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Sprega G, Kobidze G, Lo Faro AF, Pichini S, Farkas T, Tini A, Mskhiladze A, Busardò FP, Chankvetadze B. Optimization of enantioselective high-performance liquid chromatography-tandem mass spectrometry method for the quantitative determination of 3,4-methylenedioxy-methamphetamine (MDMA) and its phase-1 metabolites in human biological fluids. J Pharm Biomed Anal 2024; 243:116076. [PMID: 38430614 DOI: 10.1016/j.jpba.2024.116076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/12/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
Recently we published in this journal an enantioselective high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the quantitative determination of 3,4-methylenedioxymethamphetamine (MDMA) and its major phase-1 metabolites, 4-hydroxy-3-methoxyamphetamine (HMA), 4-hydroxy-3-methoxymethamphetamine (HMMA) and 3,4-methylenedioxyamphetamine (MDA) in human plasma, sweat, oral fluid and urine. Since we did not achieve simultaneous enantioseparation of all 4 compounds with a single chiral column, two amylose-based chiral columns were used alternatively. Further optimization of the mobile phase in the present study enabled baseline separation of all four pairs of enantiomers on a single Lux AMP column. In addition, by optimization of the column dimension and applied flow-rate it became possible to complete the separation within 6 minutes. These new methods were applied to the analysis of human plasma, oral fluid and urine. While results on the concentration of MDMA and its metabolites in various biological fluids were reported in our recent publication, in the present study an attempt was made to hydrolyze glucuronides in urine samples by using alternatively, hydrochloric acid or glucuronidase and to evaluate the effect of hydrolysis on the concentration and enantiomeric distribution of hydroxy metabolites of MDMA such as HMA and HMMA.
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Affiliation(s)
- Giorgia Sprega
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona 60121, Italy
| | - Giorgi Kobidze
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona 60121, Italy
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona 60121, Italy.
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Tivadar Farkas
- Phenomenex Inc., 411 Madrid Ave, Torrance, CA 90501, USA
| | - Anastasio Tini
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona 60121, Italy
| | - Antonina Mskhiladze
- Faculty of Natural Sciences, Mathematics, Technologies and Pharmacy, Sokhumi State University, Polytkovskaya 61, Tbilisi 0186, Georgia
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona 60121, Italy
| | - Bezhan Chankvetadze
- Institute of Physical and Analytical Chemistry, School of Exact and Natural Sciences, Tbilisi State University, I. Chavchavadze Ave 1, Tbilisi 0179, Georgia
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Rotolo MC, Graziano S, Varì MR, Minutillo A, Di Giorgi A, Aquilina V, Pichini S, Marchei E. NPS-EQA PART II: Four years' experience in external quality assessment program in Italy for classical and new psychoactive substances analysis in hair. J Pharm Biomed Anal 2024; 243:116100. [PMID: 38513500 DOI: 10.1016/j.jpba.2024.116100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/07/2024] [Accepted: 03/07/2024] [Indexed: 03/23/2024]
Abstract
In 2019, the Italian National Institute of Health established an external quality assessment (EQA) program to evaluate the performance of laboratories of collaborative centres participating in the National Early Warning System in hair testing for classical and new psychoactive substances (NPS). The results obtained in the four rounds (2019-2023) and the evolution in hair testing performance for classic drugs of abuse and new psychoactive substances are presented. A total of 11 hair specimens, including 3 blank samples, were prepared by adding different classes of classical and NPS at known concentrations to pre-screened drug-free hair. False negative and false positive results were calculated for the qualitative data evaluation. The quantitative evaluation included the imprecision (as % coefficient of variation, CV%) and the accuracy (as % error, ERR%) of the results with respect to a mean value obtained by reference laboratories and Z-score values were assessed. Over the years, an improvement in false negative results (from 52.4% in the first year to 34.3% in the last one) and false positive results (from 55.0% in the first year to 30.8.% in the last one) was observed. In the first round, the mean ERR% ranged from 6.2% to 112.8% due to NPS determination. However, in the subsequent three rounds, the mean ERR% ranged from 10.4% to 22.4%, The mean CV% in the four rounds was approximately 41.5% (ranging from 44.3% to 53.3%). Between 12.0% and 56.6% of the reported results in all rounds should be considered satisfactory. EQA programs help laboratories to identify and correct problems within their processes by highlighting errors and variations. This ensures that the results produced are accurate and reproducible.
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Affiliation(s)
| | - 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
| | - Alessandro Di Giorgi
- Department of Biomedical Science and Public Health, University Politecnica delle Marche, Ancona, 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.
| | - Emilia Marchei
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Jarque P, Carmona M, Roca A, Barcelo B, Pichini S, Elorza MÁ, Sanchis P, Rendal Y, Gomila I. Evaluation of three-year neurodevelopmental outcomes in infants prenatally exposed to substance use. Drug Alcohol Depend 2024; 259:111284. [PMID: 38640866 DOI: 10.1016/j.drugalcdep.2024.111284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/30/2024] [Accepted: 03/31/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION Prenatal exposure to substance use is associated with long-term deficits in the neurodevelopment of children. The objective was to investigate the association between cognitive, motor, and language neurodevelopment at three years of age in infants prenatally exposed to substance use. MATERIAL AND METHODS A prospective matched case-control study was conducted. Biomarkers of fetal exposure were measured in meconium samples. The Bayley Scales of Infant and Toddler Development (BSID-III) were used to calculate neurodevelopment scores. RESULTS 32 non-exposed and 32 exposed infants were evaluated, of which 16 were exposed to cannabis, 8 to ethanol, 2 to cocaine and 6 to more than one substance. Normal BSID-III scores ≥85 in all domains, were detected in 23 exposed infants to any substance and 29 infants non-exposed. Neurodevelopmental delay was detected in the language domain, specifically in male infants exposed to cannabis. Two infants exposed to cannabis had a severe developmental delay (score<70). Infants exposed to any substance obtained significantly lower total scores than control infants in all domains. Infants exposed to cannabis obtained significantly lower composite scores in the cognitive and motor domains. Infants exposed to more than one substance had lower scores in motor skills. By gender, only males exposed obtained significantly lower composite scores than non-exposed males in the cognitive domain. CONCLUSIONS The most common and severe neurodevelopmental delay at 36 months was detected in the domain of language in male infants prenatally exposed to cannabis. Neurodevelopmental disorders detected can enable an early intervention and plan therapeutic strategies.
