 most used new psychoactive substances (NPSs) among high-risk substance users. Various phenethylamines and NPS are also highly used in populations with mental disorders, depression, or attention deficit hyperactivity disorder (ADHD). Moreover, NPS use is highly prevalent among men and women with risky sexual behavior. Considering these specific populations and their frequent concurrent use of drugs, such as antidepressants, ADHD medication, and antiretrovirals, reports on potential interactions between these drugs, and phenethylamines 4-FA and 2C-B, were reviewed. METHODS The authors performed a systematic literature review on 4-FA and 2C-B interactions with antidepressants (citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, duloxetine, bupropion, venlafaxine, phenelzine, moclobemide, and tranylcypromine), ADHD medications (atomoxetine, dexamphetamine, methylphenidate, and modafinil), and antiretrovirals. RESULTS Limited literature exists on the pharmacokinetics and drug-drug interactions of 2C-B and 4-FA. Only one case report indicated a possible interaction between 4-FA and ADHD medication. Although pharmacokinetic interactions between 4-FA and prescription drugs remain speculative, their pharmacodynamic points toward interactions between 4-FA and ADHD medication and antidepressants. The pharmacokinetic and pharmacodynamic profile of 2C-B also points toward such interactions, between 2C-B and prescription drugs such as antidepressants and ADHD medication. CONCLUSIONS A drug-drug (phenethylamine-prescription drug) interaction potential is anticipated, mainly involving monoamine oxidases for 2C-B and 4-FA, with monoamine transporters being more specific to 4-FA.
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12
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Gatch MB, Hoch A, Carbonaro TM. Discriminative Stimulus Effects of Substituted Tryptamines in Rats. ACS Pharmacol Transl Sci 2020; 4:467-471. [PMID: 33860176 DOI: 10.1021/acsptsci.0c00173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Indexed: 01/17/2023]
Abstract
Novel synthetic compounds have been available for decades as quasi-legal alternatives to controlled substances. The hallucinogen-like effects of eight novel substituted tryptamines were evaluated to determine their potential abuse liability. Male Sprague-Dawley rats were trained to discriminate 2,5-dimethoxy-4-methylamphetamine (DOM, 0.5 mg/kg, i.p., 30 min) from saline. 4-Acetoxy-N,N-diethyltryptamine (4-AcO-DET), 4-hydroxy-N-methyl-N-ethyltryptamine (4-OH-MET), 4-hydroxy-N,N-diethyltryptamine (4-OH-DET), 4-acetoxy-N-methyl-N-isopropyltryptamine (4-AcO-MiPT), 4-acetoxy-N,N-dimethyltryptamine (4-AcO-DMT), 4-hydroxy-N,N-dimethyltryptamine (4-OH-DMT, psilocin), 5-methoxy-N-methyl-N-isopropyltryptamine (5-MeO-MiPT), 4-acetoxy-N,N-diisopropyltryptamine (4-AcO-DiPT), and 4-hydroxy-N,N-diisopropyltryptamine (4-OH-DiPT) were tested for their ability to substitute for the discriminative stimulus effects of DOM. All test compounds fully substituted for DOM with potencies less than or equal to that of DOM. 4-OH-MET, 4-OH-DET, 4-OH-DMT, and 4-AcO-DMT decreased response rate at doses that fully substituted. Because the test compounds produced DOM-like discriminative stimulus effects, they may have similar abuse liability as DOM. 4-Acetoxy substituted compounds were less potent than 4-hydroxy substituted compounds, and the N,N-diisopropyl compounds were less potent than the dimethyl, diethyl, N-methyl-N-ethyl, and N-methyl-N-isopropyl compounds.
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Affiliation(s)
- Michael B Gatch
- Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas 76107, United States
| | - Adam Hoch
- Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas 76107, United States
| | - Theresa M Carbonaro
- Diversion Control Division Drug and Chemical Evaluation Section, Drug Enforcement Administration Springfield, Virginia 22152, United States
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13
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Neicun J, Yang JC, Shih H, Nadella P, van Kessel R, Negri A, Czabanowska K, Brayne C, Roman-Urrestarazu A. Lifetime prevalence of novel psychoactive substances use among adults in the USA: Sociodemographic, mental health and illicit drug use correlates. Evidence from a population-based survey 2007-2014. PLoS One 2020; 15:e0241056. [PMID: 33125395 PMCID: PMC7598490 DOI: 10.1371/journal.pone.0241056] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 10/07/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION As Novel psychoactive substances (NPS) are conceived to mimic the effects of common illicit drugs, they represent a serious public health challenge due to the spike in intoxications and fatalities that have been linked to their use. This study aims to provide epidemiological data on NPS use in the USA, determining lifetime prevalence of use and defining demographic, socioeconomic, drug use patterns and mental health correlates. METHODS This study uses secondary data from the US National Survey on Drug Use and Health (NSDUH), which is a large cross-sectional population-based survey carried out annually in the USA. We analysed data from 2007-14 (N = 307,935) using bivariate descriptive analysis and binary logistic regression to calculate prevalence and determine factors underlying NPS consumption. Adjusted odds ratios (OR) with 95% CI's were calculated for a set of selected independent variables. RESULTS AND DISCUSSION Our analysis NSDUH from 2007-14 highlights an increase in NPS use among adults, especially among white young men aged 18 to 25. Although the level of education of NPS users was relatively higher as compared to non-users, NPS users seemed to have a less wealthy situation. However, socioeconomic vulnerability appeared to be less important than mental health issues as a correlate to NPS use. NPS users seem to have followed a pattern of polysubstance use throughout their life, which involves both traditional illicit drugs and classic synthetic drugs. As NPS use seemed to be more prevalent among people having mental health issues, the rise in their use may have a negative impact on population mental health outcomes. CONCLUSION Further comparative research on trends in NPS use and potential public health responses would be instrumental for developing appropriate health interventions, including drug checking, education for users and training for healthcare professionals working both within emergency wards and in/outpatient addiction and mental health services.
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Affiliation(s)
- Jessica Neicun
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
- * E-mail:
| | | | - Hueyjong Shih
- Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Pranay Nadella
- Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Robin van Kessel
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Attilio Negri
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, United Kingdom
| | - Kasia Czabanowska
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- National Institute of Public Health, Warsaw, Poland
| | - Carol Brayne
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Andres Roman-Urrestarazu
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
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14
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Fattore L, Marti M, Mostallino R, Castelli MP. Sex and Gender Differences in the Effects of Novel Psychoactive Substances. Brain Sci 2020; 10:brainsci10090606. [PMID: 32899299 PMCID: PMC7564810 DOI: 10.3390/brainsci10090606] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 12/12/2022] Open
Abstract
Sex and gender deeply affect the subjective effects and pharmaco-toxicological responses to drugs. Men are more likely than women to use almost all types of illicit drugs and to present to emergency departments for serious or fatal intoxications. However, women are just as likely as men to develop substance use disorders, and may be more susceptible to craving and relapse. Clinical and preclinical studies have shown important differences between males and females after administration of “classic” drugs of abuse (e.g., Δ9-tetrahydrocannabinol (THC), morphine, cocaine). This scenario has become enormously complicated in the last decade with the overbearing appearance of the new psychoactive substances (NPS) that have emerged as alternatives to regulated drugs. To date, more than 900 NPS have been identified, and can be catalogued in different pharmacological categories including synthetic cannabinoids, synthetic stimulants (cathinones and amphetamine-like), hallucinogenic phenethylamines, synthetic opioids (fentanyls and non-fentanyls), new benzodiazepines and dissociative anesthetics (i.e., methoxetamine and phencyclidine-derivatives). This work collects the little knowledge reached so far on the effects of NPS in male and female animal and human subjects, highlighting how much sex and gender differences in the effects of NPS has yet to be studied and understood.
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Affiliation(s)
- Liana Fattore
- Institute of Neuroscience-Cagliari, National Research Council (CNR), Cittadella Universitaria, 09042 Monserrato, Cagliari, Italy
- Correspondence:
| | - Matteo Marti
- Department of Morphology, Surgery and Experimental Medicine, Section of Legal Medicine and LTTA Center, University of Ferrara, 44121 Ferrara, Italy;
- Department of Anti-Drug Policies, Collaborative Center for the Italian National Early Warning System, Presidency of the Council of Ministers, 00187 Rome, Italy
| | - Rafaela Mostallino
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cittadella Universitaria, 09042 Monserrato, Cagliari, Italy; (R.M.); (M.P.C.)
| | - Maria Paola Castelli
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cittadella Universitaria, 09042 Monserrato, Cagliari, Italy; (R.M.); (M.P.C.)
- National Institute of Neuroscience (INN), University of Cagliari, 09124 Cagliari, Italy
- Center of Excellence “Neurobiology of Addiction”, University of Cagliari, 09124 Cagliari, Italy
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15
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The Clinical Toxicology of 4-Bromo-2,5-dimethoxyphenethylamine (2C-B): The Severity of Poisoning After Exposure to Low to Moderate and High Doses. Ann Emerg Med 2020; 76:303-317. [PMID: 32507489 DOI: 10.1016/j.annemergmed.2020.04.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/30/2020] [Accepted: 04/08/2020] [Indexed: 12/13/2022]
Abstract
STUDY OBJECTIVE We studied the severity of poisoning after exposure to low to moderate and high doses of 4-bromo-2,5-dimethoxyphenethylamine (2C-B). METHODS Patients for whom the Dutch Poisons Information Centre was consulted for 2C-B exposure from 2016 to 2018 were included in a prospective cohort study. Data were collected through telephone interviews with the physician or patient. Patients were categorized according to the reported 2C-B dose: low to moderate (up to 20 mg), high (greater than 20 mg), or unknown. Presence of 2C-B was analyzed in leftover drug and biological samples with liquid/gas chromatography-mass spectrometry. The severity of poisoning was graded with the Poisoning Severity Score. RESULTS We included 59 patients, of whom 32 could be followed up. Low to moderate 2C-B doses were reported by 9 patients (28%), high doses by 17 (53%), and unknown doses by 6 (19%). Poisoning was moderate in the majority of patients in both the low- to moderate-dose and high-dose groups. Frequently reported symptoms included mydriasis, agitation or aggression, hallucinations, confusion, anxiety, hypertension, and tachycardia. The presence of 2C-B was confirmed in 5 patients in urine (n=3) or drug samples (n=4). CONCLUSION In this study, most 2C-B poisonings resulted in moderate toxicity even at high reported doses up to 192 mg. No severe cases were observed. The clinical course was usually short-lived (up to 24 hours) and typically involved hallucinations in addition to mild somatic effects.
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16
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Jones NS, Comparin JH. Interpol review of controlled substances 2016-2019. Forensic Sci Int Synerg 2020; 2:608-669. [PMID: 33385148 PMCID: PMC7770462 DOI: 10.1016/j.fsisyn.2020.01.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/23/2020] [Indexed: 12/14/2022]
Abstract
This review paper covers the forensic-relevant literature in controlled substances from 2016 to 2019 as a part of the 19th Interpol International Forensic Science Managers Symposium. The review papers are also available at the Interpol website at: https://www.interpol.int/content/download/14458/file/Interpol%20Review%20Papers%202019.pdf.
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Affiliation(s)
- Nicole S. Jones
- RTI International, Applied Justice Research Division, Center for Forensic Sciences, 3040 E. Cornwallis Road, Research Triangle Park, NC, 22709-2194, USA
| | - Jeffrey H. Comparin
- United States Drug Enforcement Administration, Special Testing and Research Laboratory, USA
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17
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Papaseit E, Olesti E, Pérez-Mañá C, Torrens M, Grifell M, Ventura M, Pozo OJ, de Sousa Fernandes Perna EB, Ramaekers JG, de la Torre R, Farré M. Acute Effects of 2C-E in Humans: An Observational Study. Front Pharmacol 2020; 11:233. [PMID: 32256350 PMCID: PMC7093582 DOI: 10.3389/fphar.2020.00233] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 02/20/2020] [Indexed: 12/20/2022] Open
Abstract
2,5-Dimethoxy-4-ethylphenethylamine (2C-E) is psychedelic phenylethylamine, with a chemical structure similar to mescaline, used as new psychoactive substance (NPS). It inhibits norepinephrine and serotonin uptake and, more relevant, acts as a partial agonist of the serotonin 2A (5-HT2 A), 2B (5-HT2 B), and (5-HT2 C) receptors. Consumers have reported that 2C-E induces mild-moderate psychedelic effects, but its pharmacology in humans, including pharmacological effects and pharmacokinetics, have not yet studied. To assess the acute effects of 2C-E on physiological and subjective effects and evaluate its pharmacokinetics, an observational study was carried-out. Ten recreational users of psychedelics self-administered a single oral dose of 2C-E (6.5, 8, 10, 15, or 25 mg). Blood pressure and heart rate were evaluated at baseline, 2, 4, and 6 h post-administration. Three rating scales were administered to evaluate subjective effects: a set of Visual Analog Scales (VAS), the 49-item short form version of the Addiction Research Centre Inventory (ARCI), and the Evaluation of the Subjective Effects of Substances with Abuse Potential (VESSPA-SSE) at baseline, 2, 4, and 6 h after self-administration. To assess 2C-E concentrations oral fluid (saliva) was collected during 6 h. 2C-E induced primarily alterations in perceptions, hallucinations, and euphoric-mood. Saliva maximal concentrations were achieved 2 h after self-administration. Administration of oral 2C-E at recreational doses produces a group of psychedelic-like effects such to 2C-B and other serotonin-acting drugs.
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Affiliation(s)
- Esther Papaseit
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol-Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eulalia Olesti
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Universitat Pompeu Fabra, Departament de Ciències Experimentals i de la Salut (CEXS-UPF), Barcelona, Spain
| | - Clara Pérez-Mañá
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol-Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Marta Torrens
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Drug Addiction Program, Institut de Neuropsiquiatria i Adiccions (INAD), Barcelona, Spain
| | - Marc Grifell
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Drug Addiction Program, Institut de Neuropsiquiatria i Adiccions (INAD), Barcelona, Spain.,Energy Control, Associació Benestar i Desenvolupament, Barcelona, Spain
| | - Mireia Ventura
- Energy Control, Associació Benestar i Desenvolupament, Barcelona, Spain
| | - Oscar J Pozo
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | | | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Rafael de la Torre
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Universitat Pompeu Fabra, Departament de Ciències Experimentals i de la Salut (CEXS-UPF), Barcelona, Spain
| | - Magí Farré
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol-Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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18
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Drapalova E, Belackova V, Cadet-Taïrou A. How to ask about the use of new psychoactive substances to increase the validity of results in self-report prevalence surveys. Drug Alcohol Rev 2020; 39:278-286. [PMID: 32078202 DOI: 10.1111/dar.13036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/21/2019] [Accepted: 01/01/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS New psychoactive substances (NPS) represent hundreds of novel compounds. However, the general public might not be familiar with the overarching term NPS. This can result in both under- and over-reporting of NPS use. DESIGN AND METHODS The study analysed the last-year prevalence of NPS use in an online survey conducted across I-TREND project countries (the Czech Republic, the Netherlands and Poland). Self-reported NPS use was assessed within two types of questions-a generic and a checklist question. We analysed prevalence for each question separately, incorporated the free-text probe 'other' that followed them, and combined the two questions into a conservative and an inclusive estimate. RESULTS Including free-text responses to the 'other' categories increased prevalence of NPS use (from 51% to 56% for the checklist question and 25% to 32% for the generic question). Taking an inclusive approach to estimating prevalence (i.e. indicating NPS use in either a generic list or from the checklist) yielded a higher prevalence estimate (60%, 95% confidence interval 58-62%), compared to a more conservative approach in which NPS use had to be affirmed by both questions (27%, 95% confidence interval 26-29%). DISCUSSION AND CONCLUSIONS Generic questions might lead to notably lower estimates of self-reported NPS use in comparison to checklists. However, creating relevant checklists is challenging and lengthy survey instruments have limitations. Further surveys might benefit from featuring a combination of the strategies used in this study-a single (generic) question involving a number of locally specific NPSs and a free-text 'other' probe.
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Affiliation(s)
- Eva Drapalova
- Department of Addictology, 1st Faculty of Medicine, Charles University in Prague and General Teaching Hospital in Prague, Prague, Czech Republic
| | - Vendula Belackova
- Department of Addictology, 1st Faculty of Medicine, Charles University in Prague and General Teaching Hospital in Prague, Prague, Czech Republic
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19
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Palamar JJ, Acosta P. A qualitative descriptive analysis of effects of psychedelic phenethylamines and tryptamines. Hum Psychopharmacol 2020; 35:e2719. [PMID: 31909513 PMCID: PMC6995261 DOI: 10.1002/hup.2719] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The number of novel psychedelic phenethylamines and tryptamines has continued to increase, but little academic research has focused on the effects of these substances. We sought to determine and compare the subjective effects of various substances. METHODS We conducted in-depth interviews with 39 adults (75.4% male and 87.2% White) who reported experience using psychedelic phenethylamines and/or tryptamines. Participants described the effects of compounds they have used. We examined the subjective drug effects in a qualitative descriptive manner. RESULTS Participants reported on the use of 36 compounds. The majority (64.1%) reported the use of 2C series drugs, with 2C-B use being most prevalent; 38.5% reported the use of NBOMe, and 25.6% reported the use of DOx. With regard to tryptamines, 46.2% reported use, and 4-AcO-DMT was the most prevalent drug used in this class. 2C-B was often described as being more favorable than other 2C series compounds with the effects described as being comparable with MDMA and LSD. NBOMe effects were generally described in an unfavorable manner, and the effects of DOx were often described as lasting too long (12-36 hr). The effects of 4-AcO-DMT were often described as mimicking psilocybin. CONCLUSION Knowing the effects of various compounds can inform education, prevention, and harm reduction efforts regarding the use of these drugs.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population HealthNew York University School of Medicine New York New York
| | - Patricia Acosta
- Department of Population HealthNew York University School of Medicine New York New York
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Griffin M, Callander D, Duncan DT, Palamar JJ. Differential Risk for Drug Use by Sexual Minority Status among Electronic Dance Music Party Attendees in New York City. Subst Use Misuse 2020; 55:230-240. [PMID: 31530057 PMCID: PMC6980202 DOI: 10.1080/10826084.2019.1662811] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: Drug use among electronic dance music (EDM) party attendees is common; however, studies are needed to examine associations between drug use and sexual orientation as this can inform prevention and harm reduction efforts in the lesbian, gay, and bisexual (LGB) community. Methods: Data were examined from a repeated cross-sectional study of 3066 young adult EDM party attendees surveyed entering nightclubs and dance festivals in New York City between 2016 and 2018. Of these participants, 277 identified as gay/lesbian, 293 identified as bisexual, and 83 identified as other sexuality. We examined how sexual orientation relates to past-year use of various 'traditional' drugs (e.g., ecstasy/MDMA/Molly) and new psychoactive substances (NPS; e.g., "bath salts") in a bivariable and multivariable manner, stratified by sex. Results: Compared to heterosexual males, gay males were at higher odds for use of ecstasy, GHB, and methamphetamine; bisexual males were at higher odds for use of LSD and unknown powders, and males identifying as "other" sexuality were at higher odds for use of mushrooms and 2C drugs. Compared to heterosexual females, lesbians were at higher odds for use of mushrooms and GHB; bisexual females were at higher odds for use of cocaine, LSD, mushrooms, and tryptamines, and females identifying as "other" sexuality were at higher odds for use of cocaine and tryptamines. Conclusions: We determined differential risk of use of different drugs among those who attend EDM parties according to sexual orientation. Findings can be used to tailor prevention messaging to specific groups within the LGB community.
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Affiliation(s)
- Marybec Griffin
- School of Public Health, Rutgers University, Newark, New Jersey, USA
| | - Denton Callander
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Dustin T Duncan
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Joseph J Palamar
- Department of Population Health, New York University School of Medicine, New York, New York, USA
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Abstract
Abstract
Purpose
The recreational drug market remains dynamic. After the introduction of 25I-NBOH, an N-benzylphenethylamine and new psychoactive substance, as option for LSD and NBOMe drugs, new NBOH substances have been identified in recent years. Herein, we report our efforts for the identification and structural elucidation of three new NBOHs detected in seized blotter papers: 25B-NBOH, 25C-NBOH, and 25E-NBOH.
Methods
Blotter papers seized between 2017 and 2018 by local police force in Brazil were submitted to extraction, purification, identification and characterization using attenuated total reflectance-Fourier transform infrared spectroscopy, gas chromatography—mass spectrometry, liquid chromatography—tandem mass spectrometry, and one- and two-dimensional nuclear magnetic resonance spectroscopy.
Results
Three new NBOHs were characterized: 2-(((4-ethyl-2,5-dimethoxyphenethyl)amino)methyl)phenol (25E-NBOH, 2C-E-NBOH), 2-(((4-chloro-2,5-dimethoxyphenethyl)amino)methyl)phenol (25C-NBOH, 2C-C-NBOH), and 2-(((4-bromo-2,5-dimethoxyphenethyl)amino)methyl)phenol (25B-NBOH, 2C-B-NBOH).
Conclusions
To our knowledge, this is the first report for identification and detailed characterization of 25B-NBOH, 25C-NBOH, and 25E-NBOH in seized samples. NBOH substances are not under United Nations Conventions control. The identification of seized blotter papers between 2014 and beginning of 2019 showed that NBOH substances have become the main hallucinogenic drug in the region. These group are thermolabile under gas chromatographic conditions, demanding other analytical approaches of analysis to avoid misidentifications. Unfortunately, the knowledge about toxicology of NBOHs are limited.
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Palamar JJ, Acosta P, Le A, Cleland CM, Nelson LS. Adverse drug-related effects among electronic dance music party attendees. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 73:81-87. [PMID: 31349134 DOI: 10.1016/j.drugpo.2019.07.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/20/2019] [Accepted: 07/02/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Drug use is prevalent among electronic dance music (EDM) party attendees, but research is needed to determine the extent of adverse drug-related outcomes in this population in order to better inform prevention and harm reduction efforts. METHOD 1029 adults were surveyed entering EDM parties in New York City in 2018. Those reporting past-year use of a drug were asked if they experienced a harmful or very unpleasant effect after use in which they were concerned about their immediate safety. They were also asked about co-use of other drugs and whether they sought help. RESULTS We estimate that a third (33.5%) of EDM party attendees have experienced a drug-related adverse effect in the past year. Two-thirds (67.8%) of adverse effects involved use of alcohol. Relative to use, adverse effects most commonly resulted from use of opioids (e.g., prescription opioid misuse, 41.2%) or alcohol (33.9%). Among those reporting an adverse effect, concomitant use of other drugs was common, particularly among users of LSD (56.5%), ketamine (56.3%), cocaine (55.7%), and ecstasy/MDMA/Molly (47.7%). Adverse effects resulting from synthetic cathinone ("bath salt") use were most likely to result in a hospital visit (57.1%). CONCLUSION Adverse effects from drug use are common among those in the EDM party scene and polydrug use appears to be a common risk factor. More research is needed, however, to determine the extent of event-specific adverse outcomes. Results can inform prevention and harm reduction efforts in this population.
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Affiliation(s)
- Joseph J Palamar
- New York University School of Medicine, Department of Population Health, New York, NY, United States; Center for Drug Use and HIV/HCV Research, New York University College of Global Public Health, New York, NY, United States.
| | - Patricia Acosta
- New York University School of Medicine, Department of Population Health, New York, NY, United States
| | - Austin Le
- New York University School of Medicine, Department of Population Health, New York, NY, United States; New York University College of Dentistry, New York, NY, United States
| | - Charles M Cleland
- New York University School of Medicine, Department of Population Health, New York, NY, United States; Center for Drug Use and HIV/HCV Research, New York University College of Global Public Health, New York, NY, United States
| | - Lewis S Nelson
- Rutgers University, School of Public Health, Rutgers University, Newark, NJ, United States
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Salomone A, Palamar JJ, Bigiarini R, Gerace E, Di Corcia D, Vincenti M. Detection of Fentanyl Analogs and Synthetic Opioids in Real Hair Samples. J Anal Toxicol 2019; 43:259-265. [PMID: 30462247 PMCID: PMC6460334 DOI: 10.1093/jat/bky093] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/17/2018] [Accepted: 10/23/2018] [Indexed: 11/13/2022] Open
Abstract
Novel synthetic opioids include various analogs of fentanyl and emerging non-fentanyl compounds with different chemical structures, such as AH-7921, MT-45 and U-47700. In recent years, these drugs have rapidly emerged on the drug market, and their abuse has been increasing worldwide. The motivations for use of these new compounds include their legal status, ready availability, low cost, users' curiosity or preference for their particular pharmacological properties and the intention to avoid detection. Furthermore, more common drugs like heroin are now increasingly being replaced or cut with fentanyl or new designer opioids; thus, many drug users are unintentionally or unknowingly using synthetic fentanyl analogs. In this scenario, the detection of new psychoactive substances in hair can provide insight into their current diffusion among the population and social characteristics of these synthetic drug users. In this manuscript, we describe a simple, fast, specific and sensitive UHPLC-MS-MS method able to detect 13 synthetic opioids (including fentanyl analogs) and metabolites in hair samples. Furthermore, the method includes the detection of 4-anilino-N-phenethyl-piperidine (4-ANPP), which is considered both a precursor and a metabolite of several fentanyl analogs. The method was applied to 34 real hair samples collected in New York City from subjects who had reported past-year non-medical opioid and/or heroin use. In total, 17 samples tested positive for at least one target analyte, with oxycodone (nine samples) and tramadol (eight samples) being the most common. Among these, the method was able to quantify furanyl-fentanyl and fentanyl in the pg/mg range in two samples. Simultaneously, also 4-ANPP was detected, giving evidence for the first time that this compound can be selected as a marker of fentanyl analogs use via hair testing. In conclusion, this study confirmed the increasing diffusion of new synthetic opioids and "fentalogs" with high potency among non-medical opioid users.
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Affiliation(s)
- Alberto Salomone
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
| | - Joseph J Palamar
- Department of Population Health, New York University Langone Medical Center
- Center for Drug Use and HIV/HCV Research, New York University College of Nursing New York, NY, USA
| | | | - Enrico Gerace
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
| | - Daniele Di Corcia
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
- Dipartimento di Chimica, Università di Torino, Turin, Italy
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Oliver CF, Palamar JJ, Salomone A, Simmons SJ, Philogene-Khalid HL, Stokes-McCloskey N, Rawls SM. Synthetic cathinone adulteration of illegal drugs. Psychopharmacology (Berl) 2019; 236:869-879. [PMID: 30338489 PMCID: PMC6472990 DOI: 10.1007/s00213-018-5066-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/03/2018] [Indexed: 01/28/2023]
Abstract
RATIONALE Current prevalence estimates of synthetic cathinone ("bath salt") use may be underestimates given that traditional metrics (e.g., surveys, urinalysis) often fail to capture the emergent issue of synthetic cathinone adulteration of more common illegal drugs, such as ecstasy (3,4-methylenedioxymethamphetamine). OBJECTIVES This review examines the evolution of synthetic cathinones and prevalence of use over the past decade in the United States. We also review methods of self-report and biological testing of these compounds as well as adverse outcomes associated with adulterated drug use. RESULTS Synthetic cathinone use emerged in the United States by 2009 with use associated with tens of thousands of poisonings. Reported poisonings and self-reported use have substantially decreased over the past five years. However, our review suggests that current estimates of use are underestimates due to underreporting stemming primarily from unknown or unintentional use of adulterated formulations of relatively popular illegal drugs, such as ecstasy. CONCLUSIONS While intentional synthetic cathinone use has decreased in recent years, evidence suggests that prevalence of use is underestimated. Testing of drugs and/or biological specimens can improve the accuracy of synthetic cathinone use estimates. Furthermore, we advocate that researchers and clinicians should become better aware that exposure to these potent compounds (e.g., as adulterants) often occurs unknowingly or unintentionally. To improve our understanding of synthetic cathinone adulteration, research utilizing a combinatorial approach (survey and biological testing) will help more accurately estimate the prevalence and impact of this public health issue.
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Affiliation(s)
- Chicora F Oliver
- Center for Substance Abuse Research, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, 882A, Philadelphia, PA, 19140, USA.
| | - Joseph J Palamar
- Department of Population Health, 180 Madison Avenue Room 1752, New York, NY, 10016, USA
| | - Alberto Salomone
- Centro Regionale Antidoping "A. Bertinaria", Regione Gonzole 10/1, 10043, Orbassano, Torino, Italy
| | - Steven J Simmons
- Center for Substance Abuse Research, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, 882A, Philadelphia, PA, 19140, USA
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia Research Institute, Philadelphia, PA, 19104, USA
| | - Helene L Philogene-Khalid
- Center for Substance Abuse Research, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, 882A, Philadelphia, PA, 19140, USA
- Department of Psychiatry, 100 E. Lehigh Ave, Philadelphia, PA, 19125, USA
| | - Nick Stokes-McCloskey
- Center for Substance Abuse Research, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, 882A, Philadelphia, PA, 19140, USA
| | - Scott M Rawls
- Center for Substance Abuse Research, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, 882A, Philadelphia, PA, 19140, USA
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25
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"Flakka" use among high school seniors in the United States. Drug Alcohol Depend 2019; 196:86-90. [PMID: 30709657 PMCID: PMC6377311 DOI: 10.1016/j.drugalcdep.2018.12.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Use of synthetic cathinones, commonly referred to as "bath salts", has been associated with tens of thousands of emergency department visits in the US; however, few national studies have estimated prevalence of use and we know very little about use among adolescents. In this study we estimate prevalence and correlates of use of "Flakka" (alpha-PVP), a highly-potent "bath salt" associated with at least 80 deaths in the US. METHODS We analyzed data from the 2016/2017 Monitoring the Future study, which surveyed a nationally representative sample of high school seniors in the US (n = 3786). Bivariable and multivariable models were used to determine demographic and drug-related correlates of use. RESULTS Overall, 0.8% (95% CI: 0.5-1.2) of high school seniors in 2016/2017 is estimated to have used Flakka in the past year. Students whose parents have less than a high school education were at higher odds for use (aOR = 4.12, 95% CI: 1.00-16.94). Flakka users reported high prevalence of use of other drugs, particularly synthetic cannabinoids (85.6%), ketamine (72.3%), marijuana (59.1%), and GHB (47.5%). Flakka use was also associated with use of a higher number of other drugs and higher frequency of use of other drugs, with 51.7% using 4-12 other drugs and 22.4% using 4-12 other drugs >6 times. CONCLUSIONS Students who use multiple drugs are elevated risk for Flakka use, suggesting synthetic cathinone use alone is rare and the use of multiple substances may compound adverse effects of these drugs. Socio-economic disparities are concerning given reduced access to prevention and intervention.
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Palamar JJ, Le A. Use of new and uncommon synthetic psychoactive drugs among a nationally representative sample in the United States, 2005-2017. Hum Psychopharmacol 2019; 34:e2690. [PMID: 30843283 PMCID: PMC6534815 DOI: 10.1002/hup.2690] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/20/2019] [Accepted: 01/22/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVES This study aims to examine patterns and first mentions of reported use of new or uncommon drugs across 13 years, among nationally representative samples in the United States. METHODS Participants (ages ≥12) in the National Surveys on Drug Use and Health (2005-2017, N = 730,418) were provided opportunities to type in names of new or uncommon drugs they had ever used that were not specifically queried. We examined self-reported use across survey years and determined years of first mentions. RESULTS From 2005 to 2017, there were 2,343 type-in responses for use of 79 new or uncommon synthetic drugs, and 54 were first-ever mentions of these drugs. The majority (65.8%) of mentions were phenethylamines (e.g., 2C-x, NBOMe), which were also the plurality of new drug mentions (n = 22; 40.7%). Mentions of 2C-x drugs in particular increased from 30 mentions in 2005 to 147 mentions in 2013. We estimate an upward trend in use of new or uncommon drugs between 2005 and 2017 (p < 0.001). CONCLUSION Although type-in responses on surveys are limited and underestimate prevalence of use, such responses can help inform researchers when new compounds are used. Continued surveillance of use of new and uncommon drugs is needed to inform adequate public health response.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University Langone Medical Center, New York, New York, USA
| | - Austin Le
- Department of Population Health, New York University Langone Medical Center, New York, New York, USA
- New York University College of Dentistry, New York, New York, USA
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27
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Fernández-Calderón F, Díaz-Batanero C, Barratt MJ, Palamar JJ. Harm reduction strategies related to dosing and their relation to harms among festival attendees who use multiple drugs. Drug Alcohol Rev 2019; 38:57-67. [PMID: 30302851 PMCID: PMC6338512 DOI: 10.1111/dar.12868] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 02/05/2023]
Abstract
INTRODUCTION AND AIMS Polysubstance users are a high-risk population for negative health-related consequences. Although some studies have described harm reduction strategies adopted by polysubstance users, studies have not examined their effectiveness in minimising health-related consequences. We aimed to identify dosing-related harm reduction strategies in a sample of polysubstance-using dance festival attendees, and explore the relationship between harm reduction strategies and self-reported adverse health consequences. DESIGN AND METHODS Data were examined for 1226 past-year dance festival attendees who self-identified as past-year multiple drug users. We conducted bivariable and multivariable analyses to explore relationships between six dosing-related harm reduction strategies and 13 self-reported adverse consequences. RESULTS Self-reported use of dosing-related harm reduction strategies was prevalent, mainly avoidance of mixing depressants (69.2%) and setting limits on quantity (62.2%). Frequent users of harm reduction strategies reported experiencing fewer adverse health consequences (P values < 0.05). Those who reportedly set limits on quantity were at decreased odds of experiencing a bad mood after drug use, sexual difficulties while under drug influence, injuries or fractures while under drug influence, and involvement in fights or being attacked while under drug influence (P values < 0.05). Moreover, those who report frequently avoid mixing depressants were at decreased odds of experiencing headache, loss of consciousness, drop in blood pressure, injuries of fractures, and fights or attacks (P values < 0.05). DISCUSSION AND CONCLUSIONS Adoption of dosing-related harm reduction strategies appears to be associated with less drug-related harm among polysubstance-using festival attendees. Findings may inform organisations and policymakers in the designing of harm reduction interventions with this population.
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Affiliation(s)
- Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Carmen Díaz-Batanero
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Monica J Barratt
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, Australia
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
| | - Joseph J Palamar
- Department of Population Health, New York University Langone Medical Center, New York, USA
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Palamar JJ, Acosta P, Cleland CM. Planned and Unplanned Drug Use during a Night out at an Electronic Dance Music Party. Subst Use Misuse 2019; 54:885-893. [PMID: 30821597 PMCID: PMC6476644 DOI: 10.1080/10826084.2018.1529186] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Electronic dance music (EDM) parties at nightclubs and festivals are high-risk scenes for drug use. Although intention to use drugs (such as ecstasy) has been shown to be the most proximal determinant of use, little is known regarding the extent to which drug use is unplanned in this high-risk scene. METHODS We surveyed 954 adults entering EDM parties in New York City in 2017 and asked about planned drug use that night. A quarter (n = 236) completed the optional online follow-up survey which asked about drug use during their outing. We examined prevalence and correlates of planned and unplanned use. RESULTS A fifth (21.0%) of attendees reported planning to use a specific drug the night of the party and over a third (35.4%) reported using a drug later that night. A quarter (26.6%) used in an unplanned manner. Unplanned marijuana use was most common (10.7%), followed by unplanned use of ecstasy (7.3%), cocaine (4.7%), amphetamine (1.4%), LSD (1.3%), and MDA (1.1%). Unplanned initiation of ecstasy and PMA also occurred. Unplanned drug use was more likely to occur among those recruited outside of nightclubs compared to festivals. Non-heterosexual participants and those with a college degree or higher were also more likely to engage in unplanned marijuana use compared to heterosexual and less educated participants, respectively. CONCLUSIONS Unplanned drug use is common at EDM parties. Results can inform prevention and harm reduction in these scenes as unplanned use may exacerbate potential adverse outcomes related to drug use and often extreme party environments.
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Affiliation(s)
- Joseph J Palamar
- a Department of Population Health , New York University Langone Medical Center , New York , NY , USA.,b Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing , New York , NY , USA
| | - Patricia Acosta
- a Department of Population Health , New York University Langone Medical Center , New York , NY , USA
| | - Charles M Cleland
- b Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing , New York , NY , USA.,c New York University Rory Meyers College of Nursing , New York , NY , USA
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Abstract
Use of synthetic cathinones ("bath salts") has been associated with tens of thousands of emergency department visits. Few surveys, however, query use. Research on "bath salt" use is needed, especially in high-risk populations, to inform prevention and harm reduction efforts. A total of 933 adults (ages 18-40) were surveyed entering electronic dance music (EDM) parties in New York City in 2017. Lifetime use of 22 different synthetic cathinones was queried, and agreement with four statements about "bath salts" was also assessed. Prevalence and correlates of self-reported "bath salt" use was examined as well as correlates of beliefs about "bath salts." An estimated 3.5% of EDM attendees have knowingly used "bath salts." Almost half (46.7%) believe "bath salts" are more harmful than MDMA, 30.1% believe "bath salts" have turned users into cannibals, 30.0% believe "bath salts" are sometimes found in Molly, and 14.9% believe they might have unknowingly used "bath salts." Males, those earning <$500 per week, and those with a college degree were at higher risk for use. Believing "bath salts" have turned users into cannibals, however, was protective against use. Findings suggest the need for more accurate information (e.g., regarding drug effects) on this large and heterogeneous group of compounds.
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Affiliation(s)
- Joseph J Palamar
- a Associate Professor of Population Health, Department of Population Health , New York University Langone Medical Center , New York , NY , USA
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Palamar JJ, Le A. Trends in DMT and other tryptamine use among young adults in the United States. Am J Addict 2018; 27:578-585. [PMID: 30260086 PMCID: PMC6182767 DOI: 10.1111/ajad.12803] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 08/02/2018] [Accepted: 08/25/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The popularity of tryptamines such as N,N-dimethyltryptamine (DMT) appears to be increasing in the United States (US), but epidemiologic literature on prevalence of use is scant. This paper aims to determine trends in prevalence and correlates of past-year tryptamine use among a nationally representative sample of young adults in the US. METHODS Participants in the National Survey on Drug Use and Health survey were queried about past-year use of tryptamines-specifically DMT, α-methyltryptamine (AMT), and 5-MeO-DIPT ("Foxy"). Data were examined from young adults (ages 18-25), years 2007-2014 (N = 144,787). Linear trends in prevalence of past-year tryptamine use were examined in the full sample and stratified by specific demographic and drug use characteristics. RESULTS Tryptamine use is rare, but increased from .2% in 2007/08 to .7% in 2013/14, a 273% relative increase (p < .001). While prevalence increased among all demographic groups, prevalence was substantially higher among individuals who use other drugs. In particular, between 2007/08 and 2013/14, prevalence of tryptamine use increased among past-year ecstasy users (from 2.1% to 10.0%) and LSD users (from 7.0% to 15.5%) (ps < .01). Prevalence of tryptamine use tended to be higher among lifetime and past-year users of psychedelic drugs compared to users of non-psychedelic drugs. CONCLUSION While tryptamine use is not prevalent in the general young adult population, prevalence is increasing. Users of various other drugs-particularly drugs with psychedelic effects-report higher prevalence of tryptamine use. SCIENTIFIC SIGNIFICANCE Users of other drugs can be targeted when disseminating information about tryptamines to ensure user safety. (Am J Addict 2018;27:578-585).
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Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Langone Medical Center, New York, New York
| | - Austin Le
- Department of Population Health, New York University Langone Medical Center, New York, New York
- New York University College of Dentistry, New York, New York
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Palamar JJ, Le A, Cleland CM. Nonmedical opioid use among electronic dance music party attendees in New York City. Drug Alcohol Depend 2018; 186:226-232. [PMID: 29614447 PMCID: PMC5911182 DOI: 10.1016/j.drugalcdep.2018.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 01/28/2018] [Accepted: 03/03/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Nonmedical opioid use remains an epidemic in the United States. Electronic dance music (EDM) party attendees have been found to be at high risk for the use of drugs such as ecstasy, but little is known about nonmedical opioid use in this population. METHODS Using time-space sampling, we surveyed 954 individuals (ages 18-40) attending randomly selected EDM parties in New York City in 2017. Participants were asked about the use of 18 different opioids and about willingness to use if offered by a friend in the next 30 days. We estimated the prevalence of use in this population and examined correlates of past-year and past-month use. RESULTS Almost a quarter (23.9%) of EDM party attendees are estimated to have used opioids non-medically in their lifetime, and one out of ten (9.8%) in the past year. 5% are estimated to be current users (reporting past-month use), and 16.4% are willing to use opioids non-medically if offered by a friend in the next 30 days. Past-year nonmedical benzodiazepine users were at high odds for reporting current nonmedical opioid use (aOR = 10.11, p < 0.001) and, on average, report using more different opioid drugs in the past year than non-past-year-users (p = 0.012). Nearly three-quarters (73.6%) of those who have used in the past year indicated that they would use again if offered by a friend in the next 30 days. CONCLUSION Nonmedical opioid use is prevalent in the EDM scene and many attendees are willing to use if offered. Prevention efforts are needed in this high-risk population.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University Langone Medical Center, New York, NY, USA,Center for Drug Use and HIV/HCV Research, NYU Rory Meyers College of Nursing, 433 First Avenue, New York, NY, 10010, USA
| | - Austin Le
- Department of Population Health, New York University Langone Medical Center, New York, NY, USA,College of Dentistry, New York University, 345 E. 24th Street, New York, NY, 10010, USA
| | - Charles M. Cleland
- Center for Drug Use and HIV/HCV Research, NYU Rory Meyers College of Nursing, 433 First Avenue, New York, NY, 10010, USA
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Papaseit E, Farré M, Pérez-Mañá C, Torrens M, Ventura M, Pujadas M, de la Torre R, González D. Acute Pharmacological Effects of 2C-B in Humans: An Observational Study. Front Pharmacol 2018; 9:206. [PMID: 29593537 PMCID: PMC5859368 DOI: 10.3389/fphar.2018.00206] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/23/2018] [Indexed: 12/31/2022] Open
Abstract
2,5-dimethoxy-4-bromophenethylamine (2C-B) is a psychedelic phenylethylamine derivative, structurally similar to mescaline. It is a serotonin 5-hydroxytryptamine-2A (5-HT2A), 5-hydroxytryptamine-2B (5-HT2B), and 5-hydroxytryptamine-2C (5-HT2C) receptor partial agonist used recreationally as a new psychoactive substance. It has been reported that 2C-B induces mild psychedelic effects, although its acute pharmacological effects and pharmacokinetics have not yet been fully studied in humans. An observational study was conducted to assess the acute subjective and physiological effects, as well as pharmacokinetics of 2C-B. Sixteen healthy, experienced drug users self-administered an oral dose of 2C-B (10, 15, or 20 mg). Vital signs (blood pressure and heart rate) were measured at baseline 1, 2, 3, 4, and 6 hours (h). Each participant completed subjective effects using three rating scales: the visual analog scale (VAS), the Addiction Research Centre Inventory (ARCI), and the Evaluation of the Subjective Effects of Substances with Abuse Potential (VESSPA-SSE) at baseline, 2–3 and 6 h after self-administration (maximum effects along 6 h), and the Hallucinogenic Rating Scale (maximum effects along 6 h). Oral fluid (saliva) was collected to assess 2C-B and cortisol concentrations during 24 h. Acute administration of 2C-B increased blood pressure and heart rate. Scores of scales related to euphoria increased (high, liking, and stimulated), and changes in perceptions (distances, colors, shapes, and lights) and different body feelings/surrounding were produced. Mild hallucinating effects were described in five subjects. Maximum concentrations of 2C-B and cortisol were reached at 1 and 3 h after self-administration, respectively. Oral 2C-B at recreational doses induces a constellation of psychedelic/psychostimulant-like effects similar to those associated with serotonin-acting drugs.
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Affiliation(s)
- Esther Papaseit
- Clinical Pharmacology Unit, Germans Trias i Pujol University Hospital, Institute for Health Science Research Germans Trias i Pujol, Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Magí Farré
- Clinical Pharmacology Unit, Germans Trias i Pujol University Hospital, Institute for Health Science Research Germans Trias i Pujol, Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Clara Pérez-Mañá
- Clinical Pharmacology Unit, Germans Trias i Pujol University Hospital, Institute for Health Science Research Germans Trias i Pujol, Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Marta Torrens
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain.,Drug Addiction Program, Institute of Neuropsychiatry and Addictions, Barcelona, Spain
| | - Mireia Ventura
- Energy Control, Associació Benestar i Desenvolupament, Barcelona, Spain
| | - Mitona Pujadas
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Rafael de la Torre
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Débora González
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Fernández-Calderón F, Cleland CM, Palamar JJ. Polysubstance use profiles among electronic dance music party attendees in New York City and their relation to use of new psychoactive substances. Addict Behav 2018; 78:85-93. [PMID: 29128711 PMCID: PMC5783759 DOI: 10.1016/j.addbeh.2017.11.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 11/02/2017] [Accepted: 11/03/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Electronic Dance Music (EDM) party attendees are often polysubstance users and are at high risk for use of new psychoactive substances (NPS). We sought to identify patterns of use of common illegal drugs among EDM party attendees, sociodemographic correlates, and use of NPS as a function of patterns of use of more common drugs to inform prevention and harm reduction. METHOD Using time-space-sampling, 1045 individuals aged 18-40 were surveyed entering EDM parties in New York City. We queried past-year use of common illegal drugs and 98 NPS. We conducted latent class analysis to identify polysubstance use profiles of use of eight common drugs (i.e., ecstasy, ketamine, LSD, mushrooms, powder cocaine, marijuana, amphetamine, benzodiazepines). Relationships between drug classification membership and sociodemographics and use of drugs within six NPS categories were examined. RESULTS We identified four profiles of use of common drugs: non-polysubstance use (61.1%), extensive polysubstance use (19.2%), moderate polysubstance use/stimulants (12.8%), and moderate polysubstance use/psychedelics (6.7%). Those in the moderate/psychedelic group were at higher odds of using NPS with psychedelic-type effects (2C, tryptamines, and other "new" psychedelics; Ps<0.05). Extensive polysubstance users were at increased odds of reporting use of 2C drugs, synthetic cathinones ("bath salts"), tryptamines, other new (non-phenethylamine) psychedelics, new dissociatives, and synthetic cannabinoids (Ps<0.05). CONCLUSION NPS preference is linked to the profile of use of common drugs among individuals in the EDM scene. Most participants were identified as non-polysubstance users, but findings may help inform preventive and harm reduction interventions among those at risk in this scene.
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Affiliation(s)
| | - Charles M Cleland
- New York University Rory Meyers College of Nursing, New York, NY, USA; Center for Drug Use and HIV Research, New York University Rory Meyers College of Nursing, New York, NY, USA
| | - Joseph J Palamar
- Center for Drug Use and HIV Research, New York University Rory Meyers College of Nursing, New York, NY, USA; Department of Population Health, New York University Langone Medical Center, New York, NY, USA
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Palamar JJ, Acosta P, Cleland CM. Attitudes and Beliefs About New Psychoactive Substance Use Among Electronic Dance Music Party Attendees. Subst Use Misuse 2018; 53:381-390. [PMID: 28777688 PMCID: PMC5766408 DOI: 10.1080/10826084.2017.1327980] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Attitudes and beliefs about drug use have been shown to be robust correlates of use of drugs such as alcohol, marijuana, and cocaine; however, little is known regarding attitudes or beliefs about new psychoactive substances (NPS). We sought to examine attitudes and beliefs about NPS and how they relate to self-reported use in a high-risk population-electronic dance music (EDM) party attendees. METHOD 1,048 individuals (age 18-40) were surveyed entering EDM parties in New York City in 2016. We queried lifetime use and attitudes and beliefs specific to NBOMe, 2C series drugs, "bath salts" (synthetic cathinones), tryptamines, dissociative NPS, and synthetic cannabinoids. RESULTS More than half the sample reported being unfamiliar with NPS other than "bath salts" and synthetic cannabinoids. "Bath salts" received the highest ratings of strong disapproval (34.3%), followed by synthetic cannabinoids (23.3%), compared to other NPS (10-14%). "Bath salts" were perceived to be a great risk by 43.1% of the sample, followed by synthetic cannabinoids (27.0%), and other NPS (12-16%). "Bath salts" were reportedly least likely to be used if offered (2.9%). In multivariable models, reporting no disapproval towards use was associated with increased odds of reporting use of 2C drugs, "bath salts", and tryptamines. Having friends who use and reporting intent to use or willingness to use if offered were also associated with use of various NPS classes. CONCLUSIONS This study delineated attitudinal and belief-related correlates of use of various NPS classes. Results can inform prevention effects as NPS continue to emerge.
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Affiliation(s)
- Joseph J Palamar
- a Department of Population Health , New York University Langone Medical Center , New York , NY , USA.,b Center for Drug Use and HIV Research , New York University Rory Meyers College of Nursing , New York , NY , USA
| | - Patricia Acosta
- a Department of Population Health , New York University Langone Medical Center , New York , NY , USA
| | - Charles M Cleland
- b Center for Drug Use and HIV Research , New York University Rory Meyers College of Nursing , New York , NY , USA.,c New York University Rory Meyers College of Nursing , New York , NY , USA
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Mohr ALA, Friscia M, Yeakel JK, Logan BK. Use of synthetic stimulants and hallucinogens in a cohort of electronic dance music festival attendees. Forensic Sci Int 2017; 282:168-178. [PMID: 29216523 DOI: 10.1016/j.forsciint.2017.11.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 11/10/2017] [Accepted: 11/11/2017] [Indexed: 11/29/2022]
Abstract
Novel psychoactive substances (NPS), often characterized as unregulated psychoactive compounds designed to circumvent existing legislation, have become mainstream on the illicit drug market. Because of their physical and mind-altering properties, NPS may be deliberately or inadvertently ingested at electronic dance music (EDM) festivals to enhance the attendees' appreciation of the music and overall experience. Their widespread use at EDM festivals have been well documented and several adverse events and fatalities associated with NPS ingestion have been reported in the United States. The diversity and rapid turnover in the prevalence of any particular NPS at any given point of time has created several challenges for public health officials, law enforcement, and forensic science communities. Epidemiological studies are often published long after drugs have cycled through the peak of their popularity with users and the scope of testing frequently failing to detect, identify or report the most recently available drugs. The aims of the study included discovering emerging NPS, ascertaining their overall prevalence and determining patterns of use and trends within this targeted population. Over the course of two years, biological samples were collected from 396 (126 blood samples; 227 urine samples; and 384 oral fluid samples) EDM festival attendees. Additionally, survey data regarding prescription and recreational drug use within the last week were collected with follow-up questions related to what substance(s) the person had ingested, amount taken, when the substance was last taken and perceived effects. All biological samples were screened and subsequently confirmed and/or quantified, when appropriate. In response to survey questions, 72% of the participants reported using a recreational drug or medicinal substance within the last week. Users most commonly reported using marijuana and alcohol, followed by "Molly" and cocaine. Of the 396 individuals tested, approximately 75% of the population was positive in at least one biological specimen for drugs and/or alcohol. Of those positive samples, 36% were confirmed to contain one or more NPS and/or 3,4-methylenedioxy-methamphetamine (MDMA). High rates of turnover and spikes in popularity related to NPS are supported by samples confirming positive for alpha-PVP in 2014, however, one year later not a single case was positive for alpha-PVP, and instead increasing numbers of subjects were positive for ethylone.
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Affiliation(s)
- Amanda L A Mohr
- The Center for Forensic Science Research and Education (CFSRE), 2300 Stratford Ave, Willow Grove, PA, United States
| | - Melissa Friscia
- The Center for Forensic Science Research and Education (CFSRE), 2300 Stratford Ave, Willow Grove, PA, United States
| | - Jillian K Yeakel
- Lehigh Valley Toxicology, 3864 Courtney St. Suite 150, Bethlehem, PA, United States
| | - Barry K Logan
- The Center for Forensic Science Research and Education (CFSRE), 2300 Stratford Ave, Willow Grove, PA, United States; NMS Labs, 3701 Welsh Rd, Willow Grove, PA, United States.
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Dolan SB, Forster MJ, Gatch MB. Discriminative stimulus and locomotor effects of para-substituted and benzofuran analogs of amphetamine. Drug Alcohol Depend 2017; 180:39-45. [PMID: 28865391 PMCID: PMC6463889 DOI: 10.1016/j.drugalcdep.2017.07.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 07/24/2017] [Accepted: 07/25/2017] [Indexed: 01/01/2023]
Abstract
Novel psychoactive substances have maintained a prominent role in the global drug culture, despite increased regulation by governing bodies. Novel compounds continue to become available on the market, often in "Ecstasy" or "Molly" formulations in lieu of MDMA, at a much faster rate than they can be properly characterized. The current study aimed to investigate the discriminative stimulus and locomotor effects of three putatively entactogenic compounds that have become increasingly prevalent on the drug market: 5-(2-aminopropyl)-benzofuran (5-APB), 6-(2-aminopropryl)-2,3-dihydrobenzofuran (6-APDB), and 4-fluoroamphetamine (4-FA). Locomotor stimulant effects were assessed in an open-field assay for locomotor activity using Swiss-Webster mice. Discriminative stimulus effects were assessed in Sprague-Dawley rats trained to discriminate either cocaine, methamphetamine, DOM, or MDMA from vehicle. The benzofuran compounds produced locomotor stimulation whereas 4-FA depressed locomotor activity. The benzofurans substituted for the discriminative stimulus effects of MDMA, but only partially or not at all for methamphetamine, cocaine, and DOM, whereas 4-FA fully substituted for MDMA, methamphetamine and cocaine, but not DOM. These results indicate an MDMA-like pattern of abuse might be expected for the benzofurans, whereas 4-FA may be substituted for psychostimulants and MDMA.
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Affiliation(s)
- Sean B Dolan
- University of North Texas Health Science Center, Center for Neuroscience Discovery, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, United States
| | - Michael J Forster
- University of North Texas Health Science Center, Center for Neuroscience Discovery, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, United States
| | - Michael B Gatch
- University of North Texas Health Science Center, Center for Neuroscience Discovery, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, United States.
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Palamar JJ, Salomone A, Gerace E, Di Corcia D, Vincenti M, Cleland CM. Hair testing to assess both known and unknown use of drugs amongst ecstasy users in the electronic dance music scene. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 48:91-98. [PMID: 28810159 DOI: 10.1016/j.drugpo.2017.07.010] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/18/2017] [Accepted: 07/10/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Data on both known and unknown drug use in the electronic dance music (EDM) scene is important to inform prevention and harm reduction. While surveys are the most common method of querying drug use, additional biological data can help validate use and detect unknown/unintentional use of drugs such as new psychoactive substances (NPS). We sought to determine the extent of both known and unknown use of various substances in this high-risk scene. METHODS We hair-tested 90 self-reported past-year ecstasy/MDMA/Molly users attending EDM parties in New York City during the summer of 2016 using UHPLC-MS/MS. Results were compared to self-reported past-year use. RESULTS Three quarters (74.4%) tested positive for MDMA, a third (33.3%) tested positive for an NPS, and 27.8% tested positive specifically for one or more synthetic cathinones (e.g., butylone, ethylone, pentylone, methylone, alpha-PVP). Half (51.1%) of participants tested positive for a drug not self-reported, with most testing positive for synthetic cathinones (72.0%), methamphetamine (69.0%), other NPS stimulants (e.g., 4-FA, 5/6-APB; 66.7%), or new dissociatives (e.g., methoxetamine, diphenidine; 60.0%). Attending parties every other week or more often, reporting higher-frequency ecstasy pill use, having tested one's ecstasy, and having found out one's ecstasy was adulterated, were risk factors for testing positive for synthetic cathinones and NPS in general. CONCLUSION Hair testing appears to be a valuable addition to drug epidemiology studies. Many EDM party attendees-even those who test their ecstasy-are unknowingly using NPS and/or other drugs. Prevention information and harm reduction may help reduce unknown/unintentional use.
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Affiliation(s)
- Joseph J Palamar
- New York University Langone Medical Center, Department of Population Health, New York, NY, USA; Center for Drug Use and HIV Research, New York University Rory Meyers College of Nursing, New York, NY, USA.
| | - Alberto Salomone
- Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Orbassano, Turin, Italy
| | - Enrico Gerace
- Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Orbassano, Turin, Italy
| | - Daniele Di Corcia
- Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Orbassano, Turin, Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Orbassano, Turin, Italy; Dipartimento di Chimica, Università di Torino, Turin, Italy
| | - Charles M Cleland
- Center for Drug Use and HIV Research, New York University Rory Meyers College of Nursing, New York, NY, USA; New York University Rory Meyers College of Nursing, New York, NY, USA
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Salomone A, Palamar JJ, Gerace E, Di Corcia D, Vincenti M. Hair Testing for Drugs of Abuse and New Psychoactive Substances in a High-Risk Population. J Anal Toxicol 2017; 41:376-381. [PMID: 28334805 PMCID: PMC5427665 DOI: 10.1093/jat/bkx020] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 01/18/2017] [Accepted: 02/21/2017] [Indexed: 11/13/2022] Open
Abstract
Hundreds of new psychoactive substances (NPS) have emerged in the drug market over the last decade. Few drug surveys in the USA, however, ask about use of NPS, so prevalence and correlates of use are largely unknown. A large portion of NPS use is unintentional or unknown as NPS are common adulterants in drugs like ecstasy/Molly, and most NPS are rapidly eliminated from the body, limiting efficacy of urine, blood and saliva testing. We utilized a novel method of examining prevalence of NPS use in a high-risk population utilizing hair-testing. Hair samples from high-risk nightclub and dance music attendees were tested for 82 drugs and metabolites (including NPS) using ultra-high performance liquid chromatography-tandem mass spectrometry. Eighty samples collected from different parts of the body were analyzed, 57 of which detected positive for at least one substance-either a traditional or new drug. Among these, 26 samples tested positive for at least one NPS-the most common being butylone (25 samples). Other new drugs detected include methylone, methoxetamine, 5/6-APB, α-PVP and 4-FA. Hair analysis proved a powerful tool to gain objective biological drug-prevalence information, free from possible biases of unintentional or unknown intake and untruthful reporting of use. Such testing can be used actively or retrospectively to validate survey responses and inform research on consumption patterns, including intentional and unknown use, polydrug-use, occasional NPS intake and frequent or heavy use.
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Affiliation(s)
- Alberto Salomone
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
| | - Joseph J. Palamar
- Department of Population Health, New York University Langone Medical Center, New York, USA
- Center for Drug Use and HIV Research, New York University Rory Meyers College of Nursing, New York, NY, USA
| | - Enrico Gerace
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
| | - Daniele Di Corcia
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
- Dipartimento di Chimica, Università di Torino, Turin, Italy
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Palamar JJ, Acosta P, Calderón FF, Sherman S, Cleland CM. Assessing self-reported use of new psychoactive substances: The impact of gate questions. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017; 43:609-617. [PMID: 28485987 DOI: 10.1080/00952990.2017.1322094] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND New psychoactive substances (NPS) continue to emerge; however, few surveys of substance use ask about NPS use. Research is needed to determine how to most effectively query use of NPS and other uncommon drugs. OBJECTIVE To determine whether prevalence of self-reported lifetime and past-year use differs depending on whether or not queries about NPS use are preceded by "gate questions." Gate questions utilize skip-logic, such that only a "yes" response to the use of specific drug class is followed by more extensive queries of drug use in that drug class. METHODS We surveyed 1,048 nightclub and dance festival attendees (42.6% female) entering randomly selected venues in New York City in 2016. Participants were randomized to gate vs. no gate question before each drug category. Analyses focus on eight categories classifying 145 compounds: NBOMe, 2C, DOx, "bath salts" (synthetic cathinones), other stimulants, tryptamines, dissociatives, and non-phenethylamine psychedelics. Participants, however, were asked about specific "bath salts" regardless of their response to the gate question to test reliability. We examined whether prevalence of use of each category differed by gate condition and whether gate effects were moderated by participant demographics. RESULTS Prevalence of use of DOx, other stimulants, and non-phenethylamine psychedelics was higher without a gate question. Gate effects for other stimulants and non-phenethylamine psychedelics were larger among white participants and those attending parties less frequently. Almost one in ten (9.3%) participants reporting no "bath salt" use via the gate question later reported use of a "bath salt" such as mephedrone, methedrone, or methylone. CONCLUSION Omitting gate questions may improve accuracy of data collected via self-report.
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Affiliation(s)
- Joseph J Palamar
- a Department of Population Health , New York University Langone Medical Center , New York , NY , USA.,b Center for Drug Use and HIV Research , New York University Rory Meyers College of Nursing , New York , NY , USA
| | - Patricia Acosta
- a Department of Population Health , New York University Langone Medical Center , New York , NY , USA
| | - Fermín Fernández Calderón
- c Department of Clinical , Experimental and Social Psychology, University of Huelva , Huelva , Spain
| | - Scott Sherman
- a Department of Population Health , New York University Langone Medical Center , New York , NY , USA.,b Center for Drug Use and HIV Research , New York University Rory Meyers College of Nursing , New York , NY , USA
| | - Charles M Cleland
- b Center for Drug Use and HIV Research , New York University Rory Meyers College of Nursing , New York , NY , USA.,d New York University Rory Meyers College of Nursing , New York , NY , USA
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