1
|
Marchei E, Graziano S, Varì MR, Minutillo A, Aquilina V, Pichini S, Rotolo MC. NPS-EQA PART I: Four years' experience in external quality assessment program in Italy for classical and new psychoactive substances analysis in oral fluid. J Pharm Biomed Anal 2024; 243:116084. [PMID: 38452420 DOI: 10.1016/j.jpba.2024.116084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/27/2024] [Accepted: 03/01/2024] [Indexed: 03/09/2024]
Abstract
In 2019, Italian National Institute of Health established an external quality assessment program (EQA) to evaluate the performance of oral fluid testing for classical and new psychoactive substances by laboratories participating in the National Early Warning System collaborative centres. This report presents the results of four rounds between 2019 and 2023. Eleven oral fluid specimens, including 3 blank samples, were prepared by adding different classes of and new psychoactive drugs at known concentrations to pre-screened drug-free oral fluid. False-negative and false-positive results were calculated for the qualitative data evaluation. The quantitative evaluation measured the imprecision and accuracy of the results, in terms of coefficient of variation (CV%) and percent error (ERR%), respectively, with respect to a mean value obtained by reference laboratories. Z-score values were then calculated. Over the years, there has been a significant improvement in false-negative results (from 42.7% in the first year to 19.4% in the last year), but not in false-positive results (from 33.3% in the first year to 22.2% in the last one). In addition to the classic drugs of abuse (e.g. cocaine, amphetamine, methadone), the substances found in false positive samples belonged to the class of synthetic cannabinoids (e.g 5-fluoro CUMYL-PINACA and 5-fluoro-EDMB-PICA), synthetic opioids (e.g butyrylfentanyl) and tryptamines (e.g. 5-methoxy-N-methyl-N-isopropyltryptamine). The four rounds yielded a mean ERR% of approximately 22.1% and a mean CV% of around 41.5%. The participating laboratories demonstrated variable performances in relation to the class of analysed psychoactive substances, as evidenced by the calculated Z-scores. Between 25% and 60% of the reported results in all rounds should be considered satisfactory. EQA is a crucial element of laboratory quality management systems. It promotes continuous improvement and maintains high standards in the field of forensic and clinical drug testing.
Collapse
Affiliation(s)
- Emilia Marchei
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Graziano
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Rosaria Varì
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Adele Minutillo
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Valeria Aquilina
- Investigation, Crime and International Security, Università degli Studi Internazionali di Roma - UNINT, Rome, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy.
| | | |
Collapse
|
2
|
Drevin G, Gaulier JM, Hakim F, Gish A, Férec S, Renard L, Malbranque S, Briet M, Abbara C. Synthetic cathinones in drug-facilitated sexual assault: A case report involving the novel generation substituted cathinone N-ethylpentedrone and a review of the literature. Forensic Sci Int 2024; 359:112030. [PMID: 38657324 DOI: 10.1016/j.forsciint.2024.112030] [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: 02/28/2024] [Revised: 04/05/2024] [Accepted: 04/17/2024] [Indexed: 04/26/2024]
Abstract
The use of 3,4-methylenedioxymethamphetamine (MDMA) in drug-facilitated sexual assault (DFSA) is not uncommon. Indeed, the effects associated with the use of this substance may lead to disinhibition. Several synthetic cathinones, such as mephedrone or methylone, also possess marked entactogenic properties. This manuscript aims to (i) report a DFSA case involving a novel cathinone derivative, namely N-ethyl-pentedrone (NEPD) and (ii) review previously reported DFSA cases involving synthetic cathinones. Using liquid chromatography-high-resolution mass spectrometry (LC-HRMS), NEPD was detected in both plasma and urine collected from a 36-year-old male who had been victim of DFSA. Furthermore, an exhaustive, non-period-specific English-language literature search was performed using several different electronic databases to identify DFSA cases involving synthetic cathinones. Overall, five synthetic cathinones have been associated with DFSA:methylenedioxypyrovalerone, 4-methylethcathinone, α -pyrrolidinopentiophenone, mephedrone, α -pyrrolidinohexiophenone, and methylone, which appears to be the most frequently reported. Methylone is the β-keto analog of MDMA, with which it shares substantial pharmacological similarities. Indeed, the pharmacological effects of methylone are similar to those associated with MDMA. By contrast, little is known regarding NEPD's pharmacological effects in humans. Based on subjective reports, NEPD can produce both positive and negative effects in human. Unlike what is reported in the case of methylone or mephedrone, only a small minority of NEPD users report slightly entactogenics effects. Such properties theoretically make NEPD more suitable for use in a chemsex context than in DFSA context; even though, the boundary between these two specific forms of sexualized drug use can sometimes appear tenuous.