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Affiliation(s)
- Pilar Jarque
- Division of Neonatology, Department of Pediatrics, Son Espases University Hospital, Valldemossa Road, 79, Palma de Mallorca 07120, Spain; Pediatric Multidisciplinary Research Group of Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Miguel Carmona
- Division of Neuropediatrics, Department of Pediatrics, Son Espases University Hospital, Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Antonia Roca
- Division of Neonatology, Department of Pediatrics, Son Espases University Hospital, Valldemossa Road, 79, Palma de Mallorca 07120, Spain; Pediatric Multidisciplinary Research Group of Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Bernardino Barcelo
- Clinical Analysis Service, Clinical Toxicology Unit, Son Espases University Hospital, Valldemossa Road, 79, Palma de Mallorca 07120, Spain; Clinical Toxicology Research Group of Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Viale Regina Elena, 299, Rome 00161, Italy.
| | - Miguel Ángel Elorza
- Clinical Analysis Service, Clinical Toxicology Unit, Son Espases University Hospital, Valldemossa Road, 79, Palma de Mallorca 07120, Spain; Clinical Toxicology Research Group of Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Pilar Sanchis
- Department of Chemistry, University of the Balearic Islands, Valldemossa Road, km 7.5, Palma de Mallorca 07122, Spain; Research Group in Vascular and Metabolic Pathologies of Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Yolanda Rendal
- Division of Child and Youth Psychiatry, Son Espases University Hospital, Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Isabel Gomila
- Clinical Toxicology Research Group of Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, Palma de Mallorca 07120, Spain; Clinical Analysis Service, Son Llàtzer University Hospital, Manacor Road, Palma de Mallorca 07198, Spain.
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La Maida N, Di Giorgi A, Pichini S, Pellegrini M, Di Trana A, Elmo MG, Polselli GM, Casella P, Di Stefano A, Ducci G. Comprehensive Monitoring of Psychoactive Substances in Psychiatric Patients Using Liquid Chromatography-High-Resolution Mass Spectrometry: A Key Tool for Treatment Planning and Understanding Consumption Patterns in Rome, Italy. Ther Drug Monit 2024; 46:203-209. [PMID: 38018870 DOI: 10.1097/ftd.0000000000001163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/05/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND The comprehensive monitoring of licit and illicit drug consumption plays a crucial role in understanding the complexities of patient conditions and designing effective treatment strategies. In this study, the prevalence of psychoactive prescription drugs, classical illicit drugs, and new psychoactive substances (NPS) were objectively assessed in individuals diagnosed with drug-related psychiatric disorders or episodes. METHODS Blood, urine, and hair samples were collected from psychiatric patients admitted to the Mental Health Department and Drug Addiction Service of the North Rome Local Health Authority with declared or suspected psychoactive drug use. Comprehensive drug screening was conducted for all samples using ultra-high-performance liquid chromatography-high-resolution mass spectrometry. RESULTS A total of 71 blood and urine and 50 hair samples were analyzed to confirm the suitability of the ultra-high-performance liquid chromatography-high-resolution mass spectrometry method for the study purposes. The main substances found in blood and urine were antipsychotics (71.8% and 66.2%) and benzodiazepines (62.0% and 59.2%), respectively, whereas cocaine (84.0%) and antipsychotics (74.0%) was more evident in hair. Z-drugs were detected in blood (7.0%), urine (5.6%), and hair (24%) samples; amphetamines were mainly detected in hair samples (14.0%). Synthetic cathinones were the most frequently detected NPS in hair specimens (8.0%), whereas synthetic cannabinoids were mainly found in blood samples (11.3%). These analyses showed that patients were polydrug users (77.5% detected in blood and urine, and 94.0% in hair). CONCLUSIONS Comprehensive screening enabled the assessment of past, recent, and actual consumption of psychoactive substances, including licit and illicit drugs and NPS, by psychiatric patients. A thorough understanding of substance consumption patterns can enhance therapeutic interventions and management of psychiatric disorders associated with psychoactive substance use.
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Affiliation(s)
- Nunzia La Maida
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Alessandro Di Giorgi
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche" of Ancona, Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Manuela Pellegrini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Annagiulia Di Trana
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Giuseppa Elmo
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Servizio Psichiatrico di Diagnosi e Cura (SPDC), San Filippo Neri Hospital, Rome, Italy
| | - Gian Marco Polselli
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Servizio Psichiatrico di Diagnosi e Cura (SPDC), San Filippo Neri Hospital, Rome, Italy
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Servizio Psichiatrico di Diagnosi e Cura (SPDC), S. Spirito Hospital, Rome, Italy
| | - Pietro Casella
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Drug Dipendence and Addiction Unit, Rome, Italy; and
| | - Adele Di Stefano
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Mental Health and Drug Dipendence Unit in prison, Rome, Italy
| | - Giuseppe Ducci
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Servizio Psichiatrico di Diagnosi e Cura (SPDC), San Filippo Neri Hospital, Rome, