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Martens R, Gozdzialski L, Newman E, Gill C, Wallace B, Hore DK. Trace Detection of Adulterants in Illicit Opioid Samples Using Surface-Enhanced Raman Scattering and Random Forest Classification. Anal Chem 2024; 96. [PMID: 39016148 PMCID: PMC11296309 DOI: 10.1021/acs.analchem.4c01271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 07/02/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
The detection of trace adulterants in opioid samples is an important aspect of drug checking, a harm reduction measure that is required as a result of the variability and unpredictability of the illicit drug supply. While many analytical methods are suitable for such analysis, community-based approaches require techniques that are amenable to point-of-care applications with minimal sample preparation and automated analysis. We demonstrate that surface-enhanced Raman spectroscopy (SERS), combined with a random forest classifier, is able to detect the presence of two common sedatives, bromazolam (0.32-36% w/w) and xylazine (0.15-15% w/w), found in street opioid samples collected as a part of a community drug checking service. The Raman predictions, benchmarked against mass spectrometry results, exhibited high specificity (88% for bromazolam, 96% for xylazine) and sensitivity (88% for bromazolam, 92% for xylazine) for the compounds of interest. We additionally provide evidence that this exceeds the performance of a more conventional approach using infrared spectral data acquired on the same samples. This demonstrates the feasibility of SERS for point-of-care analysis of challenging multicomponent samples containing trace adulterants.
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Affiliation(s)
- Rebecca
R. Martens
- Department
of Chemistry, University of Victoria, Victoria, British Columbia V8W 3V6, Canada
| | - Lea Gozdzialski
- Department
of Chemistry, University of Victoria, Victoria, British Columbia V8W 3V6, Canada
| | - Ella Newman
- Department
of Chemistry, University of Victoria, Victoria, British Columbia V8W 3V6, Canada
| | - Chris Gill
- Department
of Chemistry, University of Victoria, Victoria, British Columbia V8W 3V6, Canada
- Department
of Chemistry, Vancouver Island University, Nanaimo, British Columbia V9R 5S5, Canada
- Department
of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington 98195, United States
- Canadian
Institute for Substance Use Research, University
of Victoria, Victoria, British Columbia V8W 2Y2, Canada
| | - Bruce Wallace
- Canadian
Institute for Substance Use Research, University
of Victoria, Victoria, British Columbia V8W 2Y2, Canada
- School
of Social Work, University of Victoria, Victoria, British Columbia V8W 2Y2, Canada
| | - Dennis K. Hore
- Department
of Chemistry, University of Victoria, Victoria, British Columbia V8W 3V6, Canada
- Canadian
Institute for Substance Use Research, University
of Victoria, Victoria, British Columbia V8W 2Y2, Canada
- Department
of Computer Science, University of Victoria, Victoria, British Columbia V8W 3P6, Canada
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Deconinck E, Lievens S, Canfyn M, Van Campenhout P, Debehault L, Gremaux L, Balcaen M. Full Characterisation of Heroin Samples Using Infrared Spectroscopy and Multivariate Calibration. Molecules 2024; 29:1116. [PMID: 38474628 DOI: 10.3390/molecules29051116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/23/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
The analysis of heroin samples, before use in the protected environment of user centra, could be a supplementary service in the context of harm reduction. Infrared spectroscopy hyphenated with multivariate calibration could be a valuable asset in this context, and therefore 125 heroin samples were collected directly from users and analysed with classical chromatographic techniques. Further, Mid-Infrared spectra were collected for all samples, to be used in Partial Least Squares (PLS) modelling, in order to obtain qualitative and quantitative models based on real live samples. The approach showed that it was possible to identify and quantify heroin in the samples based on the collected spectral data and PLS modelling. These models were able to identify heroin correctly for 96% of the samples of the external test set with precision, specificity and sensitivity values of 100.0, 75.0 and 95.5%, respectively. For regression, a root mean squared error of prediction (RMSEP) of 0.04 was obtained, pointing at good predictive properties. Furthermore, during mass spectrometric screening, 10 different adulterants and impurities were encountered. Using the spectral data to model the presence of each of these resulted in performant models for seven of them. All models showed promising correct-classification rates (between 92 and 96%) and good values for sensitivity, specificity and precision. For codeine and morphine, the models were not satisfactory, probably due to the low concentration of these impurities as a consequence of acetylation. For methacetin, the approach failed.