Collapse
Affiliation(s)
- Guillaume Drevin
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre Hospitalo-Universitaire d'Angers, Angers, France.
| | - Jean-Michel Gaulier
- CHU Lille, Unité Fonctionnelle de Toxicologie, Lille 59000, France; Univ. Lille, URL 4483, IMPECS, IMPact de l'Environnement Chimique sur la Santé humaine, Lille, France
| | - Florian Hakim
- CHU Lille, Unité Fonctionnelle de Toxicologie, Lille 59000, France; Univ. Lille, URL 4483, IMPECS, IMPact de l'Environnement Chimique sur la Santé humaine, Lille, France
| | - Alexandr Gish
- CHU Lille, Unité Fonctionnelle de Toxicologie, Lille 59000, France; Univ. Lille, URL 4483, IMPECS, IMPact de l'Environnement Chimique sur la Santé humaine, Lille, France
| | - Séverine Férec
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre Hospitalo-Universitaire d'Angers, Angers, France
| | - Laura Renard
- Institut de Médecine légale, Centre Hospitalo-Universitaire d'Angers, Angers, France
| | - Stéphane Malbranque
- Institut de Médecine légale, Centre Hospitalo-Universitaire d'Angers, Angers, France
| | - Marie Briet
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre Hospitalo-Universitaire d'Angers, Angers, France; Université d'Angers, Angers, France; Laboratoire MitoVasc, Team Carme, SFR ICAT, UMR CNRS 6015 INSERM 1083, Angers, France
| | - Chadi Abbara
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre Hospitalo-Universitaire d'Angers, Angers, France
| |
Collapse
|
3
|
Massano M, Nuñez-Montero M, Papaseit E, Hladun O, Pérez-Maña C, Ventura M, Marchei E, Alladio E, Gerace E, Pichini S, Farrè M, Salomone A. Metabolic profile of N-ethylhexedrone, N-ethylpentedrone, and 4-chloromethcathinone in urine samples by UHPLC-QTOF-HRMS. J Pharm Biomed Anal 2024; 241:115994. [PMID: 38309098 DOI: 10.1016/j.jpba.2024.115994] [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: 11/10/2023] [Revised: 01/08/2024] [Accepted: 01/18/2024] [Indexed: 02/05/2024]
Abstract
Forensic laboratories are constantly required to identify new drugs and their metabolites. N-ethylhexedrone (NEH, HEXEN), N-Ethylpentedrone (NEP), and 4-Chloromethcathinone (4-CMC, clephedrone) are synthetic substances structurally related to natural cathinone, alkaloid present in the leaves of the Catha edulis (Khat) plant. These synthetic cathinones (SC) are members of the heterogenous family of new psychoactive substances (NPS) that raised major concerns in scientific and forensic communities over the past years due to their widespread consumption. In this context, we investigated their metabolic profile using of UHPLC-QTOF-HRMS to elucidate the distribution of the parent drug and its metabolites in urine samples over time. Initially, both male and female volunteers were divided into three groups and eight subjects of each group were administered intranasally or orally with one SC (20-40 mg of NEH or NEP intranasal, 100-150 mg of 4-CMC oral). Urine samples were collected at 0-2 and 2-4 or 2-5 h. Urine (50 μL) was diluted 1:2 with acetonitrile/methanol (95:5) and injected into the UHPLC-QTOF-HRMS. Phase-I and phase-II metabolites were identified on the basis of fragmentation patterns and exact masses. Several phase-I and glucuronide-phase-II metabolites were identified in urine samples. Keto group reduction, hydroxylation and dealkylation were the common metabolic pathways identified for all cathinones and the presence of NEH-glucuronide, NEP-glucuronide and 4-CMC-glucuronide was also relevant. Significant is the slower metabolite formation for 4-CMC, which was detected at high concentrations in its original form even 5 h after administration, due to its long half-life and low intrinsic clearance compared to the other SCs. UHPLC-QTOF-HRMS demonstrated a considerable capability to semi-quantify the three synthetic cathinones and identify the target metabolites with high reliability. The introduction of new target compounds improves the efficiency of toxicological screening analysis on real samples and extends the window of detection of the SCs in biological matrices.
Collapse
Affiliation(s)
- Marta Massano
- Department of Chemistry, University of Turin, Italy; Centro Regionale Antidoping, Orbassano, TO, Italy.
| | - Melani Nuñez-Montero
- Unit of Clinical Pharmacology Hospital Universitari Germans Trias i Pujol (HUGTiP-IGTP) and Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Esther Papaseit
- Unit of Clinical Pharmacology Hospital Universitari Germans Trias i Pujol (HUGTiP-IGTP) and Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Olga Hladun
- Unit of Clinical Pharmacology Hospital Universitari Germans Trias i Pujol (HUGTiP-IGTP) and Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Clara Pérez-Maña
- Unit of Clinical Pharmacology Hospital Universitari Germans Trias i Pujol (HUGTiP-IGTP) and Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mireia Ventura
- Energy Control, Associació Benestar i Desenvolupament, 08012 Barcelona, Spain
| | - Emilia Marchei
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Eugenio Alladio
- Department of Chemistry, University of Turin, Italy; Centro Regionale Antidoping, Orbassano, TO, Italy
| | | | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Magi Farrè
- Unit of Clinical Pharmacology Hospital Universitari Germans Trias i Pujol (HUGTiP-IGTP) and Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alberto Salomone
- Department of Chemistry, University of Turin, Italy; Centro Regionale Antidoping, Orbassano, TO, Italy
| |
Collapse
|