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Miller JJ, Yazdanpanah M, Colantonio DA, Beriault DR, Delaney SR. New psychoactive Substances: A Canadian perspective on emerging trends and challenges for the clinical laboratory. Clin Biochem 2024:110810. [PMID: 39181179 DOI: 10.1016/j.clinbiochem.2024.110810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 08/05/2024] [Accepted: 08/12/2024] [Indexed: 08/27/2024]
Abstract
The production and use of New Psychoactive Substances (NPS) has skyrocketed over the last decade, causing major challenges for government authorities, public health agencies, and laboratories across the world. NPS are designed to mimic the psychoactive effects of unregulated or controlled drugs, while constantly being modified to evade drug control regulation. Hence, they are referred to as "legal highs", as they are technically legal to sell, possess, and use. NPS can be classified by their pharmacological mechanism of action and include cannabimimetic, depressants, dissociatives, hallucinogens, opioids, and stimulants. There is significant structural diversity within each NPS class, leading to variable detection using traditional clinical laboratory testing and complicating the interpretation of results. In this article, we review each of the NPS classes and summarize their associated mechanism of action, common structures, and metabolic pathways, and provide examples of recent drugs and emerging threats with a focus on Canadian drug trends. We also explore the current analytical advantages and limitations commonly faced by the clinical laboratory and provide insight on how toxicosurveillance can improve detection of NPS in the ever-changing NPS landscape.
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Affiliation(s)
- Jessica J Miller
- Laboratory Medicine Program, University Health Network, Toronto, ON, Canada
| | - Mehrdad Yazdanpanah
- Department of Laboratory Medicine, St. Michael's Hospital, Toronto, ON, Canada
| | - David A Colantonio
- The Ottawa Hospital and Eastern Ontario Regional Laboratory Association, Ottawa, ON, Canada; Department of Pathology and Laboratory Medicine, The University of Ottawa, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, The University of Ottawa, Ottawa, ON, Canada
| | - Daniel R Beriault
- Department of Laboratory Medicine, St. Michael's Hospital, Toronto, ON, Canada; Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Sarah R Delaney
- Department of Laboratory Medicine, St. Michael's Hospital, Toronto, ON, Canada; Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada.
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Baldo BA. The entactogen 3,4-methylenedioxymethamphetamine (MDMA; ecstasy) as a treatment aid in psychotherapy and its safety concerns. Arch Toxicol 2024; 98:2409-2427. [PMID: 38743292 DOI: 10.1007/s00204-024-03765-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
The phenylethylamine, 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy'), is the prototypical example of an entactogen. Its original placement in highly restrictive drug usage categories in the US and UK, led to an inevitable restriction on MDMA neuroscience research and treatment. The dominant pharmacological effects of MDMA are its properties of release and inhibition of reuptake of amine neurotransmitter transporters for dopamine, norepinephrine, and serotonin. MDMA is an agonist of a wide range of receptors; its mood-altering effects are mediated via 5-HT2A receptors; this receptor may also mediate its effects on body temperature, analgesia, and anxiolytic properties. The mechanisms underlying MDMA's entactogenic properties of sociability and interpersonal closeness are not known but release and involvement of oxytocin, a peptide thought by some to be involved in social bonding, has been suggested. Adverse effects of MDMA are mostly transient; acute multiorgan adverse effects occurring during raves or crowded dance gatherings include dehydration, hyperthermia, seizures, rhabdomyolysis, disseminated intravascular coagulation, and acute renal failure. Deaths following MDMA taken by itself are rare compared to fatalities following coadministration with other drugs. A recent FDA-approved phase 3 clinical trial of MDMA for post-traumatic stress disorder (PTSD) led to the conclusion that MDMA-assisted therapy represents a potential breakthrough treatment meriting expedited clinical evaluation. Despite the ongoing deliberations by the FDA and EMA for approval of MDMA treatment of PTSD, the Australian Therapeutic Goods Administration (TGA) recently announced that after an evaluation of the therapeutic value, benefits, and risks of MDMA, it will permit its prescribing for the treatment of PTSD. Further examples of regulatory relaxation toward MDMA-assisted psychotherapy are underway. These include the FDA's recently approved clinical trial to assess MDMA's efficacy in the treatment of "asociality" in patients with schizophrenia and an open trial of MDMA treatment for alcohol-use disorder which showed decreased alcohol consumption. There are also ongoing studies on the little understood startle response, anxiety associated with life-threatening illness, and social anxiety in autistic adults.
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Affiliation(s)
- Brian A Baldo
- Kolling Institute of Medical Research, Royal North Shore Hospital of Sydney, Sydney, NSW, 2065, Australia.
- Department of Medicine, University of Sydney, Sydney, NSW, 2000, Australia.
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Zimmerman-Federle H, Ren G, Dowling S, Warren C, Rusyniak D, Avera R, Manicke NE. Plasma drug screening using paper spray mass spectrometry with integrated solid phase extraction. Drug Test Anal 2024. [PMID: 38584344 DOI: 10.1002/dta.3687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/04/2024] [Accepted: 03/14/2024] [Indexed: 04/09/2024]
Abstract
Drug overdoses have risen dramatically in recent years. We developed a simple nontargeted method using a disposable paper spray cartridge with an integrated solid phase extraction column. This method was used to screen for ~160 fentanyl analogs, synthetic cannabinoids, other synthetic drugs, and traditional drugs of abuse in over 300 authentic overdose samples collected at emergency departments in Indianapolis. A solid phase extraction step was implemented on the paper spray cartridge to enable subnanograms per milliliter synthetic drugs screening in plasma. Analysis was performed on a quadrupole orbitrap mass spectrometer using the sequential window acquisition of all theoretical fragment ion spectra approach in which tandem mass spectrometry was performed using 7 m/z isolation windows in the quadrupole. Calibration curves with isotopically labeled internal standards were constructed for 35 of the most frequently encountered synthetic and traditional illicit drugs by US toxicology labs. Additional qualitative-only drugs in a suspect screening list were also included. Limits of detection in plasma for synthetic cannabinoids ranged from 0.1 to 0.5 and 0.1 to 0.3 ng/mL for fentanyl and its analogs and between 1 and 5 ng/mL for most other drugs. Relative matrix effects were evaluated by determining the variation of the calibration slope in 10 different lots of biofluid and found to be between 3% and 20%. The method was validated on authentic overdose samples collected from two emergency departments in Indianapolis, Indiana, from suspected or known overdoses. Commonly detected synthetic drugs included fentanyl related substances, designer benzodiazepines such as flubromazolam, and the synthetic cannabinoid 5F-PB-22.
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Affiliation(s)
- Hannah Zimmerman-Federle
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Greta Ren
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Sarah Dowling
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Cassandra Warren
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Daniel Rusyniak
- School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Robert Avera
- School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Nicholas E Manicke
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
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Kumar Nandi N, Das S, Choudhary D, Saini S, Bhatia R, Chawla P, Kaur R, Kalra S, Rawat R, Eyupoglu V, Kumar B. Exploration of oxadiazole clubbed benzhydrylpiperazine pharmacophoric features as structural feature for antidepressant activity: In vitro, in vivo and in silico analysis. Bioorg Chem 2024; 144:107148. [PMID: 38306828 DOI: 10.1016/j.bioorg.2024.107148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/20/2023] [Accepted: 01/22/2024] [Indexed: 02/04/2024]
Abstract
Arylpiperazine clubbed various heterocyclic molecules present potential pharmacophoric structural features for the development of psychoactive drugs. There are various CNS active molecules possessing arylpiperazine moiety in their pharmacophore approved by USFDA. In the current study, we have explored the benzhydrylpiperazine moiety clubbed with various substituted oxadiazole moieties (AP1-12) for their monoamine oxidase (MAO) inhibition and antidepressant potential. Compounds AP3 and AP12 exhibited highly potent and selective MAO-A inhibition with IC50 values of 1.34 ± 0.93 µM and 1.13 ± 0.54 µM, respectively, and a selectivity index of 10- and 13-folds, respectively. Both the compounds displayed reversible binding character at the active site of MAO-A. In further in vivo evaluation, both the compounds AP3 and AP12 displayed potential antidepressant-like character in FST and TST studies via significantly reduced immobility time in comparison to non-treated animals. These compounds displayed no cytotoxicity in SH-SY5Y cell lines, which indicates that these compounds are safe for further evaluation. In silico studies reveal that synthesized compounds possess drug-likeness with minimal to no toxicity. In silico studies were conducted to understand the binding interactions and stability of compounds at the binding pocket of enzyme and observed that both the best compounds fit well at the active site of MAO-A lined by amino acid residues Tyr69, Asn181, Phe208, Ile335, Leu337, Phe352, and Tyr444 similar to standard MAO-A inhibitor clorgiline. The molecular dynamic studies demonstrated that AP3 and AP12 formed quite a stable complex at the active site of MAO-A and did not break under small abruption forces. The favourable binding interactions and appropriate ADMET properties present the benzhydrylpiperazine clubbed oxadiazole pharmacophoric features as a potential structural skeleton for further clinical evaluation and development of a new antidepressant drug molecule.
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Affiliation(s)
- Nilay Kumar Nandi
- Department of Pharmaceutical technology, Meerut institute of engineering and technology, Meerut, Uttar Pradesh 250005, India
| | - Shibam Das
- Department of Pharmaceutical Chemistry and Analysis, ISF College of Pharmacy, Ghal Kalan, Ferozpur G.T. Road, Moga 142001, Punjab, India; Department of Chemistry, University of Turin, Via Pietro Giuria, 7, 10125 Turin, Italy
| | - Diksha Choudhary
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
| | - Suresh Saini
- Center for Nano and Material Science, Jain University (Deemed-to-be University), Jain Global Campus, Jakkasandra Post, Ramanagara 562112, India
| | - Rohit Bhatia
- Department of Pharmaceutical Chemistry and Analysis, ISF College of Pharmacy, Ghal Kalan, Ferozpur G.T. Road, Moga 142001, Punjab, India
| | - Pooja Chawla
- University Institute of Pharmaceutical Sciences and Research, Baba Farid University of Health Sciences, Faridkot, Punjab 151203, India
| | - Rajwinder Kaur
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
| | - Sourav Kalra
- School of Pharmacy, Chitkara University, Baddi, Himachal Pradesh 174103, India
| | - Ravi Rawat
- School of Health Sciences & Technology, UPES University, Dehradun 248007, India.
| | - Volkan Eyupoglu
- Department of Chemistry, Cankırı Karatekin University, Cankırı 18100, Turkey
| | - Bhupinder Kumar
- Department of Pharmaceutical Sciences, HNB Garhwal University, Chauras Campus, Srinagar, Garhwal, Uttarakhand 246174, India; Department of Chemistry, Graphic Era (Deemed to be University), Dehradun 248002, Uttrakhand, India.
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Bassi M, Bilel S, Tirri M, Corli G, Di Rosa F, Gregori A, Alkilany AM, Rachid O, Roda E, Zauli G, Locatelli CA, Marti M. Pharmaco-toxicological effects of the novel tryptamine hallucinogen 5-MeO-MiPT on motor, sensorimotor, physiological, and cardiorespiratory parameters in mice-from a human poisoning case to the preclinical evidence. Psychopharmacology (Berl) 2024; 241:489-511. [PMID: 38214743 PMCID: PMC10884077 DOI: 10.1007/s00213-024-06526-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/01/2024] [Indexed: 01/13/2024]
Abstract
RATIONALE The 5-methoxy-N-methyl-N-isopropyltryptamine (5-MeO-MiPT, known online as "Moxy") is a new psychedelic tryptamine first identified on Italian national territory in 2014. Its hallucinogen effects are broadly well-known; however, only few information is available regarding its pharmaco-toxicological effects. OBJECTIVES Following the seizure of this new psychoactive substances by the Arm of Carabinieri and the occurrence of a human intoxication case, in the current study we had the aim to characterize the in vivo acute effects of systemic administration of 5-MeO-MiPT (0.01-30 mg/kg i.p.) on sensorimotor (visual, acoustic, and overall tactile) responses, thermoregulation, and stimulated motor activity (drag and accelerod test) in CD-1 male mice. We also evaluated variation on sensory gating (PPI, prepulse inhibition; 0.01-10 mg/kg i.p.) and on cardiorespiratory parameters (MouseOx and BP-2000; 30 mg/kg i.p.). Lastly, we investigated the in silico ADMET (absorption, distribution, metabolism, excretion, toxicity) profile of 5-MeO-MiPT compared to 5-methoxy-N,N-diisopropyltryptamine (5-MeO-DIPT) and N,N-dimethyltryptamine (DMT). RESULTS This study demonstrates that 5-MeO-MiPT dose-dependently inhibits sensorimotor and PPI responses and, at high doses, induces impairment of the stimulated motor activity and cardiorespiratory changes in mice. In silico prediction shows that the 5-MeO-MiPT toxicokinetic profile shares similarities with 5-MeO-DIPT and DMT and highlights a cytochrome risk associated with this compound. CONCLUSIONS Consumption of 5-MeO-MiPT can affect the ability to perform activities and pose a risk to human health status, as the correspondence between the effects induced in mice and the symptoms occurred in the intoxication case suggests. However, our findings suggest that 5-MeO-MiPT should not be excluded from research in the psychiatric therapy field.
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Grants
- Effects of NPS: development of a multicentre research for the information enhancement of the Early Warning System Anti-Drug Policies Department, Presidency of the Council of Ministers, Italy
- Implementation of the identification Anti-Drug Policies Department, Presidency of the Council of Ministers, Italy
- study of the effects of NPS: Development of a multicentric research to strengthen the database of the National Monitoring Centre for Drug Addiction Anti-Drug Policies Department, Presidency of the Council of Ministers, Italy
- the Early Warning System Anti-Drug Policies Department, Presidency of the Council of Ministers, Italy
- FAR 2021 Università degli Studi di Ferrara
- FAR 2022 Università degli Studi di Ferrara
- Anti-Drug Policies Department, Presidency of the Council of Ministers, Italy
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Affiliation(s)
- Marta Bassi
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Via Fossato Di Mortara 70, 44121, Ferrara, Italy
| | - Sabrine Bilel
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Via Fossato Di Mortara 70, 44121, Ferrara, Italy
| | - Micaela Tirri
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Via Fossato Di Mortara 70, 44121, Ferrara, Italy
| | - Giorgia Corli
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Via Fossato Di Mortara 70, 44121, Ferrara, Italy
| | - Fabiana Di Rosa
- Department of Scientific Investigation (RIS), Carabinieri, 00191, Rome, Italy
| | - Adolfo Gregori
- Department of Scientific Investigation (RIS), Carabinieri, 00191, Rome, Italy
| | - Alaaldin M Alkilany
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Ousama Rachid
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Elisa Roda
- Laboratory of Clinical & Experimental Toxicology, Pavia Poison Centre, National Toxicology Information Centre, Toxicology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Giorgio Zauli
- Research Department, King Khaled Eye Specialistic Hospital, Riyadh, Saudi Arabia
| | - Carlo Alessandro Locatelli
- Laboratory of Clinical & Experimental Toxicology, Pavia Poison Centre, National Toxicology Information Centre, Toxicology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Matteo Marti
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Via Fossato Di Mortara 70, 44121, Ferrara, Italy.
- Department of Anti-Drug Policies, Collaborative Center for the Italian National Early Warning System, Presidency of the Council of Ministers, Ferrara, Italy.
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Burback L, Brémault-Phillips S, Nijdam MJ, McFarlane A, Vermetten E. Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review. Curr Neuropharmacol 2024; 22:557-635. [PMID: 37132142 PMCID: PMC10845104 DOI: 10.2174/1570159x21666230428091433] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 05/04/2023] Open
Abstract
This narrative state-of-the-art review paper describes the progress in the understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over the last four decades, the scientific landscape has matured, with many interdisciplinary contributions to understanding its diagnosis, etiology, and epidemiology. Advances in genetics, neurobiology, stress pathophysiology, and brain imaging have made it apparent that chronic PTSD is a systemic disorder with high allostatic load. The current state of PTSD treatment includes a wide variety of pharmacological and psychotherapeutic approaches, of which many are evidence-based. However, the myriad challenges inherent in the disorder, such as individual and systemic barriers to good treatment outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, and trauma-related guilt and shame, often render treatment response suboptimal. These challenges are discussed as drivers for emerging novel treatment approaches, including early interventions in the Golden Hours, pharmacological and psychotherapeutic interventions, medication augmentation interventions, the use of psychedelics, as well as interventions targeting the brain and nervous system. All of this aims to improve symptom relief and clinical outcomes. Finally, a phase orientation to treatment is recognized as a tool to strategize treatment of the disorder, and position interventions in step with the progression of the pathophysiology. Revisions to guidelines and systems of care will be needed to incorporate innovative treatments as evidence emerges and they become mainstream. This generation is well-positioned to address the devastating and often chronic disabling impact of traumatic stress events through holistic, cutting-edge clinical efforts and interdisciplinary research.
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Affiliation(s)
- Lisa Burback
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | | | - Mirjam J. Nijdam
- ARQ National Psychotrauma Center, Diemen, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Department of Psychiatry, New York University Grossman School of Medicine, New York, USA
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Haller J, Rompos É, Szabó Í, Humli V, Christián L. Drug regulations and trafficking: Synthetic cannabinoids and cathinones in Hungary. Forensic Sci Int 2023; 349:111778. [PMID: 37437415 DOI: 10.1016/j.forsciint.2023.111778] [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: 02/03/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/14/2023]
Abstract
In principle, new psychoactive substances (NPSs) are produced to circumvent drug regulations. However, the mixed success of regulatory efforts suggests that the dynamics of marketing is incompletely understood. To address this issue, we conducted a comprehensive study on the marketing of all synthetic cannabinoids and cathinones present in Hungary over ten years. Market evaluation was based on drug seizure data and chemical analyses provided by the Hungarian Institute for Forensic Sciences. Over ten years, 18 synthetic cannabinoids and 11 cathinones were identified. Total seizure counts were 22,906 and 10,273, respectively. When new synthetic cannabinoids emerged, seizures increased exponentially, but rapidly declined after their banning. In parallel, new synthetic cannabinoids emerged on the market. The systematic monitoring of local legislation allowed large sales between market introduction and legal control. Cathinones were also marketed in successive waves, but trading intensity was not associated with local regulations. Sales remained low throughout, likely because the risks involved by the temporal mismatch between marketing and legal control. One can hypothesize that marketing was driven by general trends in EU regulations or by measures taken by large countries. Our findings imply the existence of two different strategies for NPS marketing. The choice between the two may depend on multiple factors from the availability of skills required by rapid marketing adjustments to cost/benefit evaluations for various market segments. Studying NPS market strategies in neighboring and distant EU countries may help analyzing and predicting market events.
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Affiliation(s)
- József Haller
- Drug Research Institute, Budapest, Hungary; University of Public Service, Budapest, Hungary.
| | - Éva Rompos
- Hungarian Institute for Forensic Sciences, Budapest, Hungary
| | | | | | - László Christián
- Drug Research Institute, Budapest, Hungary; University of Public Service, Budapest, Hungary
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Holborn T, Schifano F, Deluca P. No prescription? No problem: A qualitative study investigating self-medication with novel psychoactive substances (NPS). THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 118:104109. [PMID: 37422986 DOI: 10.1016/j.drugpo.2023.104109] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND The proliferation of Novel Psychoactive Substances (NPS) presents a challenge for global drug policy. The ease of online drug purchase and the emergence of the dark web have created new avenues for the growth of NPS. Despite the global nature of this issue, limited research has examined motivations of use. These include perceived safety or convenience, an interest in novel pharmacology and self-exploration. Recent evidence has suggested individuals may be self-medicating with NPS, however this phenomenon has yet to be thoroughly explored. This study aims to investigate the occurrence of NPS self-medication, identify the specific NPS involved, and understand the motivations behind their use. METHODS Discussions surrounding self-medication using NPS were collected between October 2022 and February 2023 via a content analysis of a Reddit community. Ninety-three threads, comprising 182,490 words and 5023 comments, were collected and cleaned. A frequency analysis was conducted to identify the NPS discussed, and data was analysed systematically through the process of iterative categorization (IC). RESULTS Our study revealed frequent discussions about the self-medication with several NPS, notably etizolam, clonazolam, diclazepam, flualprazolam, 2-FMA, 4F-MPH, 3-FPM and 3-MeO-PCP. Individuals were mainly self-treating ADHD, anxiety and depression. Motivations for choosing NPS included access, cost, legality and a dissatisfaction with conventional healthcare. Substances were often chosen based on a profile of "Functionality" and outcomes varied. The use of clonazolam was highlighted as particularly problematic. CONCLUSION The current study provides insight into the phenomenon of self-medication with NPS within an internet demographic, exploring the motivations behind why individuals choose NPS for a variety of disorders. The easy access to NPS and lack of scientific data pose a significant challenge for drug policy. Future policies should focus on improving healthcare providers knowledge of NPS use, removing barriers to adult ADHD diagnosis and rebuilding trust between individuals and addiction services.
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Affiliation(s)
- Tayler Holborn
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Fabrizio Schifano
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
| | - Paolo Deluca
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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Schifano F, Vento A, Scherbaum N, Guirguis A. Stimulant and hallucinogenic novel psychoactive substances; an update. Expert Rev Clin Pharmacol 2023; 16:1109-1123. [PMID: 37968919 DOI: 10.1080/17512433.2023.2279192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/31/2023] [Indexed: 11/17/2023]
Abstract
INTRODUCTION The renewed interest in considering a range of stimulants, psychedelics and dissociatives as therapeutics emphasizes the need to draft an updated overview of these drugs' clinical and pharmacological issues. AREAS COVERED The focus here was on: stimulants (e.g. amphetamines, methamphetamine, and pseudoephedrine; phenethylamines; synthetic cathinones; benzofurans; piperazines; aminoindanes; aminorex derivatives; phenmetrazine derivatives; phenidates); classical (e.g. ergolines; tryptamines; psychedelic phenethylamines), and atypical (e.g. PCP/ketamine-like dissociatives) psychedelics.Stimulant and psychedelics are associated with: a) increased central DA levels (psychedelic phenethylamines, synthetic cathinones and stimulants); b) 5-HT receptor subtypes' activation (psychedelic phenethylamines; recent tryptamine and lysergamide derivatives); and c) antagonist activity at NMDA receptors, (phencyclidine-like dissociatives). EXPERT OPINION Clinicians should be regularly informed about the range of NPS and their medical, psychobiological and psychopathological risks both in the acute and long term. Future research should focus on an integrative model in which pro-drug websites' analyses are combined with advanced research approaches, including computational chemistry studies so that in vitro and in vivo preclinical studies of index novel psychoactives can be organized. The future of psychedelic research should focus on identifying robust study designs to convincingly assess the potential therapeutic benefits of psychedelics, molecules likely to present with limited dependence liability levels.
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Affiliation(s)
- F Schifano
- Psychopharmacology Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts (UK)
| | - A Vento
- Mental Health Department, Addiction Observatory (Osservatorio sulle dipendenze)- NonProfit Association - Rome, Rome, Italy
| | - N Scherbaum
- LVR-University Hospital, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - A Guirguis
- Psychopharmacology Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts (UK)
- Pharmacy, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Wales, UK
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Abstract
INTRODUCTION Designer benzodiazepines (DBs) are a subclass of novel psychoactive substances (NPS). DBs mimic the properties of approved and prescribed benzodiazepines. AREA COVERED A systematic search of literature on DB classification, structure-activity relationships, pharmacologic properties, and adverse effects. EXPERT OPINION The prevalence of DB use has increased substantially over the last decade. All DBs are full-agonist ligands at the gamma-aminobutyric acid type A-benzodiazepine (GABAA-BZ) receptor system. This is not surprising, since DBs largely represent either minor structural modifications, or well-recognized active metabolites, of existing approved benzodiazepines. As such, the pharmacologic profile and associated risks and hazards of DBs are similar or identical to clinically approved and legitimately prescribed benzodiazepines, most of which have been in use for decades. Concurrent use of DBs along with other abusable or recreational drugs (alcohol, opioids, cocaine, stimulants, hallucinogens, other sedative-hypnotics) represents the principal public health risk. The increasing illicit availability and use of DBs is of concern and requires regulatory attention, but DBs do not rank highly among designer psychotropic agents in terms of health risk to humans.
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Affiliation(s)
- Xiao Yu
- Program in Pharmacology and Drug Development, Tufts University School of Medicine and Graduate School of Biomedical Sciences, Boston, MA, USA
| | - H Karl Greenblatt
- Program in Pharmacology and Drug Development, Tufts University School of Medicine and Graduate School of Biomedical Sciences, Boston, MA, USA
| | - David J Greenblatt
- Program in Pharmacology and Drug Development, Tufts University School of Medicine and Graduate School of Biomedical Sciences, Boston, MA, USA
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Sajwani HS. The Dilemma of New Psychoactive Substances: A Growing Threat. Saudi Pharm J 2023; 31:348-350. [PMID: 37026049 PMCID: PMC10071313 DOI: 10.1016/j.jsps.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
New psychoactive substances (NPS) pose a major public threat and are a growing problem worldwide. They were designed to replace banned or controlled drugs while escaping quality control measures. Their chemical structure is constantly changed which imposes a major forensic challenge, and makes it difficult for law enforcement measures to track and ban them. Hence, they are called "legal highs" as they replicate illicit drugs whilst remaining legal. Low cost, easy accessibility and less legal liability are the main factors that contribute to the popularity of NPS among the public. This is particularly with the lack of knowledge of the health risks and harms associated with NPS not only amongst the public, but healthcare professionals as well, which further constitutes a challenge for preventative and treatment measures. Further medico-legal investigation, extensive laboratory and non-laboratory analyses, and advanced forensic measures are necessary to identify, schedule and control new psychoactive substances. Besides, additional efforts are required to educate the public and increase their awareness regarding NPS and their potential harms.
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Design, Synthesis, Pharmacological and In Silico Screening of Disubstituted-Piperazine Derivatives as Selective and Reversible MAO-A Inhibitors for Treatment of Depression. J Mol Struct 2022. [DOI: 10.1016/j.molstruc.2022.134671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Garus-Pakowska A, Kolmaga A, Gaszyńska E, Ulrichs M. The Scale of Intoxications with New Psychoactive Substances over the Period 2014-2020-Characteristics of the Trends and Impacts of the COVID-19 Pandemic on the Example of Łódź Province, Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4427. [PMID: 35457295 PMCID: PMC9031094 DOI: 10.3390/ijerph19084427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 12/04/2022]
Abstract
Legal highs are new psychoactive substances (NPSs) which pose a high risk for human health, and the spread of the SARS-CoV-2 pandemic has changed peoples’ behaviours, including the demand for NPS. The aim of the study was to assess both the frequency of intoxication with NPS in Łódź province over the period 2014−2020, and the impact of the COVID-19 pandemic on developing this trend. An analysis was carried out of data on intoxications in Łódź province in the years 2014−2020 reported by hospitals. The medical interventions rate (MI) per 100,000 people in the population was calculated. The frequency of intoxications was compared taking sociodemographic variables into account, and the effect of seasonal influence on intoxications was calculated using the Holt−Winter multiplicative seasonal method. In the period considered, there were 7175 acute NPS poisonings in the Łódź province and 25,495 in Poland. The averaged MI rate between 2014−2020 was 9.45 for Poland and 38.53 for the Łódź province, and the lowest value was found during the COVID pandemic in the year 2020 (respectively, 2.1 vs. 16.94). NPS users were mainly young men of 19−24 years old from a big city. Most cases were registered at weekends and in summer months. The majority of intoxications were caused by unidentified psychoactive substances of legal highs (chi2 = 513.98, p < 0.05). The actual number of NPS-related poisonings in the Łódź province in 2020 was lower than the value extrapolated from trend analysis of data between 2014−2019. NPS use in Poland decreased during the pandemic. It should be noted that a decrease in the number of drug-related incidents can have more than one reason, e.g., preventive programs, increased awareness, or changes in the law. This paper advocates that, in addition to monitoring NPS-related intoxications, there is further investigation into the social, cultural, and behavioural determinants of NPS to facilitate targeted prevention programmes and the development of new medical treatments.
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Affiliation(s)
- Anna Garus-Pakowska
- Department of Nutrition and Epidemiology, Medical University of Lodz, 90-752 Lodz, Poland; (A.K.); (E.G.)
| | - Agnieszka Kolmaga
- Department of Nutrition and Epidemiology, Medical University of Lodz, 90-752 Lodz, Poland; (A.K.); (E.G.)
| | - Ewelina Gaszyńska
- Department of Nutrition and Epidemiology, Medical University of Lodz, 90-752 Lodz, Poland; (A.K.); (E.G.)
| | - Magdalena Ulrichs
- Department of Econometrics, Faculty of Economics and Sociology, University of Lodz, 90-255 Lodz, Poland;
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Yoon KS, Cha HJ, Choi SO, Lee JM. 2-((2-(4-Iodo-2,5-dimethoxyphenyl)ethylamino)methyl)phenol (25I-NBOH) and 2-(((2-(4-chloro-2,5-dimethoxyphenyl)ethyl)amino)methyl)phenol (25C-NBOH) induce adverse effects on the cardiovascular system. Toxicol Lett 2022; 355:160-169. [PMID: 34843874 DOI: 10.1016/j.toxlet.2021.11.016] [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: 08/04/2021] [Revised: 10/30/2021] [Accepted: 11/24/2021] [Indexed: 12/14/2022]
Abstract
Two new psychoactive substances (NPSs) classified as phenethylamines, namely 2-((2-(4-Iodo-2,5-dimethoxyphenyl)ethylamino)methyl)phenol (25I-NBOH) and 2-(((2-(4-chloro-2,5-dimethoxyphenyl)ethyl)amino)methyl)phenol (25C-NBOH), are being abused by people seeking recreational hallucinogens. These NPSs may cause serious health problems as their adverse effects are not known in most cases. Therefore, in the present study, we evaluated the cardiotoxicity of 25I-NBOH and 25C-NBOH using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, rat electrocardiography (ECG), Langendorff test, and human ether-a-go-go-related gene (hERG) assay. Furthermore, we analyzed the expression levels of p21 CDC42/RAC1-activated kinase 1 (PAK1), which is known to play various roles in the cardiovascular system. In the MTT assay, treatment with 25I-NBOH or 25C-NBOH dramatically decreased viability of H9c2 cardiomyocytes. Meanwhile, these two compounds significantly increased QT intervals and RR intervals in the rat ECG measurement. 25I-NBOH down-regulated the PAK1 protein expression in rat primary cardiomyocytes as well as H9c2 cells. However, 25C-NBOH had no effect on the PAK1 expression in H9c2 cells. In an in-depth study, 25I-NBOH inhibited potassium channels in the hERG assay, but in ex vivo test, the substance did not affect the left ventricular developed pressure (LVDP) and heart rate of the isolated rat hearts. Taken together, these results suggest that both 25I-NBOH and 25C-NBOH may have adverse cardiovascular effect. Further investigation would be needed to determine which factors mainly influence the relationship between PAK1 expression and cardiotoxicity.
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Affiliation(s)
- Kyung Sik Yoon
- National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Osong, Cheongju, Republic of Korea.
| | - Hye Jin Cha
- National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Osong, Cheongju, Republic of Korea.
| | - Sun Ok Choi
- National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Osong, Cheongju, Republic of Korea.
| | - Jin-Moo Lee
- National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Osong, Cheongju, Republic of Korea.
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15
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Massano M, Incardona C, Gerace E, Negri P, Alladio E, Salomone A, Vincenti M. Development and validation of a UHPLC-HRMS-QTOF method for the detection of 132 New Psychoactive Substances and synthetic opioids, including fentanyl, in Dried Blood Spots. Talanta 2022; 241:123265. [DOI: 10.1016/j.talanta.2022.123265] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/19/2022]
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Parker AN, France S. Completion of the Set: Synthesis of the (6,X')-Flubromazepam Positional Isomers as Standards for Forensic Analysis. J Org Chem 2021; 87:813-822. [PMID: 34889596 DOI: 10.1021/acs.joc.1c02492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Mounting concern among forensic examiners regarding the emergence of positional isomers as technically legal alternatives to scheduled benzodiazepines has encouraged the preemptive synthesis of analogues as standards. Recently, flubromazepam was identified by the Drug Enforcement Administration for future scheduling, and subsequently, 9 of the 12 possible flubromazepam isomers were synthesized. However, the three (6,X')-isomers proved inaccessible via that approach. Herein, through a redesigned synthetic approach, the remaining three isomers were obtained, thus completing the set and enabling future forensic analysis.
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Affiliation(s)
- Ariel N Parker
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia 30332, United States
| | - Stefan France
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia 30332, United States.,Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia 30332, United States
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17
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Mazzarino M, Camuto C, Comunità F, de la Torre X, Stacchini C, Botrè F. Application of liquid chromatography coupled to data-independent acquisition mass spectrometry for the metabolic profiling of N-ethyl heptedrone. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1185:122989. [PMID: 34678705 DOI: 10.1016/j.jchromb.2021.122989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 01/13/2023]
Abstract
We have investigated the metabolic profile of N-ethyl heptedrone, a new designer synthetic stimulant drug, by using data independent acquisition mass spectrometry. Phase I and phase II metabolism was studied by in vitro models, followed by liquid-chromatography coupled to mass spectrometry, to characterize and pre-select the most diagnostic markers of intake. N-ethyl heptedrone was incubated in the presence of pooled human liver microsomes. The contribution of individual enzymatic isoforms in the formation of the phase I and phase II metabolites was further investigated by using human recombinant cDNA-expressed cytochrome P450 enzymesand uridine 5'-diphospho glucuronosyltransferases. The analytical workflow consisted of liquid-liquid extraction with tert-butyl-methyl-ether at alkaline pH, performed before (to investigate the phase I metabolic profile) and after (to investigate the glucuronidation profile) enzymatic hydrolysis. The separation, identification, and determination of the compounds formed in the in vitro experiments were carried out by using liquid chromatography coupled to either high- or low-resolution mass spectrometry. Data independent acquisition method, namely sequential window acquisition of all theoretical fragment-ion spectra (SWATH®) and product ion scan were selected for high-resolution mass spectrometry, whereas multiple reaction monitoring was used for low-resolution mass spectrometry. Thirteen phase-I metabolites were isolated, formed from reactions being catalyzed mainly by CYP1A2, CYP2C9, CYP2C19 and CYP2D6 and, to a lesser degree, by CYP3A4 and CYP3A5. The phase I biotransformation pathways included hydroxylation in different positions, reduction of the ketone group, carbonylation, N-dealkylation, and combinations of the above. Most of the hydroxylated metabolites underwent conjugation reactions to form the corresponding glucurono-conjugated metabolites. Based on our in vitro observation, the metabolic products resulting from reduction of the keto group, N-dealkylation and hydroxylation of the aliphatic chain appear to be the most diagnostic target analytes to be selected as markers of exposure to N-ethyl heptedrone.
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Affiliation(s)
- Monica Mazzarino
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, Rome 00197, Italy
| | - Cristian Camuto
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, Rome 00197, Italy
| | - Fabio Comunità
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, Rome 00197, Italy
| | - Xavier de la Torre
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, Rome 00197, Italy
| | - Carlotta Stacchini
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, Rome 00197, Italy; Dipartimento Chimica e Tecnologia del farmaco "Sapienza" Università di Roma, Piazzale Aldo Moro 5, Rome 00161, Italy
| | - Francesco Botrè
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, Rome 00197, Italy; REDs - Research and Expertise in anti-Doping Sciences, ISSUL - Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.
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Batistic FK, Rhumorbarbe D, Lefrancois E, Tettey J, Raithelhuber M, Rossy Q, Morelato M. Analysis of Google Trends to monitor new psychoactive substance. Is there an added value? Forensic Sci Int 2021; 326:110918. [PMID: 34325112 DOI: 10.1016/j.forsciint.2021.110918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/16/2021] [Accepted: 07/18/2021] [Indexed: 11/19/2022]
Abstract
The past decade has seen an increase in the development and availability of a broad category of drugs, known as new psychoactive substances (NPS). NPS are challenging for public health authorities, therefore the two major drug monitoring bodies - the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and the United Nations Office on Drugs and Crime (UNODC) - have implemented the EU Early Warning System (EWS) and Early Warning Advisory (EWA), respectively. While these monitoring systems are informative, it is difficult to keep up with the constant and rapid developmental rate of NPS. The EMCDDA has recognised the need for an alternative and technologically derived early warning system. The aim of this research is to determine whether Google Trends and drug discussion forum data can be used to complement early warning systems for NPS. Forty-eight substances were used in this study and classed into groups based on their chemical structure, following the UNODC classification system. Google Trends data (time range: 2004-2019) and drug forum data (time range: 2003-2018) were extracted for each substance and visual trend profiles were created for class groups as well as individual substances. Analysis was conducted to determine when a substance first appeared on Google Trends and a drug discussion forum as well as their trends over time. This date of first appearance was then compared to the date the substance was first reported to UNODC. Of the three data sources utilised, substances were most likely to appear on Google Trends first. Amongst the different classes of NPS, discernible trends ('block', 'successive', and 'generational' trends) were observed. These trends reflect the evolution of the manufacture of substances or generations of substances that has been observed in the literature. For example, in the synthetic cannabinoids' category, a generational trend is observed that corresponds to the different generations of synthetic cannabinoids. When comparing Google Trends and Drugs-Forum directly, the order of appearance and duration of presence for substances aligns accurately for most classes. Google Trends showed the emergence, persistence, or transient nature of substances, which could direct the focus of law enforcement, health organisation and laboratory resources towards a limited number of substances. When one considers the reliance of individual information seeking on the Web as well as the prominence of NPS on the Web, it becomes clear that Google Trends and drug discussion forums could be used as a complement to current early warning systems.
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Affiliation(s)
- Frana-Katica Batistic
- Centre for Forensic Science, School of Mathematical and Physical Sciences, University of Technology Sydney, Australia.
| | - Damien Rhumorbarbe
- Ecole des Sciences Criminelles, Faculty of Law, Criminal Justice and Public Administration, University of Lausanne, Switzerland.
| | - Elodie Lefrancois
- Ecole des Sciences Criminelles, Faculty of Law, Criminal Justice and Public Administration, University of Lausanne, Switzerland.
| | - Justice Tettey
- Laboratory and Scientific Section, Division for Policy Analysis and Public Affairs, United Nations Office on Drugs and Crime, Vienna International Centre, Vienna, Austria.
| | - Martin Raithelhuber
- Laboratory and Scientific Section, Division for Policy Analysis and Public Affairs, United Nations Office on Drugs and Crime, Vienna International Centre, Vienna, Austria.
| | - Quentin Rossy
- Ecole des Sciences Criminelles, Faculty of Law, Criminal Justice and Public Administration, University of Lausanne, Switzerland.
| | - Marie Morelato
- Centre for Forensic Science, School of Mathematical and Physical Sciences, University of Technology Sydney, Australia.
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In Vitro and In Vivo Pharmaco-Toxicological Characterization of 1-Cyclohexyl-x-methoxybenzene Derivatives in Mice: Comparison with Tramadol and PCP. Int J Mol Sci 2021; 22:ijms22147659. [PMID: 34299276 PMCID: PMC8306156 DOI: 10.3390/ijms22147659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/02/2021] [Accepted: 07/15/2021] [Indexed: 11/17/2022] Open
Abstract
1-cyclohexyl-x-methoxybenzene is a novel psychoactive substance (NPS), first discovered in Europe in 2012 as unknown racemic mixture of its three stereoisomers: ortho, meta and para. Each of these has structural similarities with the analgesic tramadol and the dissociative anesthetic phencyclidine. In light of these structural analogies, and based on the fact that both tramadol and phencyclidine are substances that cause toxic effects in humans, the aim of this study was to investigate the in vitro and in vivo pharmacodynamic profile of these molecules, and to compare them with those caused by tramadol and phencyclidine. In vitro studies demonstrated that tramadol, ortho, meta and para were inactive at mu, kappa and delta opioid receptors. Systemic administration of the three stereoisomers impairs sensorimotor responses, modulates spontaneous motor activity, induces modest analgesia, and alters thermoregulation and cardiorespiratory responses in the mouse in some cases, with a similar profile to that of tramadol and phencyclidine. Naloxone partially prevents only the visual sensorimotor impairments caused by three stereoisomers, without preventing other effects. The present data show that 1-cyclohexyl-x-methoxybenzene derivatives cause pharmaco-toxicological effects by activating both opioid and non-opioid mechanisms and suggest that their use could potentially lead to abuse and bodily harm.
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Ortiz DM, Custodio RJP, Abiero A, Botanas CJ, Sayson LV, Kim M, Lee HJ, Kim HJ, Jeong Y, Yoon S, Lee YS, Cheong JH. The dopaminergic alterations induced by 4-F-PCP and 4-Keto-PCP may enhance their drug-induced rewarding and reinforcing effects: Implications for abuse. Addict Biol 2021; 26:e12981. [PMID: 33135332 DOI: 10.1111/adb.12981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/11/2022]
Abstract
Novel psychoactive substances remain the popular recreational drugs of use over the years. They continue to bypass government restrictions due to their synthesis and modifications. Recent additions to the lists are the 4-F-PCP and 4-Keto-PCP, analogs of the drug phencyclidine (PCP) known to induce adverse effects and abuse potential. However, studies on the abuse potential of 4-F-PCP and 4-Keto-PCP remain scarce. The rewarding and reinforcing effects of the drugs were assessed using conditioned place preference (CPP), self-administration, and locomotor sensitization tests. Dopamine (DA) receptor antagonists (SCH23390 and haloperidol) were administered during CPP to evaluate the involvement of the mesolimbic dopaminergic system. DA-related protein expression in the nucleus accumbens (NAcc) and ventral tegmental area (VTA) was measured. Additionally, phosphorylated cyclic-adenosine monophosphate-activated protein (AMP) response element-binding (p-CREB) protein, deltaFosB (∆FosB), and brain-derived neurotrophic factor (BDNF) protein levels in the NAcc were measured to assess the addiction neural plasticity effect of the drugs. Both 4-F-PCP and 4-Keto-PCP-induced CPP and self-administration; however, only 4-F-PCP elicited locomotor sensitization. Treatment with DA receptor antagonists (SH23390 and haloperidol) inhibited the 4-F- and 4-Keto-induced CPP. Both substances altered the levels of DA receptor D1 (DRD1), thyroxine hydroxylase (TH), DA receptor D2 (DRD2), p-CREB, ∆FosB, and BDNF. The results suggest that 4-F-PCP and 4-Keto-PCP may induce abuse potential in rodents via alterations in dopaminergic system accompanied by addiction neural plasticity.
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Affiliation(s)
- Darlene Mae Ortiz
- Uimyung Research Institute for Neuroscience, Department of Pharmacy Sahmyook University Seoul Republic of Korea
| | - Raly James Perez Custodio
- Uimyung Research Institute for Neuroscience, Department of Pharmacy Sahmyook University Seoul Republic of Korea
| | - Arvie Abiero
- Uimyung Research Institute for Neuroscience, Department of Pharmacy Sahmyook University Seoul Republic of Korea
- Centre for Neuroscience and Regenerative Medicine, Faculty of Science University of Technology Sydney Ultimo New South Wales Australia
| | - Chrislean Jun Botanas
- Uimyung Research Institute for Neuroscience, Department of Pharmacy Sahmyook University Seoul Republic of Korea
- Department of Psychiatry University of Maryland School of Medicine Baltimore Maryland USA
| | - Leandro Val Sayson
- Uimyung Research Institute for Neuroscience, Department of Pharmacy Sahmyook University Seoul Republic of Korea
| | - Mikyung Kim
- Department of Chemistry and Life Science Sahmyook University Seoul Republic of Korea
| | - Hyun Jun Lee
- Uimyung Research Institute for Neuroscience, Department of Pharmacy Sahmyook University Seoul Republic of Korea
| | - Hee Jin Kim
- Uimyung Research Institute for Neuroscience, Department of Pharmacy Sahmyook University Seoul Republic of Korea
| | - Youngdo Jeong
- Medicinal Chemistry Laboratory, Department of Pharmacy and Department of Life and Nanopharmaceutical Sciences, College of Pharmacy Kyung Hee University Seoul Republic of Korea
| | - Sulmin Yoon
- School of Pharmacy Jeonbuk National University Jeonju‐si Jeollabuk‐do Republic of Korea
| | - Yong Sup Lee
- Medicinal Chemistry Laboratory, Department of Pharmacy and Department of Life and Nanopharmaceutical Sciences, College of Pharmacy Kyung Hee University Seoul Republic of Korea
| | - Jae Hoon Cheong
- Uimyung Research Institute for Neuroscience, Department of Pharmacy Sahmyook University Seoul Republic of Korea
- School of Pharmacy Jeonbuk National University Jeonju‐si Jeollabuk‐do Republic of Korea
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Rosenberger C, Gertzen M, Strasburger M, Schwarz J, Gernun S, Rabenstein A, Lermer E, Rüther T. We Have a Lot to Do: Lack of Sexual Protection and Information-Results of the German-Language Online Survey "Let's Talk About Chemsex". Front Psychiatry 2021; 12:690242. [PMID: 34135790 PMCID: PMC8200571 DOI: 10.3389/fpsyt.2021.690242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 05/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The prevalence of chemsex and sexualized substance use is increasing in several European countries, particularly among men who have sex with men. In this subgroup, illegal substance use is associated with increased sexual risk behavior, which can result in severe physical and psychological impairments. The present study examined the incidence and prevalence of chemsex in German-speaking countries. Methods: To further describe the high-risk group of Chemsex users, participants (N = 429) were asked about their psychotropic substance use, sexual and health-related behavior, health status, and socio-demographic information by using an online questionnaire. Whether Chemsex has negative effects on well-being was measured with the WHO well-being index. Of additional interest was how informed Chemsex users are about the topic and what needs are placed on the practitioners. The online questionnaire consisted of 105 items, and data was collected from March to May 2019. Thousand forty seven datasets were saved with a dropout rate of 59%, 123 completed questionnaires fulfilled the criteria for chemsex users (n =123). Results: There were no significant differences in well-being between chemsex users and non-users. All participants protected themselves against sexually transmitted diseases irregularly or not at all. The majority of chemsex users reported intermittently using illegal substances (ketamine, methamphetamine, mephedrone, γ-butyrolactone/γ-hydroxy butyric acid). They viewed their sexual and substance use behavior as problematic, but few showed motivation for behavior change. Chemsex users clearly expressed a need for more information and advice centers. Conclusion: The results provide information on chemsex users that can be used for the future development of a therapy manual and thus contribute to improving health care for this group. The prevalence of chemsex is increasing and urgently needs more research to protect clients from health impairments and stigmatization.
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Affiliation(s)
- Cornelia Rosenberger
- Department of Addiction Medicine, kbo-Isar-Amper-Klinikum Munich East, Haar, Germany
| | - Marcus Gertzen
- Psychotherapy and Psychosomatics, Medical Faculty, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Moritz Strasburger
- Department of Psychiatry, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Johanna Schwarz
- Department of Psychiatry, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Solveig Gernun
- Department of Psychiatry, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Andrea Rabenstein
- Department of Psychiatry, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Eva Lermer
- FOM University of Applied Sciences for Economics and Management, Munich, Germany
- LMU Center for Leadership and People Management, Ludwig-Maximilians-University, Munich, Germany
| | - Tobias Rüther
- Department of Psychiatry, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
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22
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Molecular Mechanisms of Action of Novel Psychoactive Substances (NPS). A New Threat for Young Drug Users with Forensic-Toxicological Implications. Life (Basel) 2021; 11:life11050440. [PMID: 34068903 PMCID: PMC8156937 DOI: 10.3390/life11050440] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 12/16/2022] Open
Abstract
Novel psychoactive substances (NPS) represent a severe health risk for drug users. Even though the phenomenon has been growing since the early 2000s, the mechanisms of action of NPS at the receptors and beyond them are still scarcely understood. The aim of the present study was to provide a systematic review of the updated knowledge regarding the molecular mechanisms underlying the toxicity of synthetic opioids, cannabinoids, cathinones, and stimulants. The study was conducted on the PubMed database. Study eligibility criteria included relevance to the topic, English language, and time of publication (2010–2020). A combined Mesh and free-text protocols search was performed. Study selection was performed on the title/abstract and, in doubtful cases, on the full texts of papers. Of the 580 records identified through PubMed searching and reference checking, 307 were excluded by title/abstract and 78 additional papers were excluded after full-text reading, leaving a total of 155 included papers. Molecular mechanisms of synthetic opioids, synthetic cannabinoids, stimulants, psychedelics, and hallucinogens were reviewed and mostly involved both a receptor-mediated and non-receptor mediated cellular modulation with multiple neurotransmitters interactions. The molecular mechanisms underlying the action of NPS are more complex than expected, with a wide range of overlap among activated receptors and neurotransmitter systems. The peculiar action profile of single compounds does not necessarily reflect that of the structural class to which they belong, accounting for possible unexpected toxic reactions.
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23
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Gent L, Paul R. Air monitoring for illegal drugs including new psychoactive substances: A review of trends, techniques and thermal degradation products. Drug Test Anal 2021; 13:1078-1094. [PMID: 33870654 DOI: 10.1002/dta.3051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/17/2021] [Accepted: 04/14/2021] [Indexed: 12/23/2022]
Abstract
The detection of illicit psychotropic substances in both indoor and outdoor air is a challenging analytical discipline, and the data from such investigation may provide intelligence in a variety of fields. Applications of drug monitoring in air include providing data on national and international drug consumption trends, as monitored by organisations such as the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and the United Nations Office on Drugs and Crime (UNODC). Air monitoring enables mapping of illicit drug manufacturing, dealing or consumption in cities and the identification of emergent compounds including the recent proliferation of new psychoactive substances (NPS). The rapid spread of NPS has changed the global drug market with greater diversity and dynamic spread of such compounds over several nations. This review provides an up to date analysis of key thematic areas within this analytical discipline. The process of how illicit psychotropic substances spread from emission sources to the atmosphere is considered alongside the sampling and analytical procedures involved. Applications of the technique applied globally are reviewed with studies ranging from the analysis of individual dwellings through to major international air-monitoring campaigns providing evidence on global drug trends. Finally, we consider thermal breakdown products of illicit psychotropic substances including NPS that are released upon heating, combustion or vaping and related potential for exposure to these compounds in the air.
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Affiliation(s)
- Luke Gent
- Faculty of Science and Technology, Bournemouth University, Dorset, UK
| | - Richard Paul
- Faculty of Science and Technology, Bournemouth University, Dorset, UK
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The e-psychonaut drugs' psychopharmacology. Curr Opin Pharmacol 2021; 57:165-174. [PMID: 33774473 DOI: 10.1016/j.coph.2021.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 01/31/2023]
Abstract
The focus here was on the pharmacological and clinical pharmacological issues pertaining to the vast range of drugs (e.g. synthetic cannabimimetics, synthetic opioids, novel stimulants, novel psychedelics, PCP/ketamine-like compounds, prescribed medicinal compounds and popular psychotropic herbs/plants) discussed by Internet-based enthusiasts of new/novel psychoactive substances (NPS), 'e-psychonauts'. Currently ongoing related in silico studies, followed by further in vitro and in vivo/preclinical studies, will hopefully provide important findings in terms of which molecules within each given NPS class may present with higher levels of receptor affinities, and hence clinical potency. Understanding the pharmacological characteristics/potency of those novel recreational molecules will hopefully help in predicting related NPS diffusion, morbidity and possible lethality data.
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Abstract
There is growing recognition that substance use is associated with the emergence of psychosis.Elements of post-modernity dominate contemporary social contexts and operate as existential background factors that contribute to the emergence of substance-related psychotic phenomena, particularly use of potent and highly rewarding novel psychoactive substances (NPS). About 25% of first-episode psychoses are substance-induced (SIP). DSM-5 SIP diagnosis is based on the assumption that symptoms are transient and disappear after sustained abstinence. This narrowed definition does not consider the issue of persistent SIP. There is a clear need for a new diagnostic framework that provides reliable, unambiguous clinical criteria to differentiate between comorbid conditions (i.e., schizophrenia patients with a substance use disorder) and substance-related psychoses. In the present contribution, we aim to outline a novel and separate clinical entity: substancerelated exogenous psychosis (SREP). Within this diagnostic category, we refer to both transientand persistent psychoses associated with substance use. SREP is conceived as a distinct psychoticdisorder with psychopathological specificities that clearly differentiate it from schizophrenia. We address differences in terms of clinical presentation, epidemiology, etiological models and treatment response. SREP is characterized by altered states of consciousness, persecutory delusions, visual and cenesthetic hallucinations, impulsivity and psychomotor agitation, affectiveand negative symptoms, a pervasive feeling of unreality and intact insight. Delusions are typically secondary to abnormal perception resulting from a characteristic "sensorialization" of the world. Longitudinal studies are warranted to substantiate our hypothesis of a novel diagnostic categoryand support the clinical validity of SREP. This may have important implications in terms of early differential diagnosis and staging (i.e., between comorbid conditions, persistent and transientsubstance-related psychotic states) as well as choice of treatment interventions.
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Schifano F, Napoletano F, Chiappini S, Guirguis A, Corkery JM, Bonaccorso S, Ricciardi A, Scherbaum N, Vento A. New/emerging psychoactive substances and associated psychopathological consequences. Psychol Med 2021; 51:30-42. [PMID: 31327332 DOI: 10.1017/s0033291719001727] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND The present paper provides an updated review of both the large number of new/novel/emerging psychoactive substances (NPS) and their associated psychopathological consequences. Focus was here given on identification of those NPS being commented in specialised online sources and the related short-/long-term psychopathological and medical ill-health effects. METHODS NPS have been identified through an innovative crawling/navigating software, called the 'NPS.Finder®', created in order to facilitate the process of early recognition of NPS online. A range of information regarding NPS, including chemical and street names; chemical formula; three-dimensional image and anecdotally reported clinical/psychoactive effects, were here made available. RESULTS Using the 'NPS.Finder®' approach, a few thousand NPS were here preliminarily identified, a number which is about 4-fold higher than those figures suggested by European and international drug agencies. NPS most commonly associated with the onset of psychopathological consequences included here synthetic cannabinoids/cannabimimetics; new synthetic opioids; ketamine-like dissociatives; novel stimulants; novel psychedelics and several prescription and over-the-counter medicines. CONCLUSIONS The ever-increasing changes in terms of recreational psychotropics' availability represent a relatively new challenge for psychiatry, as the pharmacodynamics and pharmacokinetics of many NPS have not been thoroughly understood. Health/mental health professionals should be informed about the range of NPS; their intake modalities; their psychoactive sought-after effects; the idiosyncratic psychotropics' combinations and finally, their medical and psychopathological risks.
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Affiliation(s)
- F Schifano
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | - S Chiappini
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - A Guirguis
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Singleton Park, Swansea, Wales
| | - J M Corkery
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - S Bonaccorso
- Camden and Islington NHS Mental Health Foundation Trust, London, UK
| | - A Ricciardi
- Camden and Islington NHS Mental Health Foundation Trust, London, UK
- Department of Mental Health, ASL Roma 1, Rome, Italy
| | - N Scherbaum
- LVR-Klinikum Essen, Klinik für Psychiatrie und Psychotherapie, University of Duisburg-Essen, Essen, Germany
| | - A Vento
- Addictions' Observatory (ODDPSS), Rome, Italy
- 'Guglielmo Marconi' University, Rome, Italy
- Department of Mental Health, ASL Roma 2, Rome, Italy
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Tubman L, Mullen N, Tracy DK. Fifteen-minute consultation: Recognition and management of the child or young person who has ingested a novel psychoactive substance. Arch Dis Child Educ Pract Ed 2020; 105:336-341. [PMID: 32366379 DOI: 10.1136/archdischild-2019-318390] [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] [Received: 03/23/2020] [Revised: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 11/03/2022]
Abstract
Intoxicated children and young people (CYP) attending the paediatric emergency department (PED) are typically under the influence of alcohol or established recreational agents such as cannabis or ecstasy. The last decade or so has seen an increase in the numbers of CYP in PED who have used novel psychoactive substances (NPS). In this review, we describe four different functional classes of NPS, their legal status, clinical effects, acute management and interventions to reduce harm.
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Affiliation(s)
- Lee Tubman
- Paediatric Emergency Department, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Niall Mullen
- Paediatric Emergency Department, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Derek K Tracy
- Oxleas NHS Foundation Trust, London, UK.,Cognition, Schizophrenia and Imaging Laboratory, Department of Psychosis Studies, The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Dos Santos NA, Macrino CJ, Allochio Filho JF, Gonçalves FF, Almeida CM, Agostini F, Guizolfi T, Moura S, Lacerda V, Filgueiras PR, Ortiz RS, Romão W. Exploring the chemical profile of designer drugs by ESI(+) and PSI(+) mass spectrometry-An approach on the fragmentation mechanisms and chemometric analysis. JOURNAL OF MASS SPECTROMETRY : JMS 2020; 55:e4596. [PMID: 32729201 DOI: 10.1002/jms.4596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 06/11/2023]
Abstract
The consumption of design drugs, frequently known as new psychoactive substances (NPS), has increased considerably worldwide, becoming a severe issue for the responsible governmental agencies. These illicit substances can be defined as synthetic compounds produced in clandestine laboratories in order to act as analogs of schedule drugs mimetizing its chemical structure and improving its pharmacological effects while hampering the control and making regulation more complicated. In this way, the development of new methodologies for chemical analysis of NPS drugs is indispensable to determine a novel class of drugs arising from the underground market. Therefore, this work shows the use of high-resolution mass spectrometry Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS) applying different ionization sources such as paper spray ionization (PSI) and electrospray ionization (ESI) in the evaluation of miscellaneous of seized drugs samples as blotter paper (n = 79) and tablet (n = 100). Also, an elucidative analysis was performed by ESI(+)MS/MS experiments, and fragmentation mechanisms were proposed to confirm the chemical structure of compounds identified. Besides, the results of ESI(+) and PSI(+)-FT-ICR MS were compared with those of GC-MS, revealing that ESI(+)MS showed greater detection efficiency among the methodologies employed in this study. Moreover, this study stands out as a guide for the chemical analysis of NPS drugs, highlighting the differences between the techniques of ESI(+)-FT-ICR MS, PSI(+)-FT-ICR MS, and GC-MS.
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Affiliation(s)
- Nayara A Dos Santos
- Laboratório de Petroleômica e Forense, Universidade Federal do Espírito Santo (UFES), Avenida Fernando Ferrari, 514, Goiabeiras, Vitória, ES, CEP: 29075-910, Brazil
- Instituto Nacional de Ciência e Tecnologia Forense (INCT Forense), Vitoria, Brazil
| | - Clebson J Macrino
- Laboratório de Petroleômica e Forense, Universidade Federal do Espírito Santo (UFES), Avenida Fernando Ferrari, 514, Goiabeiras, Vitória, ES, CEP: 29075-910, Brazil
- Instituto Nacional de Ciência e Tecnologia Forense (INCT Forense), Vitoria, Brazil
| | - João Francisco Allochio Filho
- Laboratório de Petroleômica e Forense, Universidade Federal do Espírito Santo (UFES), Avenida Fernando Ferrari, 514, Goiabeiras, Vitória, ES, CEP: 29075-910, Brazil
- Instituto Nacional de Ciência e Tecnologia Forense (INCT Forense), Vitoria, Brazil
- Instituto Federal do Espírito Santo (IFES), Rodovia BR-101 Norte, Km 58, Litorâneo, São Mateus, Espírito Santo, 29932-540, Brazil
| | - Fernanda F Gonçalves
- Laboratório de Petroleômica e Forense, Universidade Federal do Espírito Santo (UFES), Avenida Fernando Ferrari, 514, Goiabeiras, Vitória, ES, CEP: 29075-910, Brazil
| | - Camila M Almeida
- Laboratório de Petroleômica e Forense, Universidade Federal do Espírito Santo (UFES), Avenida Fernando Ferrari, 514, Goiabeiras, Vitória, ES, CEP: 29075-910, Brazil
- Instituto Nacional de Ciência e Tecnologia Forense (INCT Forense), Vitoria, Brazil
| | - Fabiana Agostini
- Instituto Nacional de Ciência e Tecnologia Forense (INCT Forense), Vitoria, Brazil
- Laboratório de Biotecnologia de Produtos Naturais e Sintéticos, Instituto de Biotecnologia, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, 95020260, Brazil
| | - Tainara Guizolfi
- Instituto Nacional de Ciência e Tecnologia Forense (INCT Forense), Vitoria, Brazil
- Laboratório de Biotecnologia de Produtos Naturais e Sintéticos, Instituto de Biotecnologia, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, 95020260, Brazil
| | - Sidnei Moura
- Instituto Nacional de Ciência e Tecnologia Forense (INCT Forense), Vitoria, Brazil
- Laboratório de Biotecnologia de Produtos Naturais e Sintéticos, Instituto de Biotecnologia, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, 95020260, Brazil
| | - Valdemar Lacerda
- Laboratório de Petroleômica e Forense, Universidade Federal do Espírito Santo (UFES), Avenida Fernando Ferrari, 514, Goiabeiras, Vitória, ES, CEP: 29075-910, Brazil
| | - Paulo R Filgueiras
- Laboratório de Petroleômica e Forense, Universidade Federal do Espírito Santo (UFES), Avenida Fernando Ferrari, 514, Goiabeiras, Vitória, ES, CEP: 29075-910, Brazil
| | - Rafael S Ortiz
- Instituto Nacional de Ciência e Tecnologia Forense (INCT Forense), Vitoria, Brazil
- Superintendência da Polícia Federal no Rio Grande Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Wanderson Romão
- Laboratório de Petroleômica e Forense, Universidade Federal do Espírito Santo (UFES), Avenida Fernando Ferrari, 514, Goiabeiras, Vitória, ES, CEP: 29075-910, Brazil
- Instituto Nacional de Ciência e Tecnologia Forense (INCT Forense), Vitoria, Brazil
- Instituto Federal do Espírito Santo (IFES), Av. Ministro Salgado Filho, Soteco, Vila Velha, Espírito Santo, 29106-010, Brazil
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Sorribes-Soriano A, Armenta S, Esteve- Turrillas F, Herrero-Martínez J. Tuning the selectivity of molecularly imprinted polymer extraction of arylcyclohexylamines: From class-selective to specific. Anal Chim Acta 2020; 1124:94-103. [DOI: 10.1016/j.aca.2020.05.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 12/17/2022]
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30
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Eichler J, Rehm M, Azad SC. „Legal Highs“ (neue psychoaktive Substanzen). Anaesthesist 2020; 69:599-608. [DOI: 10.1007/s00101-020-00790-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Jalali R, Dmochowska P, Godlewska I, Balmas J, Młynarska K, Narkun K, Zawadzki A, Wojnar M. Designers Drugs—A New Challenge to Emergency Departments—An Observational Study in Poland. Medicina (B Aires) 2020; 56:medicina56070354. [PMID: 32708850 PMCID: PMC7404717 DOI: 10.3390/medicina56070354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 11/16/2022] Open
Abstract
Background and Objective: In the last decade, the phenomenon of using new psychoactive substances (NPS), called designer drugs, has been on rise. Though their production and marketing in Poland is prohibited, reports of the Supreme Audit Office noted that young people are increasingly reaching for new intoxication agents in the form of designer drugs. There is a significant increase in the number of patients with NPS abuse admitted to the emergency departments. As NPS cannot be detected by standard tests for the presence of psychoactive substances, it is difficult to choose the appropriate therapeutic intervention. Therefore, the aim of the present study was to evaluate the patient characteristics in the population of adults and children suspected of using NPS and formulate the protocol for diagnosis and treatment. Materials and Method: The paper is based on a retrospective analysis of medical records of hospitalized patients in the Clinical Emergency Department of The Regional Specialist Hospital in Olsztyn (SKOR WSS, emergency department (ED)) and the Pediatric Emergency Department of the Provincial Specialist Children′s Hospital in Olsztyn (SORD WSSD, pediatric emergency department (PED)) between years 2013 to 2018. The patient records related to their general symptoms at admission, mental state and laboratory diagnostic tests were evaluated. Results: The majority of patients hospitalized due to the suspected use of NPS were adolescents in 2013–2016 and a reversal of this trend was observed in 2017–2018 when number of adults admitted to the emergency department (ED) due to NPS use was higher. The NPS abuse was significantly higher among male patients, alcoholics, people using other psychoactive substances, patients suffering from mental disorders and teenagers in difficult socio-economic family situations. Whereas, the most common symptoms among pediatric patients were co-ordination disorder and aggression, in adults mainly tachycardia and aggression was observed. The laboratory tests in significant number of adult patients showed leukocytosis and ketonuria. Conclusions: In the present study, no unambiguous toxidrome or biochemical pattern characteristic for using NPS was observed. However, evaluation of blood morphology, coagulation parameters, liver and kidney function can be helpful in the diagnostic and therapeutic process. Symptomatic treatment of patients, fluid therapy and sedation was sufficient in most cases to resolve the patient symptoms in 48 h.
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Affiliation(s)
- Rakesh Jalali
- Emergency Medicine Department, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, ul. Żołnierska 18 10-561 Olsztyn, Poland; (P.D.); (I.G.); (J.B.); (A.Z.)
- Clinical Emergency Department of Regional Specialist Hospital in Olsztyn, Żołnierska 18, 10-561 Olsztyn, Poland
- Correspondence: ; Fax: +48-89-538-62-99
| | - Paula Dmochowska
- Emergency Medicine Department, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, ul. Żołnierska 18 10-561 Olsztyn, Poland; (P.D.); (I.G.); (J.B.); (A.Z.)
| | - Izabela Godlewska
- Emergency Medicine Department, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, ul. Żołnierska 18 10-561 Olsztyn, Poland; (P.D.); (I.G.); (J.B.); (A.Z.)
| | - Justyna Balmas
- Emergency Medicine Department, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, ul. Żołnierska 18 10-561 Olsztyn, Poland; (P.D.); (I.G.); (J.B.); (A.Z.)
| | - Katarzyna Młynarska
- Pediatric Emergency Department of the Provincial Specialist Children′s Hospital in Olsztyn, Żołnierska 18a, 10-561 Olsztyn, Poland; (K.M.); (K.N.)
| | - Krzysztof Narkun
- Pediatric Emergency Department of the Provincial Specialist Children′s Hospital in Olsztyn, Żołnierska 18a, 10-561 Olsztyn, Poland; (K.M.); (K.N.)
| | - Andrzej Zawadzki
- Emergency Medicine Department, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, ul. Żołnierska 18 10-561 Olsztyn, Poland; (P.D.); (I.G.); (J.B.); (A.Z.)
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland;
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Yoon KS, Gu SM, Cha HJ, Kim YH, Yun J, Lee JM. 25I-NBOMe, a phenethylamine derivative, induces adverse cardiovascular effects in rodents: possible involvement of p21 (CDC42/RAC)-activated kinase 1. Drug Chem Toxicol 2020; 45:898-906. [PMID: 32597268 DOI: 10.1080/01480545.2020.1784924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Abuse of new psychoactive substances is an emerging social problem. Several phenethylamines are internationally controlled substances as they are likely to be abused and have adverse effects. Phenethylamine analog 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25I-NBOMe) has been reported as one of the most commonly abused psychoactive substance. However, the cardiotoxicity of this compound has not been extensively evaluated. Thus, in this study, we investigated the adverse cardiovascular effects of 25I-NBOMe, related to p21 (CDC42/RAC)-activated kinase 1 (PAK1). The cardiotoxicity of 25I-NBOMe was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, live/dead cytotoxicity assay, PAK1/CDC42 kinase assay, and in vivo electrocardiography (ECG). Also, we analyzed the expression level of PAK1, which is known to play key roles in the cardiovascular system. In the MTT assay, cell viability of 25I-NBOMe-treated H9c2 cells or primary cardiomyocytes of ICR mice decreased in a concentration-dependent manner. Results from the in vitro cytotoxicity assay in cardiomyocytes showed that 25I-NBOMe decreased the viability of H9c2 rat cardiomyocytes, and TC50 of 25I-NBOMe was found to be 70.4 μM. We also observed that 25I-NBOMe reduced PAK1 activity in vitro. Surface ECG measurement revealed that intravenous injection of 25I-NBOMe (doses of 1.0 and 3.0 mg/kg, corresponding to serum concentrations of 18.1 and 28.6 ng/mL, respectively) prolonged the QTc interval in SD rats. Furthermore, treatment with 25I-NBOMe downregulated the expression of PAK1 in the hearts of SD rats and H9c2 cells. In summary, our findings indicate that PAK1-related adverse effects of 25I-NBOMe can cause toxicity to cardiomyocytes and induce an abnormal ECG pattern in animals.
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Affiliation(s)
- Kyung Sik Yoon
- Ministry of Food and Drug Safety, National Institute of Food and Drug Safety Evaluation, Cheongju-si, Republic of Korea
| | - Sun Mi Gu
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju-si, Republic of Korea
| | - Hye Jin Cha
- Ministry of Food and Drug Safety, National Institute of Food and Drug Safety Evaluation, Cheongju-si, Republic of Korea
| | - Young-Hoon Kim
- Ministry of Food and Drug Safety, National Institute of Food and Drug Safety Evaluation, Cheongju-si, Republic of Korea
| | - Jaesuk Yun
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju-si, Republic of Korea
| | - Jin-Moo Lee
- Ministry of Food and Drug Safety, National Institute of Food and Drug Safety Evaluation, Cheongju-si, Republic of Korea
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Richter A, Sason A, Adelson M, Frish O, Peles E. Cognitive state, substance use patterns and outcome after discharge from Kfar Izun, a unique rehabilitation facility. J Addict Dis 2020; 38:387-399. [PMID: 32527211 DOI: 10.1080/10550887.2020.1773730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We studied cognitive performance following discharge from a novel rehabilitation facility, treating individuals with psychosis that developed during trips abroad following mandatory military service. Montreal Cognitive Assessment (MoCA), phonetic and semantic fluency, State-Trait Anxiety, and self-Efficiency were administered before discharge, and 3 and 6 months after discharge. Of the 43 participants (30.2% females), 23(54.8%) had cognitive impairment (MoCA <27), and 15(35.7%) had poor phonetic fluency. Anxiety trait and state were high and inversely correlated with self-efficacy (R=-0.48, p = 0.001) and phonetic fluency (R=-0.43, p = 0.004) and was higher among those who experienced physical exposure, females, and those who served in non-combat army units. Six months after discharge, of 32 participants, 28 were working/studying with a 58.1% reduction in smoking and alcohol consumption, and 16 participants stopped substance use. Phonetic fluency improved among the high anxiety state group with no change among the others. High anxiety levels lowered among those who were still using drugs after six months. The anxiety level lowered and 87.1% of the participants were conducting a productive lifestyle at 6 months after discharge, but half still abused cannabis. Bigger sample and longer follow up would be needed to learn more about the impact of rehabilitation.
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Affiliation(s)
- Alon Richter
- Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research, Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Anat Sason
- Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research, Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Miriam Adelson
- Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research, Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Omri Frish
- Kfar Izun (Harmony Village), Kibbutz Sedot Yam, Mobile Post Menashe
| | - Einat Peles
- Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research, Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Abiero A, Botanas CJ, Custodio RJ, Sayson LV, Kim M, Lee HJ, Kim HJ, Lee KW, Jeong Y, Seo JW, Ryu IS, Lee YS, Cheong JH. 4-MeO-PCP and 3-MeO-PCMo, new dissociative drugs, produce rewarding and reinforcing effects through activation of mesolimbic dopamine pathway and alteration of accumbal CREB, deltaFosB, and BDNF levels. Psychopharmacology (Berl) 2020; 237:757-772. [PMID: 31828394 DOI: 10.1007/s00213-019-05412-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/21/2019] [Indexed: 12/27/2022]
Abstract
RATIONALE A high number of synthetic dissociative drugs continue to be available through online stores, leading to their misuse. Recent inclusions in this category are 4-MeO-PCP and 3-MeO-PCMo, analogs of phencyclidine. Although the dissociative effects of these drugs and their recreational use have been reported, no studies have investigated their abuse potential. OBJECTIVES To examine their rewarding and reinforcing effects and explore the mechanistic correlations. METHODS We used conditioned place preference (CPP), self-administration, and locomotor sensitization tests to assess the rewarding and reinforcing effects of the drugs. We explored their mechanism of action by pretreating dopamine receptor (DR) D1 antagonist SCH23390 and DRD2 antagonist haloperidol during CPP test and investigated the effects of 4-MeO-PCP and 3-MeO-PCMo on dopamine-related proteins in the ventral tegmental area and nucleus accumbens. We also measured the levels of dopamine, phosphorylated cyclic-AMP response element-binding (p-CREB) protein, deltaFosB, and brain-derived neurotrophic factor (BDNF) in the nucleus accumbens. Additionally, we examined the effects of both drugs on brain wave activity using electroencephalography. RESULTS While both 4-MeO-PCP and 3-MeO-PCMo induced CPP and self-administration, only 4-MeO-PCP elicited locomotor sensitization. SCH23390 and haloperidol inhibited the acquisition of drug CPP. 4-MeO-PCP and 3-MeO-PCMo altered the levels of tyrosine hydroxylase, DRD1, DRD2, and dopamine, as well as that of p-CREB, deltaFosB, and BDNF. All drugs increased the delta and gamma wave activity, whereas pretreatment with SCH23390 and haloperidol inhibited it. CONCLUSION Our results indicate that 4-MeO-PCP and 3-MeO-PCMo induce rewarding and reinforcing effects that are probably mediated by the mesolimbic dopamine system, suggesting an abuse liability in humans.
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Affiliation(s)
- Arvie Abiero
- Uimyung Research Institute for Neuroscience, College of Pharmacy, Sahmyook University, 815 Hwarangro, Nowon-gu, Seoul, 01795, Republic of Korea
| | - Chrislean Jun Botanas
- Uimyung Research Institute for Neuroscience, College of Pharmacy, Sahmyook University, 815 Hwarangro, Nowon-gu, Seoul, 01795, Republic of Korea
| | - Raly James Custodio
- Uimyung Research Institute for Neuroscience, College of Pharmacy, Sahmyook University, 815 Hwarangro, Nowon-gu, Seoul, 01795, Republic of Korea
| | - Leandro Val Sayson
- Uimyung Research Institute for Neuroscience, College of Pharmacy, Sahmyook University, 815 Hwarangro, Nowon-gu, Seoul, 01795, Republic of Korea
| | - Mikyung Kim
- Uimyung Research Institute for Neuroscience, College of Pharmacy, Sahmyook University, 815 Hwarangro, Nowon-gu, Seoul, 01795, Republic of Korea
| | - Hyun Jun Lee
- Uimyung Research Institute for Neuroscience, College of Pharmacy, Sahmyook University, 815 Hwarangro, Nowon-gu, Seoul, 01795, Republic of Korea
| | - Hee Jin Kim
- Uimyung Research Institute for Neuroscience, College of Pharmacy, Sahmyook University, 815 Hwarangro, Nowon-gu, Seoul, 01795, Republic of Korea
| | - Kun Won Lee
- Medicinal Chemistry Laboratory, Department of Pharmacy & Department of Life and Nanopharmaceutical Sciences, College of Pharmacy, Kyung Hee University, 26 Kyungheedae-ro, Seoul, 02447, Republic of Korea
| | - Youngdo Jeong
- Medicinal Chemistry Laboratory, Department of Pharmacy & Department of Life and Nanopharmaceutical Sciences, College of Pharmacy, Kyung Hee University, 26 Kyungheedae-ro, Seoul, 02447, Republic of Korea
| | - Joung-Wook Seo
- Center for Safety Pharmacology, Korea Institute of Toxicology, Daejeon, 305-343, Republic of Korea
| | - In Soo Ryu
- Center for Safety Pharmacology, Korea Institute of Toxicology, Daejeon, 305-343, Republic of Korea
| | - Yong Sup Lee
- Medicinal Chemistry Laboratory, Department of Pharmacy & Department of Life and Nanopharmaceutical Sciences, College of Pharmacy, Kyung Hee University, 26 Kyungheedae-ro, Seoul, 02447, Republic of Korea.
| | - Jae Hoon Cheong
- Uimyung Research Institute for Neuroscience, College of Pharmacy, Sahmyook University, 815 Hwarangro, Nowon-gu, Seoul, 01795, Republic of Korea. .,School of Pharmacy, Chonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do, 54896, Republic of Korea.
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Orsolini L, Corkery JM, Chiappini S, Guirguis A, Vento A, De Berardis D, Papanti D, Schifano F. 'New/Designer Benzodiazepines': An Analysis of the Literature and Psychonauts' Trip Reports. Curr Neuropharmacol 2020; 18:809-837. [PMID: 31933443 PMCID: PMC7569319 DOI: 10.2174/1570159x18666200110121333] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/08/2019] [Accepted: 01/09/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND NPS belonging to the benzodiazepine (BZD) class, e.g., 'legal/designer BZDs'/'research chemicals', have recently emerged in the drug (mainly online/virtual) market. OBJECTIVE While certain NPS belonging to the BZD class possess pharmacological profiles similar to controlled pharmaceutical BZDs, clinical and pharmacological profiles of current emerging BZDs are still not well-described. Therefore, there is a need to increase clinicians'/public health knowledge/awareness, to incentive harm reduction strategies. METHOD A comprehensive overview was carried out by using the EMCDDA/EDND database regularly monitored by our research team, by specifically looking at the 'new BZDs' so far notified. Furthermore, given the limitation of peer-reviewed data published so far, a nonparticipant multilingual qualitative netnographic study was conducted to obtain further clinical/pharmacological/ toxicological data, including psychonauts' online trip reports. RESULTS First designer BZDs appeared as NPS around 2007. So far, 29 designer BZDs have been notified to the EMCDDA, being some of them extremely powerful, also at lower dosages. They are sold as tablets/powder/pellets/capsules/blotters/liquids, at very affordable prices, and variably administered. Some are also sold on the illicit drugmarket as counterfeit forms of traditional BZDs or as either adulterants or diluents in heroin or other synthetic opioids/cannabinoids. Nowadays, there is no guarantee of the quality of designer BZDs composition/purification and, hence, most NPS consumers may be inadvertently exposed to unsafe and harmful compounds. CONCLUSION Given the limited information on their pharmacology/toxicity, variations in dosage, onset of effects, combination of substances, potency, and general patient or individual variability, the concomitant use of these substances with other drugs entails several and unpredictable risks.
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Affiliation(s)
- Laura Orsolini
- Address correspondence to this author at the Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, Herts, UK; Villa Jolanda Hospital, Neomesia Mental Health, Villa Jolanda, Italy; Polyedra, Teramo, Italy; Tel: (+39) 392 3244643; E-mail:
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Scotton WJ, Hill LJ, Williams AC, Barnes NM. Serotonin Syndrome: Pathophysiology, Clinical Features, Management, and Potential Future Directions. Int J Tryptophan Res 2019; 12:1178646919873925. [PMID: 31523132 PMCID: PMC6734608 DOI: 10.1177/1178646919873925] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/13/2019] [Indexed: 12/18/2022] Open
Abstract
Serotonin syndrome (SS) (also referred to as serotonin toxicity) is a potentially life-threatening drug-induced toxidrome associated with increased serotonergic activity in both the peripheral (PNS) and central nervous systems (CNS). It is characterised by a dose-relevant spectrum of clinical findings related to the level of free serotonin (5-hydroxytryptamine [5-HT]), or 5-HT receptor activation (predominantly the 5-HT1A and 5-HT2A subtypes), which include neuromuscular abnormalities, autonomic hyperactivity, and mental state changes. Severe SS is only usually precipitated by the simultaneous initiation of 2 or more serotonergic drugs, but the syndrome can also occur after the initiation of a single serotonergic drug in a susceptible individual, the addition of a second or third agent to long-standing doses of a maintenance serotonergic drug, or after an overdose. The combination of a monoamine oxidase inhibitor (MAOI), in particular MAO-A inhibitors that preferentially inhibit the metabolism of 5-HT, with serotonergic drugs is especially dangerous, and may lead to the most severe form of the syndrome, and occasionally death. This review describes our current understanding of the pathophysiology, clinical presentation and management of SS, and summarises some of the drugs and interactions that may precipitate the condition. We also discuss the newer novel psychoactive substances (NPSs), a growing public health concern due to their increased availability and use, and their potential risk to evoke the syndrome. Finally, we discuss whether the inhibition of tryptophan hydroxylase (TPH), in particular the neuronal isoform (TPH2), may provide an opportunity to pharmacologically target central 5-HT synthesis, and so develop new treatments for severe, life-threatening SS.
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Affiliation(s)
- William J Scotton
- Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Lisa J Hill
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Adrian C Williams
- Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Nicholas M Barnes
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
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Higgins K, O’Neill N, O’Hara L, Jordan JA, McCann M, O’Neill T, Clarke M, O’Neill T, Campbell A. Evidence for public health on novel psychoactive substance use: a mixed-methods study. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background
Novel psychoactive substances (NPSs) contribute to the public health impact of substance misuse. This report provides research evidence addressing 11 research questions related to NPSs, covering types, patterns and settings of use; supply sources; and implications for policy and practice.
Methods
The study used a conceptually linked three-phase mixed-methods design with a shared conceptual framework based on multiple-context risk and protective factors. Phase 1 was a quantitative phase involving secondary data analysis of the longitudinal Belfast Youth Development Study (BYDS), a latent class analysis using the 2039 BYDS participants. Phase 2 was an extensive qualitative analysis via narrative interviews with participants, sampled from BYDS, drug/alcohol services and prisons, to explore NPS use trajectories. Phase 3 was the final quantitative phase; generalisability of the shared risk factor part of the model was tested using the manual three-step approach to examine risk factors associated with latent class membership. The quantitative and qualitative analyses were integrated, thus allowing emerging findings to be further explored.
Results
The data suggest that NPSs have a place within a range of polydrug use trajectories. Models showed no distinctive NPS class, with no clear evidence of differential risks for NPS use compared with the use of other substances. From the qualitative analysis, a taxonomy of groups was derived that explored how and where NPSs featured in a range of trajectories. This taxonomy was used to structure the analysis of factors linked to use within a risk and protective framework. Drivers for use were considered alongside knowledge, perceptions and experience of harms. Suggestions about how interventions could best respond to the various patterns of use – with special consideration of synthetic cannabinoids (SCs), including how they relate to the use of heroin and the potential for NPSs to operate as a ‘snare’ to more problem use – were also presented.
Limitations
The study was conducted during 2016/17; generalisability beyond this sample and time point is limited. The level of missing data for some of the BYDS analysis was a limitation, as was the fact that the BYDS data were collected in 2011, so in a different context from the data collected during the narrative interviews. The Psychoactive Substances Act 2016 (Great Britain. Psychoactive Substances Act 2016. London: The Stationery Office; 2016) came into force during qualitative fieldwork and, although not particularly influential in this study, may be influential in future work. It is acknowledged that many of the data related to SCs and mephedrone. Although drug use was measured by self-report, the strength of rapport within interviews, reflective diaries and methodological acceptability checks helped to mitigate self-report bias.
Conclusions
NPSs continue to present significant challenges for legislation and monitoring, researching and developing interventions. Understanding of usage patterns remains poor, with most information based on populations and settings where problems have already occurred. This research contributes to the evidence base by providing much needed further empirical data on the lived experiences of NPS users across a range of settings. In the light of these data, implications for policy and practice are discussed.
Future work
Future research must generate improved epidemiological data on the extent, patterns and motivations for use longitudinally. The uniqueness of the information concerning SC use points to a specific set of findings not evidenced in other literature (e.g. intensity of SC withdrawal). Future research should focus on the symbiotic link between SC and heroin use.
Funding
The National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Kathryn Higgins
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
| | - Nina O’Neill
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
| | - Leeanne O’Hara
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
| | - Julie-Ann Jordan
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
| | - Mark McCann
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Tara O’Neill
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Psychology, Queen’s University Belfast, Belfast, UK
| | - Mike Clarke
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Tony O’Neill
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Anne Campbell
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
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Peck Y, Clough AR, Culshaw PN, Liddell MJ. Multi-drug cocktails: Impurities in commonly used illicit drugs seized by police in Queensland, Australia. Drug Alcohol Depend 2019; 201:49-57. [PMID: 31181437 DOI: 10.1016/j.drugalcdep.2019.03.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/21/2019] [Accepted: 03/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Impurities in commonly used illicit drugs raise concerns for unwitting consumers when pharmacologically active adulterants, especially new psychoactive substances (NPS), are used. This study examines impurities detected in illicit drugs seized in one Australian jurisdiction. METHODS Queensland Health Forensic and Scientific Services provided analytical data. Data described the chemical composition of 9346 samples of 11 illicit drugs seized by police during 2015-2016. Impurities present in primary drugs were summarized and tabulated. A systematic search for published evidence reporting similar analyses was conducted. RESULTS Methamphetamine was the primary drug in 6608 samples, followed by MDMA (1232 samples) and cocaine (516 samples). Purity of primary drugs ranged from ∼30% for cocaine, 2-CB and GHB to >90% for THC, methamphetamine, heroin and MDMA. Methamphetamine and MDMA contained the largest variety of impurities: 22 and 18 variants, respectively. Drug adulteration patterns were broadly similar to those found elsewhere, including NPS, but in some primary drugs impurities were found which had not been reported elsewhere. Psychostimulants were adulterated with each other. Levamisole was a common impurity in cocaine. Psychedelics were adulterated with methamphetamine and NPS. Opioids were quite pure, but some samples contained methamphetamine and synthetic opioids. CONCLUSIONS Impurities detected were mostly pharmacologically active adulterants probably added to enhance desired effects or for active bulking. Given the designer nature of these drug cocktails, the effects of the adulterated drugs on users from possible complex multi-drug interactions is unpredictable. Awareness-raising among users, research into complex multi-drug effects and ongoing monitoring is required.
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Affiliation(s)
- Yoshimi Peck
- College of Science and Engineering, James Cook University, 14-88 McGregor Road, Smithfield, Queensland, Australia.
| | - Alan R Clough
- College of Public Health, Medical and Vet Sciences, James Cook University, 14-88 McGregor Road, Smithfield, Queensland, Australia
| | - Peter N Culshaw
- Forensic Chemistry, Forensic and Scientific Services, Queensland Health, 39 Kessels Road, Coopers Plains, 4108, Queensland, Australia
| | - Michael J Liddell
- College of Science and Engineering, James Cook University, 14-88 McGregor Road, Smithfield, Queensland, Australia
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Mathews EM, Jeffries E, Hsieh C, Jones G, Buckner JD. Synthetic cannabinoid use among college students. Addict Behav 2019; 93:219-224. [PMID: 30772774 DOI: 10.1016/j.addbeh.2019.02.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 02/07/2019] [Accepted: 02/09/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Synthetic cannabinoid use is associated with severe problems, including psychosis, kidney failure, and death. Given that young adults are especially vulnerable to using synthetic cannabinoids, the current study sought to identify factors and consequences related to use within this population. METHODS 1140 undergraduates completed an online survey of synthetic cannabinoid use, consequences, and related constructs. RESULTS The prevalence of lifetime synthetic cannabinoid use was 7.9% (n = 90), 15.6% (n = 13) of which were regular users, meaning they used once a year or more often. Synthetic cannabinoid users reported multiple adverse effects (e.g., anxiety, paranoia, tachycardia, lightheadedness) and 16.7% (n = 15) of users said they considered or did go to the Emergency Room while using synthetic cannabinoids. In the entire sample, participants believed their friends (t = 18.3, p < .001) and students in general (t = 46.0, p < .001) use synthetic cannabinoids more than they do. Natural cannabis users were associated with increased odds of having tried synthetic cannabinoids than those who had never used natural cannabis, OR = 7.63 (4.44 to 13.14) p < .0001, and 92.2% (n = 83) of synthetic cannabinoid users reported lifetime use of natural cannabis. Common reasons for use were legality, not appearing on drug tests, and availability, not that students enjoyed using synthetic cannabinoids or thought they were safe to use. DISCUSSION AND CONCLUSIONS Synthetic cannabinoid use is associated with a variety of negative consequences. The data also supports a strong link between natural cannabis use and synthetic cannabinoid use. SCIENTIFIC SIGNIFICANCE Natural cannabis users appear to be a high-risk group for using synthetic cannabinoids. There are multiple negative effects associated with synthetic cannabinoid use and reasons for use relate to convenience vs. enjoyment. Data have important implications for prevention and treatment efforts.
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Affiliation(s)
- Eva M Mathews
- Psychiatry Residency Program, Louisiana State University Health Sciences Center, Baton Rouge, LA, United States.
| | - Emily Jeffries
- Mental Health Service Line, Edward Hines Jr. VA Hospital, Hines, IL, United States
| | - Chenen Hsieh
- Psychiatry Residency Program, Louisiana State University Health Sciences Center, Baton Rouge, LA, United States
| | - Glenn Jones
- Louisiana State University Health Sciences Center, School of Medicine, Department of Family Medicine, New Orleans, LA, United States
| | - Julia D Buckner
- Psychiatry Residency Program, Louisiana State University Health Sciences Center, Baton Rouge, LA, United States; Louisiana State University, Department of Psychology, Baton Rouge, LA, United States
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Antonides LH, Brignall RM, Costello A, Ellison J, Firth SE, Gilbert N, Groom BJ, Hudson SJ, Hulme MC, Marron J, Pullen ZA, Robertson TBR, Schofield CJ, Williamson DC, Kemsley EK, Sutcliffe OB, Mewis RE. Rapid Identification of Novel Psychoactive and Other Controlled Substances Using Low-Field 1H NMR Spectroscopy. ACS OMEGA 2019; 4:7103-7112. [PMID: 31179411 PMCID: PMC6547625 DOI: 10.1021/acsomega.9b00302] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 03/19/2019] [Indexed: 05/03/2023]
Abstract
An automated approach to the collection of 1H NMR (nuclear magnetic resonance) spectra using a benchtop NMR spectrometer and the subsequent analysis, processing, and elucidation of components present in seized drug samples are reported. An algorithm is developed to compare spectral data to a reference library of over 300 1H NMR spectra, ranking matches by a correlation-based score. A threshold for identification was set at 0.838, below which identification of the component present was deemed unreliable. Using this system, 432 samples were surveyed and validated against contemporaneously acquired GC-MS (gas chromatography-mass spectrometry) data. Following removal of samples which possessed no peaks in the GC-MS trace or in both the 1H NMR spectrum and GC-MS trace, the remaining 416 samples matched in 93% of cases. Thirteen of these samples were binary mixtures. A partial match (one component not identified) was obtained for 6% of samples surveyed whilst only 1% of samples did not match at all.
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Affiliation(s)
- Lysbeth H Antonides
- School of Science and the Environment, Division of Chemistry and Environmental Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | - Rachel M Brignall
- Oxford Instruments, Tubney Woods, Abingdon, Oxfordshire OX13 5QX, U.K
| | - Andrew Costello
- Greater Manchester Police, Openshaw Complex, Lawton Street, Openshaw, Manchester M11 2NS, U.K
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | - Jamie Ellison
- School of Science and the Environment, Division of Chemistry and Environmental Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
- Greater Manchester Police, Openshaw Complex, Lawton Street, Openshaw, Manchester M11 2NS, U.K
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | - Samuel E Firth
- School of Science and the Environment, Division of Chemistry and Environmental Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | - Nicolas Gilbert
- School of Science and the Environment, Division of Chemistry and Environmental Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | - Bethany J Groom
- School of Science and the Environment, Division of Chemistry and Environmental Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | - Samuel J Hudson
- School of Science and the Environment, Division of Chemistry and Environmental Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | - Matthew C Hulme
- School of Science and the Environment, Division of Chemistry and Environmental Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | - Jack Marron
- School of Science and the Environment, Division of Chemistry and Environmental Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | - Zoe A Pullen
- School of Science and the Environment, Division of Chemistry and Environmental Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | - Thomas B R Robertson
- School of Science and the Environment, Division of Chemistry and Environmental Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | - Christopher J Schofield
- Greater Manchester Police, Openshaw Complex, Lawton Street, Openshaw, Manchester M11 2NS, U.K
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | | | - E Kate Kemsley
- Quadram Institute Bioscience, Norwich Research Park, Norwich NR4 7UA, U.K
| | - Oliver B Sutcliffe
- School of Science and the Environment, Division of Chemistry and Environmental Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
| | - Ryan E Mewis
- School of Science and the Environment, Division of Chemistry and Environmental Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester M1 5GD, U.K
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New Psychoactive Substances (NPS), Psychedelic Experiences and Dissociation: Clinical and Clinical Pharmacological Issues. CURRENT ADDICTION REPORTS 2019. [DOI: 10.1007/s40429-019-00249-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Deconinck E, Van Campenhout R, Aouadi C, Canfyn M, Bothy J, Gremeaux L, Blanckaert P, Courselle P. Combining attenuated total reflectance- infrared spectroscopy and chemometrics for the identification and the dosage estimation of MDMA tablets. Talanta 2019; 195:142-151. [DOI: 10.1016/j.talanta.2018.11.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/06/2018] [Accepted: 11/08/2018] [Indexed: 10/27/2022]
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Greenblatt HK, Greenblatt DJ. Designer Benzodiazepines: A Review of Published Data and Public Health Significance. Clin Pharmacol Drug Dev 2019; 8:266-269. [PMID: 30730611 DOI: 10.1002/cpdd.667] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Yoon KS, Yun J, Kim YH, Shin J, Kim SJ, Seo JW, Hyun SA, Suh SK, Cha HJ. 2-(2,5-Dimethoxy-4-methylphenyl)-N-(2-methoxybenzyl)ethanamine (25D-NBOMe) and N-(2-methoxybenzyl)-2,5-dimethoxy-4-chlorophenethylamine (25C-NBOMe) induce adverse cardiac effects in vitro and in vivo. Toxicol Lett 2019; 304:50-57. [PMID: 30658151 DOI: 10.1016/j.toxlet.2019.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/21/2018] [Accepted: 01/13/2019] [Indexed: 01/08/2023]
Abstract
Two emerging psychoactive substances, 2-(2,5-dimethoxy-4-methylphenyl)-N-(2-methoxybenzyl)ethanamine (25D-NBOMe) and N-(2-methoxybenzyl)-2,5-dimethoxy-4-chlorophenethylamine (25C-NBOMe), are being abused, leading to fatal and non-fatal intoxications. However, most of their adverse effects have been reported anecdotally. In the present study, cardiotoxicity was evaluated through 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, rat electrocardiography (ECG), and human ether-a-go-go-related gene (hERG) assay. Expression levels of p21 (CDC42/RAC)-activated kinase 1 (PAK1), one of known biomarkers for cardiotoxicity, were also analyzed. Both 25D-NBOMe and 25C-NBOMe at 100 μM reduced cell viability in MTT assay. At 2.0 mg/kg and 0.75 mg/kg, they prolonged QT intervals in rat ECG. PAK1 was down-regulated by treatment with these two test compounds. Furthermore, potassium channels were inhibited by 25D-NBOMe treatment in hERG assay. Taken together, these results suggest that both 25D-NBOMe and 25C-NBOMe have potential cardiotoxicity, especially regarding cardiac rhythm. Further studies are needed to confirm the relationship between PAK1 down-regulation and cardiotoxicity.
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Affiliation(s)
- Kyung Sik Yoon
- National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety, Osong, Cheongju, Republic of Korea.
| | - Jaesuk Yun
- College of Pharmacy, Chungbuk National University, Chungju, Republic of Korea.
| | - Young-Hoon Kim
- National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety, Osong, Cheongju, Republic of Korea.
| | - Jisoon Shin
- National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety, Osong, Cheongju, Republic of Korea.
| | - Sung Jin Kim
- Cosmetics Policy Division, Ministry of Food and Drug Safety, Osong, Cheongju, Republic of Korea.
| | - Jung-Wook Seo
- Research Group for Safety Pharmacology, Korea Institute of Toxicology, KRICT, Daejeon, Republic of Korea.
| | - Sung-Ae Hyun
- Research Group for Safety Pharmacology, Korea Institute of Toxicology, KRICT, Daejeon, Republic of Korea.
| | - Soo Kyung Suh
- National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety, Osong, Cheongju, Republic of Korea.
| | - Hye Jin Cha
- National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety, Osong, Cheongju, Republic of Korea.
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A case of synthetic cannabinoid poisoning in Croatia. Arh Hig Rada Toksikol 2018; 69:186-190. [PMID: 29990295 DOI: 10.2478/aiht-2018-69-3100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 05/01/2018] [Indexed: 11/20/2022] Open
Abstract
The number of new psychoactive substances (NPS), synthetic cannabinoids (SCs) in particular, is growing constantly. Because of the insufficiently explored effects on consumer health, they have become a major problem in the emergency departments. They are difficult to identify, and there are no antidotes that could reverse their detrimental effects. We report a case of poisoning of a young man who used SCs. The patient was admitted to the emergency department of the Clinical Hospital Merkur, Zagreb (Croatia) after sniffing and smoking a herbal product bought on the street. He presented with severe cognitive difficulties and visible eye redness. Other symptoms included somnolence, disorientation, loss of coordination, unsteady gait, hyporeflexia, stiffness, cramps and cold limbs, blurred vision, teeth grinding, dry mouth, tinnitus, fear, suicidal thoughts, impaired focus, memory, and speech, sedation, fatigue, depression, thought blocking, and autistic behaviour. His skin was dry, and his mucosa dry and irritated. Herbal products "Rainbow Special" and "Luminated Aroma" used by the patient were qualitatively analysed with gas chromatography / mass spectrometry (GC/MS) after direct extraction with an organic solvent. Solid-phase extraction method was used to analyse serum and urine samples. Despite the negative findings of biological samples, mostly due to the limitations of GC/MS, the clinical picture infallibly pointed to the poisoning with SCs. This was confirmed by the findings of 5-fluoro AMB (methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3-methylbutanoate) in the herbal products.
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Champion KE, Newton NC, Stapinski L, Teesson M. Cluster randomised controlled trial of an online intervention to prevent ecstasy and new psychoactive substance use among adolescents: final results and implications for implementation. BMJ Open 2018; 8:e020433. [PMID: 30478103 PMCID: PMC6254404 DOI: 10.1136/bmjopen-2017-020433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 08/20/2018] [Accepted: 10/10/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To evaluate the effectiveness of the online Climate Schools: Ecstasy and Emerging Drugs module over 2 years, and examine the impact of intervention dose on outcomes. DESIGN Cluster randomised controlled trial. SETTING Secondary schools in Australia. PARTICIPANTS 1126 students (aged 14.9 years) from 11 schools. INTERVENTION Five schools were randomly allocated to the four-lesson internet-based Climate Schools: Ecstasy and Emerging Drugs module. This universal intervention uses cartoon storylines to deliver harm-minimisation information about ecstasy and new psychoactive substances (NPS). It was delivered during health education classes over 4 weeks. Six schools were randomised to the control group (health education as usual). Participants were not blinded to intervention allocation. OUTCOMES MEASURES Students completed self-report surveys at baseline, post-test, 6, 12 and 24 months post-baseline. Intentions to use ecstasy and NPS (including synthetic cannabis and synthetic stimulants), knowledge about ecstasy and NPS and lifetime use of ecstasy and NPS were assessed. This paper reports the results at 24 months post-baseline. ANALYSIS Mixed effects regressions were conducted to analyse intervention effects from baseline to 24 months. Post hoc analyses using Inverse Probability of Treatment Weighting compared controls with students who: i) completed all four lessons ('full dose') and ii) partially completed the intervention (≤three lessons, 'incomplete dose'). RESULTS Primary analyses found that controls were significantly more likely to intend on using synthetic cannabis compared with intervention group students (OR=3.56, p=0.01). Results from the weighted analyses indicated that controls reported significantly lower knowledge about ecstasy (p=0.001) and NPS (p=0.04) compared with the full-dose group. No significant differences were observed between the incomplete dose and control groups. CONCLUSIONS The online intervention was effective in modifying students' intentions to use synthetic cannabis up to 24 months; however, this study highlights the importance of delivering prevention programmes in full to maximise student outcomes. TRIAL REGISTRATION NUMBER ACTRN12613000708752.
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Affiliation(s)
- Katrina E Champion
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Nicola Clare Newton
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Lexine Stapinski
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Maree Teesson
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
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Roderick E, Penney J, Murrells T, Dargan PI, Norman IJ. Epidemiology of adolescent substance use in Norfolk schools. QJM 2018; 111:699-706. [PMID: 30016528 DOI: 10.1093/qjmed/hcy153] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The pattern of alcohol and substance use is changing, with the introduction of novel psychoactive substances, the internet as a means of acquisition and variations in drug purity and price. Alcohol and substance use among adolescents is associated with behavioural, mental health, health and social difficulties; arising at a vulnerable period in their development. Little is known about adolescent substance use in the UK, especially in rural areas. AIM To investigate the prevalence of substance use amongst young people, aged 16-21 years, in Norfolk schools. DESIGN Cross sectional questionnaire survey. METHOD Pupils from two, sixth form colleges in Norfolk answered a self-report questionnaire designed to measure prevalence, age of onset and frequency of use for alcohol, tobacco, illicit substances including new psychoactive substances as well as demographic data. RESULTS A total of 482 students completed the survey (68% participation rate). Life-time use of alcohol was reported by 442 (91.7%) students and over half the pupils had tried tobacco (52.5%, n=253). About 40.7% reported cannabis use and nearly one-fifth (18.9%, n=91) reported using 3,4-methylenedioxymethamphetamine (MDMA); 41.1% (n=198) students reported using 'any drug' and 23.2% (n=112) 'using an illicit drug other than cannabis' and 8.7% (n=42) reported the use of a novel psychoactive substance. CONCLUSION The most widely used substances were alcohol, tobaccos and cannabis; in keeping with European trends. Over the past decade a decline in alcohol and drug use by adolescents has been seen in the UK. However, since 2010 this decline has slowed with an increase in substance use noted in the past 2 years. This study provides evidence to support this trend. The findings demonstrate differences between the use of substances by pupils in this Norfolk sample compared to national surveys and more urbanized areas. These regional differences can be used to assist the development of local interventions targeting substance use among adolescents.
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Affiliation(s)
- E Roderick
- Department of Mental Health Nursing, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - J Penney
- Department of Mental Health Nursing, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - T Murrells
- Adult Nursing, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - P I Dargan
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - I J Norman
- Department of Mental Health Nursing, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
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Katselou M, Papoutsis I, Nikolaou P, Misailidi N, Spiliopoulou C, Athanaselis S. Diphenidine: a dissociative NPS makes an entrance on the drug scene. Forensic Toxicol 2018. [DOI: 10.1007/s11419-018-0421-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Novel Psychoactive Substances: Classification and General Information. CURRENT TOPICS IN NEUROTOXICITY 2018. [DOI: 10.1007/978-3-319-78707-7_2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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