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Affiliation(s)
- Eric Deconinck
- Sciensano, Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, J. Wytsmanstraat 14, B-1050 Brussels, Belgium
| | - Sybrien Lievens
- Sciensano, Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, J. Wytsmanstraat 14, B-1050 Brussels, Belgium
- VUB, Faculty of Sciences and Bio-Engineering, Department Chemistry, Analytical, Environmental and Geo-Chemistry, Pleinlaan 2, B-1050 Brussels, Belgium
| | - Michael Canfyn
- Sciensano, Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, J. Wytsmanstraat 14, B-1050 Brussels, Belgium
| | - Peter Van Campenhout
- Sciensano, Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, J. Wytsmanstraat 14, B-1050 Brussels, Belgium
| | - Loic Debehault
- Sciensano, Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, J. Wytsmanstraat 14, B-1050 Brussels, Belgium
| | - Lies Gremaux
- Sciensano, Scientific Direction Epidemiology and Public Health, Service Lifestyle and Chronic Diseases, J. Wytsmanstraat 14, B-1050 Brussels, Belgium
| | - Margot Balcaen
- Sciensano, Scientific Direction Epidemiology and Public Health, Service Lifestyle and Chronic Diseases, J. Wytsmanstraat 14, B-1050 Brussels, Belgium
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3
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Fakayode SO, Bolton B, Dassow B, Galvez K, Chohan H. Rapid screening and multicomponent quantifications of active components of oral syrup over-the-counter medications by Raman and UV-visible spectroscopy and multivariate regression analysis. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2024; 305:123447. [PMID: 37742594 DOI: 10.1016/j.saa.2023.123447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/29/2023] [Accepted: 09/20/2023] [Indexed: 09/26/2023]
Abstract
Over-the-counter medications (OTCMs) are frequently recommended as a first-line treatment for common ailments, diseases, and illnesses. Oral liquid dosage forms are advantageous for rapid absorption with no dissolution time and are easier for pediatric and geriatric consumers to swallow. The production of these medicines by pharmaceutical industry makes them readily available to the public. Although the US Food and Drug Administration (FDA) provides strict guidelines to drug manufacturers of these products; the risk of counterfeiting is a global issue. This can lead to several adverse effects and health issues. Here, we report a fast screening and quality assurance method using Raman and UV-visible spectroscopy combined with Principal Component Analysis (PCA) and Partial-Least-Square (PLS) regression of commonly used OTCM oral syrups. PLS regressions of UV-visible absorption spectra were used for multicomponent quantifications of the active component (acetaminophen, guaifenesin, dextromethorphan HBr, and phenylephrine HCl) concentrations of OTMCs in flavored (sugar or sugar-free) oral syrups. Raman and UV-visible spectral responses varied based on the type and concentration of the active component analyzed. PCA of the spectral data provided pattern recognition of the oral syrup OTCM. The developed PLS method demonstrated good linearity with an R2 > 0.9784 and high sensitivity with a low detection limit of 0.02 mg/mL for acetaminophen and guaifenesin. Moreover, the simultaneous quantification of concentrations of all active components by the described method yielded good accuracies ranging from 88 to 94%. This study provides an example of the benefits of the combined use of Raman and UV-vis spectral profiling, PCA, and PLS regression for the quality analysis of oral syrups OTCM providing multicomponent quantification of active components with no need for sample extraction. The reported method can be easily adapted and scaled for online detection analysis used in the drug manufacturing industry, both in-situ and field analysis, and for the quality control of syrups OTCM by regulatory agencies and quality control officers.
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Affiliation(s)
- Sayo O Fakayode
- Department of Chemistry, Physics & Astronomy, Georgia College, and State University, Milledgeville, GA 31061, United States.
| | - Brinkley Bolton
- Department of Chemistry, Physics & Astronomy, Georgia College, and State University, Milledgeville, GA 31061, United States
| | - Bailey Dassow
- Department of Chemistry, Physics & Astronomy, Georgia College, and State University, Milledgeville, GA 31061, United States
| | - Kairy Galvez
- Department of Chemistry, Physics & Astronomy, Georgia College, and State University, Milledgeville, GA 31061, United States
| | - Harmeet Chohan
- Department of Chemistry, Purdue State University, Department of Chemistry, 560 Oval Drive, West Lafayette, IN 47907-2084, United States
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4
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Ott CE, Burns A, Sisco E, Arroyo LE. Targeted fentanyl screening utilizing electrochemical surface-enhanced Raman spectroscopy (EC-SERS) applied to authentic seized drug casework samples. Forensic Chem 2023. [DOI: 10.1016/j.forc.2023.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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5
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Gozdzialski L, Wallace B, Hore D. Point-of-care community drug checking technologies: an insider look at the scientific principles and practical considerations. Harm Reduct J 2023; 20:39. [PMID: 36966319 PMCID: PMC10039693 DOI: 10.1186/s12954-023-00764-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/07/2023] [Indexed: 03/27/2023] Open
Abstract
Drug checking is increasingly being explored outside of festivals and events to be an ongoing service within communities, frequently integrated within responses to illicit drug overdose. The choice of instrumentation is a common question, and the demands on these chemical analytical instruments can be challenging as illicit substances may be more complex and include highly potent ingredients at trace levels. The answer remains nuanced as the instruments themselves are not directly comparable nor are the local demands on the service, meaning implementation factors heavily influence the assessment and effectiveness of instruments. In this perspective, we provide a technical but accessible introduction to the background of a few common drug checking methods aimed at current and potential drug checking service providers. We discuss the following tools that have been used as part of the Vancouver Island Drug Checking Project in Victoria, Canada: immunoassay test strips, attenuated total reflection IR-absorption spectroscopy, Raman spectroscopy from powder samples, surface-enhanced Raman scattering in a solution of colloidal gold nanoparticles, and gas chromatography-mass spectrometry. Using four different drug mixtures received and tested at the service, we illustrate the strengths, limitations, and capabilities of such instruments, and expose the scientific theory to give further insight into their analytical results. Each case study provides a walk-through-style analysis for a practical comparison between data from several different instruments acquired on the same sample. Ideally, a single instrument would be able to achieve all of the objectives of drug checking. However, there is no clear instrument that ticks every box; low cost, portable, rapid, easy-to-use and provides highly sensitive identification and accurate quantification. Multi-instrument approaches to drug checking may be required to effectively respond to increasingly complex and highly potent substances demanding trace level detection and the potential for quantification.
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Affiliation(s)
- Lea Gozdzialski
- Department of Chemistry, University of Victoria, Victoria, V8W 3V6, Canada
| | - Bruce Wallace
- School of Social Work, University of Victoria, Victoria, V8W 2Y2, Canada
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, V8W 2Y2, Canada
| | - Dennis Hore
- Department of Chemistry, University of Victoria, Victoria, V8W 3V6, Canada.
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, V8W 2Y2, Canada.
- Department of Computer Science, University of Victoria, Victoria, V8W 3P6, Canada.
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6
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Mullin A, Scott M, Vaccaro G, Gittins R, Ferla S, Schifano F, Guirguis A. Handheld Raman Spectroscopy in the First UK Home Office Licensed Pharmacist-Led Community Drug Checking Service. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4793. [PMID: 36981705 PMCID: PMC10049009 DOI: 10.3390/ijerph20064793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
Across the world, the interest in point-of-care drug checking as a harm-reduction intervention is growing. This is an attempt to improve intelligence about current drug trends and reduce drug-related morbidity and mortality. In the UK, drug-related harm is increasing exponentially year after year. As such, specialist community treatment services are exploring new methods to improve engagement with people who use drugs (PWUD), who may require support for their problematic drug use. This need has driven the requirement to pilot an on-site, time-responsive, readily available drug-checking service at point-of-support centres. In this study, we piloted the UK's first Home Office-licensed drug-checking service that was embedded into a community substance-misuse service and had all on-site analysis and harm-reduction interventions led and delivered by pharmacists. We report on the laboratory findings from the associated confirmatory analysis (UHPLC-MS, GC-MS, and 1H NMR) to assess the performance of the on-site hand-held Raman spectrometer and outline the challenges of providing real-time analysis of psychoactive substances in a clinical setting. Whilst acknowledging the limitation of the small sample size (n = 13), we demonstrate the potential suitability of using this technology for the purposes of screening substances in community-treatment services. Portability of equipment and timeliness of results are important and only very small samples may be provided by people who use the service. The challenges of accurately identifying substances from complex mixtures were equally found with both point-of-care Raman spectroscopy and laboratory confirmatory-analysis techniques. Further studies are required to confirm these findings.
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Affiliation(s)
- Anthony Mullin
- Department of Clinical, Pharmaceutical and Biological Science, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Mark Scott
- Department of Clinical, Pharmaceutical and Biological Science, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Giorgia Vaccaro
- Department of Clinical, Pharmaceutical and Biological Science, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Rosalind Gittins
- Clinical Department, WDP-Westminster Drug Project, 18 Dartmouth St., London SW1H 9BL, UK
| | - Salvatore Ferla
- Pharmacy, Medical School, The Grove Extension, Swansea University, Swansea SA2 8PP, UK
| | - Fabrizio Schifano
- Department of Clinical, Pharmaceutical and Biological Science, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Amira Guirguis
- Department of Clinical, Pharmaceutical and Biological Science, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
- Pharmacy, Medical School, The Grove Extension, Swansea University, Swansea SA2 8PP, UK
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7
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Substances from unregulated drug markets - A retrospective data analysis of customer-provided samples from a decade of drug checking service in Zurich (Switzerland). THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 114:103972. [PMID: 36841217 DOI: 10.1016/j.drugpo.2023.103972] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 02/07/2023] [Accepted: 02/11/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Drug checking services (DCS) are harm reduction interventions for people who consume illicit substances. Unregulated drug markets lead to samples with unexpected and variable contents. A retrospective data analysis of Zurich's DCS was performed to determine the nature of these samples. METHODS This study aims to investigate the qualitative and quantitative properties of 16,815 customer-provided psychoactive drug samples analyzed chemically through the DCS in Zurich from 1st January 2011 to 31st December 2021. The main analytical method utilized for characterizing these substances was high-performance liquid chromatography and gas chromatography-mass spectrometry. Data sets are summarized using descriptive statistics. RESULTS There was a 2.5-fold increase in the number of tested samples over the past decade. An overall proportion of 57.9% (weighted mean) of samples within our database demonstrates unexpected analytical findings and additional low sample contents during the observation period. Substantial differences in quality and quantity between substance groups were detected and an increase of sample quality and content over time was demonstrated. CONCLUSIONS Chemical analysis reveals that over half of substances acquired from unregulated drug markets analyzed through DCS in Zurich are with low qualitative and quantitative properties, which may expose users to risks. Based on longitudinal analyses over a decade, this study contributes to the body of evidence that DCS may potentially manipulate unregulated drug markets towards providing better quality substances, as well as may stabilize these markets over time. The necessity for drug policy changes to make this service accessible in further settings was highlighted, as DCS still often take place in legal grey zones. FUNDING None to declare.
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Giulini F, Keenan E, Killeen N, Ivers JH. A Systematized Review of Drug-checking and Related Considerations for Implementation as A Harm Reduction Intervention. J Psychoactive Drugs 2023; 55:85-93. [PMID: 35060837 DOI: 10.1080/02791072.2022.2028203] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Drug-checking services (DCS) provide people who use drugs (PWUD) the opportunity to have their substances tested before consumption. Though some suggest they may have adverse consequences, DCS have been introduced as a harm reduction (HR) strategy. A systematized review of the literature regarding drug checking (DC) methods and testing locations, advantages and disadvantages, and legal frameworks with an emphasis on HR was conducted referencing PRISMA guidelines. The primary search of PsychInfo, PubMed, Medline, CINHAL, CORE, and Web of Science was conducted between the 4th and 10th of September 2020, and 51 literature pieces were included in the final article. Most of the literature focuses on the benefits of currently available DCS. The services identified varied significantly in terms of testing methods, location of operation, primary goal, and the surrounding legal framework. The results suggest using multiple DC methods to be most beneficial. Further, DCS and the personalized interventions they provide can positively influence behavior change, minimize harm, and reduce mortality. DCS are a viable public health intervention that requires cross-sector support beyond the legal frameworks and testing methods. Services will need to be tailored to meet the needs of their chosen setting, local drug market, and target audience.
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Affiliation(s)
- Francesca Giulini
- Department of Public Health & Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, the University of Dublin, Tallaght, Dublin
| | - Eamon Keenan
- Department of Public Health & Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, the University of Dublin, Tallaght, Dublin.,National Office of Social Inclusion, Health Service Executive, Dublin 20
| | - Nicki Killeen
- National Office of Social Inclusion, Health Service Executive, Dublin 20
| | - Jo-Hanna Ivers
- Department of Public Health & Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, the University of Dublin, Tallaght, Dublin
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Kranenburg RF, Ramaker HJ, Weesepoel Y, Arisz PW, Keizers PH, van Esch A, Zieltjens – van Uxem C, van den Berg JD, Hulshof JW, Bakels S, Rijs AM, van Asten AC. The influence of water of crystallization in NIR-based MDMA∙HCl detection. Forensic Chem 2022. [DOI: 10.1016/j.forc.2022.100464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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10
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Paraformaldehyde-coated electrochemical sensor for improved on-site detection of amphetamine in street samples. Microchem J 2022. [DOI: 10.1016/j.microc.2022.107518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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11
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Rapid On-Site Detection of Illicit Drugs in Smuggled Samples with a Portable Electrochemical Device. CHEMOSENSORS 2022. [DOI: 10.3390/chemosensors10030108] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The smuggling of illicit drugs urges the development of new tools for rapid on-site identification in cargos. Current methods rely on presumptive color tests and portable spectroscopic techniques. However, these methods sometimes exhibit inaccurate results due to commonly used cutting agents, the colorful nature of the sample or because the drugs are smuggled in common goods. Interestingly, electrochemical sensors can deal with these specific problems. Herein, an electrochemical device is presented that uses affordable screen-printed electrodes for the electrochemical profiling of several illicit drugs by square-wave voltammetry (SWV). The identification of the illicit compound is based on the oxidation potential of the analyte. Hence, a library of electrochemical profiles is built upon the analysis of illicit drugs and common cutting agents. This library allows the design of a tailor-made script that enables the identification of each drug through a user-friendly interface (laptop or mobile phone). Importantly, the electrochemical test is compared by analyzing 48 confiscated samples with other portable devices based on Raman and FTIR spectroscopy as well as a laboratory standard method (i.e., gas chromatography–mass spectrometry). Overall, the electrochemical results, obtained through the analysis of different samples from confiscated cargos at an end-user site, present a promising alternative to current methods, offering low-cost and rapid testing in the field.
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12
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Carroll JJ, Mackin S, Schmidt C, McKenzie M, Green TC. The Bronze Age of drug checking: barriers and facilitators to implementing advanced drug checking amidst police violence and COVID-19. Harm Reduct J 2022; 19:9. [PMID: 35120531 PMCID: PMC8814788 DOI: 10.1186/s12954-022-00590-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/12/2022] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Unpredictable fluctuations in the illicit drug market increase overdose risk. Drug checking, or the use of technology to provide insight into the contents of illicit drug products, is an overdose prevention strategy with an emerging evidence base. The use of portable spectrometry devices to provide point-of-service analysis of the contents of illicit drugs been adopted by harm reduction organizations internationally but is only emerging in the United States. This study aimed to identify barriers and facilitators of implementing drug checking services with spectrometry devices in an urban harm reduction organization and syringe service program serving economically marginalized people who use drugs in Boston, Massachusetts (USA). METHODS In-vivo observations and semi-structured interviews with harm reduction staff and participants were conducted between March 2019 and December 2020. We used the consolidated framework for implementation research to identify implementation barriers and facilitators. RESULTS This implementation effort was facilitated by the organization's shared culture of harm reduction-which fostered shared implementation goals and beliefs about the intervention among staff persons-its horizontal organizational structure, strong identification with the organization among staff, and strong relationships with external funders. Barriers to implementation included the technological complexity of the advanced spectroscopy devices utilized for drug checking. Program staff indicated that commercially available spectroscopy devices are powerful but not always well-suited for drug checking efforts, describing their technological capacities as "the Bronze Age of Drug Checking." Other significant barriers include the legal ambiguity of drug checking services, disruptive and oppositional police activity, and the responses and programmatic changes demanded by the COVID-19 pandemic. CONCLUSIONS For harm reduction organizations to be successful in efforts to implement and scale drug checking services, these critical barriers-especially regressive policing policies and prohibitive costs-need to be addressed. Future research on the impact of policy changes to reduce the criminalization of substance use or to provide explicit legal frameworks for the provision of this and other harm reduction services may be merited.
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Affiliation(s)
- Jennifer J Carroll
- Department of Sociology and Anthropology, North Carolina State University, 10 Current Drive, Campus Box 8107, Raleigh, NC, 27695-8107, USA.
- Brown University, Providence, RI, USA.
| | - Sarah Mackin
- Access, Harm Reduction, Overdose Prevention and Education (AHOPE) Syringe Exchange, Boston, MA, USA
| | - Clare Schmidt
- Access, Harm Reduction, Overdose Prevention and Education (AHOPE) Syringe Exchange, Boston, MA, USA
| | - Michelle McKenzie
- Brown University, Providence, RI, USA
- The Miriam Hospital, Providence, RI, USA
| | - Traci C Green
- Brown University, Providence, RI, USA
- Brandeis University, Waltham, MA, USA
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13
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Kranenburg RF, Ramaker H, Sap S, Asten AC. A Calibration Friendly Approach to Identify Drugs of Abuse Mixtures with a Portable Near‐Infrared Analyzer. Drug Test Anal 2022; 14:1089-1101. [PMID: 35098685 PMCID: PMC9305489 DOI: 10.1002/dta.3231] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 11/10/2022]
Abstract
Both the increasing number and diversity of illicit‐drug seizures complicate forensic drug identification. Traditionally, colorimetric tests are performed on‐site, followed by transport to a laboratory for confirmatory analysis. Higher caseloads increase laboratory workload and associated transport and chain‐of‐evidence assurance performed by police officers. Colorimetric tests are specific only for a small set of drugs. The rise of new psychoactive substances therefore introduces risks for erroneous results. Near‐infrared (NIR)‐based analyzers may overcome these encumbrances by their compound‐specific spectral selectivity and broad applicability. This work introduces a portable NIR analyzer that combines a broad wavelength range (1300–2600 nm) with a chemometric model developed specifically for forensic samples. The application requires only a limited set of reference spectra for time‐efficient model training. This calibration‐light approach thus eliminates the need of extensive training sets including mixtures. Performance was demonstrated with 520 casework samples resulting in a 99.6% true negative and 97.6% true positive rate for cocaine. Similar results were obtained for MDMA, methamphetamine, ketamine, and heroin. Additionally, 236 samples were analyzed by scanning directly through their plastic packaging. Also here, a >97% true positive rate was obtained. This allows for non‐invasive, operator‐safe chemical identification of potentially potent drugs of abuse. Our results demonstrate the applicability for multiple drug‐related substances. Ideally, the combination of this NIR approach with other portable techniques, such as Raman and IR spectroscopy and electrochemical tests, may eventually eliminate the need for subsequent laboratory analysis; therefore, saving tremendous resources in the overall forensic process of confirmatory illicit drug identification.
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Affiliation(s)
- Ruben F. Kranenburg
- Dutch National Police, Unit Amsterdam, Forensic Laboratory, Kabelweg 25 Amsterdam BA The Netherlands
- Van’t Hoff Institute for Molecular Sciences University of Amsterdam Amsterdam GD The Netherlands
| | | | - Sharon Sap
- Dutch Customs Laboratory, Kingsfordweg 1 Amsterdam GN The Netherlands
| | - Arian C. Asten
- Van’t Hoff Institute for Molecular Sciences University of Amsterdam Amsterdam GD The Netherlands
- Co van Ledden Hulsebosch Center (CLHC), Amsterdam Center for Forensic Science and Medicine, Postbus 94157 Amsterdam GD The Netherlands
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14
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Dasgupta N, Figgatt MC. Invited Commentary: Drug Checking for Novel Insights Into the Unregulated Drug Supply. Am J Epidemiol 2022; 191:248-252. [PMID: 34528056 PMCID: PMC8824693 DOI: 10.1093/aje/kwab233] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/12/2021] [Accepted: 08/17/2021] [Indexed: 12/21/2022] Open
Abstract
Tobias et al. (Am J Epidemiol. 2022;191 (2):241-247) present a novel analysis of time trends in fentanyl concentrations in the unregulated drug supply in British Columbia, Canada. The preexisting knowledge about unregulated drugs had come from law-enforcement seizures and postmortem toxicology. As both of these data sources are subject to selection bias, large-scale drug-checking programs are poised to be a crucial component of the public health response to the unrelenting increase in overdose in North America. As programs expand, we offer 2 guiding principles. First, the primary purpose of these programs is to deliver timely results to people who use drugs to mitigate health risks. Second, innovation is needed to go beyond criminal justice paradigms in laboratory analysis for a more nuanced understanding of health concerns. We provide examples of the role adulterants play in our understanding of drug harms. We also describe the applications and limitations of common laboratory assays, with implications for epidemiologic surveillance. While the research and direct service teams in British Columbia have taken groundbreaking steps, there is still a need to establish best practices for communicating results to sample donors in an approachable yet nonalarmist tone.
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Affiliation(s)
- Nabarun Dasgupta
- Correspondence to Dr. Nabarun Dasgupta, University of North Carolina Injury Prevention Research Center, 725 Martin Luther King Jr. Boulevard, Chapel Hill, NC 27514 (e-mail: )
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15
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Dragan AM, Parrilla M, Feier B, Oprean R, Cristea C, De Wael K. Analytical techniques for the detection of amphetamine-type substances in different matrices: A comprehensive review. Trends Analyt Chem 2021. [DOI: 10.1016/j.trac.2021.116447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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16
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Kranenburg RF, Verduin J, de Ridder R, Weesepoel Y, Alewijn M, Heerschop M, Keizers PH, van Esch A, van Asten AC. Performance evaluation of handheld Raman spectroscopy for cocaine detection in forensic case samples. Drug Test Anal 2021; 13:1054-1067. [PMID: 33354929 PMCID: PMC8248000 DOI: 10.1002/dta.2993] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/18/2020] [Accepted: 12/20/2020] [Indexed: 01/08/2023]
Abstract
Handheld Raman spectroscopy is an emerging technique for rapid on-site detection of drugs of abuse. Most devices are developed for on-scene operation with a user interface that only shows whether cocaine has been detected. Extensive validation studies are unavailable, and so are typically the insight in raw spectral data and the identification criteria. This work evaluates the performance of a commercial handheld Raman spectrometer for cocaine detection based on (i) its performance on 0-100 wt% binary cocaine mixtures, (ii) retrospective comparison of 3,168 case samples from 2015 to 2020 analyzed by both gas chromatography-mass spectrometry (GC-MS) and Raman, (iii) assessment of spectral selectivity, and (iv) comparison of the instrument's on-screen results with combined partial least square regression (PLS-R) and discriminant analysis (PLS-DA) models. The limit of detection was dependent on sample composition and varied between 10 wt% and 40 wt% cocaine. Because the average cocaine content in street samples is well above this limit, a 97.5% true positive rate was observed in case samples. No cocaine false positives were reported, although 12.5% of the negative samples were initially reported as inconclusive by the built-in software. The spectral assessment showed high selectivity for Raman peaks at 1,712 (cocaine base) and 1,716 cm-1 (cocaine HCl). Combined PLS-R and PLS-DA models using these features confirmed and further improved instrument performance. This study scientifically assessed the performance of a commercial Raman spectrometer, providing useful insight on its applicability for both presumptive detection and legally valid evidence of cocaine presence for law enforcement.
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Affiliation(s)
- Ruben F. Kranenburg
- Forensic LaboratoryDutch National Police, Unit AmsterdamAmsterdamThe Netherlands
- Van't Hoff Institute for Molecular SciencesUniversity of AmsterdamAmsterdamThe Netherlands
| | - Joshka Verduin
- Forensic LaboratoryDutch National Police, Unit AmsterdamAmsterdamThe Netherlands
- Van't Hoff Institute for Molecular SciencesUniversity of AmsterdamAmsterdamThe Netherlands
| | - Renee de Ridder
- Forensic LaboratoryDutch National Police, Unit AmsterdamAmsterdamThe Netherlands
| | - Yannick Weesepoel
- Wageningen Food Safety ResearchWageningen University and ResearchWageningenThe Netherlands
| | - Martin Alewijn
- Wageningen Food Safety ResearchWageningen University and ResearchWageningenThe Netherlands
| | | | - Peter H.J. Keizers
- National Institute of Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | | | - Arian C. van Asten
- Van't Hoff Institute for Molecular SciencesUniversity of AmsterdamAmsterdamThe Netherlands
- Co van Ledden Hulsebosch Center (CLHC), Amsterdam Center for Forensic Science and MedicineAmsterdamThe Netherlands
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17
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Deconinck E, Aït-Kaci C, Raes A, Canfyn M, Bothy JL, Duchateau C, Mees C, De Braekeleer K, Gremaux L, Blanckaert P. An infrared spectroscopic approach to characterise white powders, easily applicable in the context of drug checking, drug prevention and on-site analysis. Drug Test Anal 2020; 13:679-693. [PMID: 33197122 DOI: 10.1002/dta.2973] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/30/2020] [Accepted: 10/13/2020] [Indexed: 11/07/2022]
Abstract
More and more events, such as the summer music festivals, are considering the possibilities for implementing on-site testing of psychoactive drugs in the context of prevention and harm reduction. Although the on-site identification is already implemented by plenty of drug checking services, the required rapid quantitative dosing of the composition of illicit substances is still a missing aspect for a successful harm reduction strategy at events. In this paper, an approach is presented to identify white powders as amphetamine, cocaine, ketamine or others and to estimate the purity of the amphetamine, cocaine and ketamine samples using spectroscopic techniques hyphenated with partial least squares (PLS) modelling. For identification purposes, it was observed that mid-infrared spectroscopy hyphenated with PLS-discriminant analysis allowed the distinction between amphetamine, cocaine, ketamine and other samples and this with a correct classification rate of 93.1% for an external test set. For quantitative estimation, near-infrared spectroscopy was more performant and allowed the estimation of the dosage/purity of the amphetamine, cocaine and ketamine samples with an error of more or less 10% w/w. An easily applicable, practical and cost-effective approach for on-site characterisation of the majority of the psychoactive samples encountered in Belgian nightlife settings based on IR spectroscopy was proposed.
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Affiliation(s)
- Eric Deconinck
- Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, Sciensano, Brussels, Belgium.,RD3 Unit of Pharmacognosy, Bioanalysis and Drug Discovery, Faculty of Pharmacy, Université Libre de Bruxelles Campus de la Plaine, Brussels, Belgium
| | - Camille Aït-Kaci
- Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, Sciensano, Brussels, Belgium.,RD3 Unit of Pharmacognosy, Bioanalysis and Drug Discovery, Faculty of Pharmacy, Université Libre de Bruxelles Campus de la Plaine, Brussels, Belgium
| | - Andries Raes
- Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, Sciensano, Brussels, Belgium
| | - Michaël Canfyn
- Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, Sciensano, Brussels, Belgium
| | - Jean-Luc Bothy
- Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, Sciensano, Brussels, Belgium
| | - Céline Duchateau
- Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, Sciensano, Brussels, Belgium.,RD3 Unit of Pharmacognosy, Bioanalysis and Drug Discovery, Faculty of Pharmacy, Université Libre de Bruxelles Campus de la Plaine, Brussels, Belgium
| | - Corenthin Mees
- RD3 Unit of Pharmacognosy, Bioanalysis and Drug Discovery, Faculty of Pharmacy, Université Libre de Bruxelles Campus de la Plaine, Brussels, Belgium
| | - Kris De Braekeleer
- RD3 Unit of Pharmacognosy, Bioanalysis and Drug Discovery, Faculty of Pharmacy, Université Libre de Bruxelles Campus de la Plaine, Brussels, Belgium
| | - Lies Gremaux
- Scientific Direction Epidemiology and Public Health, Section Lifestyle and Chronic Diseases, Sciensano, Brussels, Belgium
| | - Peter Blanckaert
- Scientific Direction Epidemiology and Public Health, Section Lifestyle and Chronic Diseases, Sciensano, Brussels, Belgium
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18
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Metwally H, Agrawal P, Smith R, Liu C, LeBlanc Y, Covey TR, Oleschuk R. Detection of Opioids on Mail/Packages Using Open Port Interface Mass Spectrometry (OPI-MS). JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2020; 31:2370-2378. [PMID: 33079532 DOI: 10.1021/jasms.0c00295] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Opioids (and their more potent synthetic analogues) are used therapeutically as effective pain killers; however, recreational use and consequent overdoses are implicated in the deaths of thousands of people across the world annually. Trafficking of opioids and other illegal drugs through international mail has become a significant challenge for law enforcement personnel. Hundreds of millions of letters are sorted by the U.S. and Canadian postal services every day. Chemical analysis of this immense volume of mail requires a very fast sampling/detection method. This work explores the use of real-time mass spectrometry analysis with the recently developed Open Port Interface (OPI) for acoustically dispensed nanoliter volume sample droplets, a type of liquid microjunction surface sampling probe, for rapid and easy non-intrusive detection of fentanyl, heroin, and oxycodone. The OPI coupled to mass spectrometry is a novel sample introduction method that allows the rapid analysis of sample surfaces without preparation or modification. Opioids on different packaging materials (e.g., paper, bubble wrap, Ziploc bags) were rapidly (<10 s) interrogated by the OPI, and the sensitivities of the method compared. Furthermore, an opioid surrogate (caffeine) could be facilely detected on envelopes after processing through postal services.
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Affiliation(s)
- Haidy Metwally
- Department of Chemistry, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - Prashant Agrawal
- Department of Chemistry, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - Rachael Smith
- Department of Chemistry, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - Chang Liu
- SCIEX, 71 Four Valley Drive, Concord, Ontario L4K 4 V8, Canada
| | - Yves LeBlanc
- SCIEX, 71 Four Valley Drive, Concord, Ontario L4K 4 V8, Canada
| | - Thomas R Covey
- SCIEX, 71 Four Valley Drive, Concord, Ontario L4K 4 V8, Canada
| | - Richard Oleschuk
- Department of Chemistry, Queen's University, Kingston, Ontario K7L 3N6, Canada
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Assi S, Khan I, Edwards A, Osselton D, Al-Obaidi H. On-spot quantification of modafinil in generic medicines purchased from the Internet using handheld Fourier transform-infrared, near-infrared and Raman spectroscopy. J Anal Sci Technol 2020. [DOI: 10.1186/s40543-020-00229-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
AbstractPoor quality medicines represent an expanding global public health threat facilitated by the Internet. A recent survey showed that one in five students have used modafinil to enhance learning ability mainly purchased from Internet sources. The aim of this work was to develop on-the-spot and simple methods for the quantification of modafinil in generic medicines using Fourier transform-infrared (FTIR), near-infrared (NIR) and Raman spectroscopy along with partial least square regression (PLSR). Modafinil tablets were measured in intact form using NIR and Raman and in powdered form using FTIR, NIR and Raman. Additionally, powder mixtures of crushed modafinil tablets and excipient(s) were prepared either by diluting the crushed tablets with excipient(s), or sequentially adding excipient(s) to the crushed tablets. Three PLSR models were constructed in MATLAB 2014a from powder mixtures and two from intact and powdered tablets. For FTIR and Raman spectroscopy, PLSR models based on tablets gave linear calibration curve with correlation coefficient (r2) values above 0.94 and a root mean square error of calibration (RMSEC) below 0.96% m/m. Conversely, the PLSR model based on powder sequential addition gave the highest accuracy using the NIR spectra (r2 = 0.99, RMSEC = 1.15% m/m). The latter model showed accuracy in predicting the concentration of the active pharmaceutical ingredient in modafinil generic medicines proving their authenticity. The overall results showed that the combination of the three spectroscopic methods with PLSR offered a rapid technique for authenticating generic modafinil medicines.
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Johnson C, Stansfield C, Hassan V. Festival testing: A survey of suspected drugs seized from New Zealand music festivals, December 2018 to March 2019. Forensic Sci Int 2020; 313:110367. [DOI: 10.1016/j.forsciint.2020.110367] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 12/14/2022]
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Abstract
PURPOSE OF REVIEW Drug checking services invite drug consumers to anonymously submit drug samples for chemical analysis and provide feedback of results. Drugs are tested for strength/dose and/or presence of adulterants. Drug checking appears to be more common in recent years in response to increases in fentanyl-related deaths and the proliferation of new psychoactive substances (NPS). We aim to provide information regarding the current state of drug checking in relation to analysis methods, adulteration rates, and behavioral responses to results. RECENT FINDINGS Various technologies are being used to detect the presence of fentanyl, its analogs, and other NPS in drug samples. Proxy drug checking, which we define as biospecimen testing for drug exposure postconsumption, is also becoming common. However, there appears to a dichotomy between research focusing on populations at high risk for fentanyl exposure and to exposure to NPS such as synthetic cathinones. SUMMARY Drug checking research and services largely focus on opioid consumers and nightclub and dance festival attendees, but more focus may be needed on the general population. Drug checking results can inform surveillance efforts, and more research is needed to overcome barriers to drug checking and to focus on whether test results indeed affect behavior change.
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22
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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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23
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Salomone A, Palamar JJ, Vincenti M. Should NPS be included in workplace drug testing? Drug Test Anal 2020; 12:191-194. [PMID: 31840414 DOI: 10.1002/dta.2749] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Alberto Salomone
- Dipartimento di Chimica, Università di Torino, Turin, Italy.,Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", , Orbassano, Turin, Italy
| | - Joseph J Palamar
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Marco Vincenti
- Dipartimento di Chimica, Università di Torino, Turin, Italy.,Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", , Orbassano, Turin, Italy
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24
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Lea T, Amada N, Jungaberle H, Schecke H, Klein M. Microdosing psychedelics: Motivations, subjective effects and harm reduction. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 75:102600. [PMID: 31778967 DOI: 10.1016/j.drugpo.2019.11.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 10/11/2019] [Accepted: 11/10/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND In recent years there has been growing media attention on microdosing psychedelics (e.g., LSD, psilocybin). This refers to people routinely taking small doses of psychedelic substances to improve mental health and wellbeing, or to enhance cognitive performance. Research evidence is currently limited. This paper examines microdosing motivations, dosing practices, perceived short-term benefits, unwanted effects, and harm reduction practices. METHODS An international online survey was conducted in 2018 examining people's experiences of using psychedelics. Eligible participants were aged 16 years or older, had used psychedelics and could comprehend written English. This paper focuses on 525 participants who were microdosing psychedelics at the time of the survey. RESULTS Participants were primarily motivated to microdose to improve mental health (40%), for personal development (31%) and cognitive enhancement (18%). Most were microdosing with psilocybin (55%) or LSD/1P-LSD (48%). Principal components analysis generated three factors examining perceived short-term benefits of microdosing: improved mood and anxiety, enhanced connection to others and environment, and cognitive enhancement; and three factors examining negative and potentially unwanted effects: stronger-than-expected psychedelic effects, anxiety-related effects, and physical adverse effects. Most participants (78%) reported at least one harm reduction practice they routinely performed while microdosing. CONCLUSION Our findings suggest that people microdosing are commonly doing so as a self-managed therapy for mental health, either as an alternative or adjunct to conventional treatments. This is despite psychedelics remaining prohibited substances in most jurisdictions. Recent findings from clinical trials with standard psychedelic doses for depression and anxiety suggest that a neurobiological effect beyond placebo is not unreasonable. Randomised controlled trials are needed, complemented by mixed methods social science research and the development of novel resources on microdosing harm reduction.
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Affiliation(s)
- Toby Lea
- German Institute for Addiction and Prevention Research, Catholic University of Applied Sciences, Wörthstr. 10, 50668 Cologne, Germany; Centre for Social Research in Health, UNSW, Sydney, NSW 2052, Australia.
| | - Nicole Amada
- The Graduate Center, City University of New York, 365 5th Ave, New York, NY 10016, USA
| | - Henrik Jungaberle
- MIND Foundation, Betahaus Berlin, Rudi-Dutschke-Straße 23, 10969 Berlin, Germany
| | - Henrike Schecke
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, LVR-Klinikum Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Michael Klein
- German Institute for Addiction and Prevention Research, Catholic University of Applied Sciences, Wörthstr. 10, 50668 Cologne, Germany
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25
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McCrae K, Tobias S, Grant C, Lysyshyn M, Laing R, Wood E, Ti L. Assessing the limit of detection of Fourier‐transform infrared spectroscopy and immunoassay strips for fentanyl in a real‐world setting. Drug Alcohol Rev 2019; 39:98-102. [DOI: 10.1111/dar.13004] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 10/08/2019] [Accepted: 10/10/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Karen McCrae
- British Columbia Centre on Substance Use Vancouver Canada
| | - Samuel Tobias
- British Columbia Centre on Substance Use Vancouver Canada
| | - Cameron Grant
- British Columbia Centre on Substance Use Vancouver Canada
| | - Mark Lysyshyn
- Vancouver Coastal Health Vancouver Canada
- School of Population and Public HealthUniversity of British Columbia Vancouver Canada
| | | | - Evan Wood
- British Columbia Centre on Substance Use Vancouver Canada
- Department of MedicineUniversity of British Columbia Vancouver Canada
| | - Lianping Ti
- British Columbia Centre on Substance Use Vancouver Canada
- Department of MedicineUniversity of British Columbia Vancouver Canada
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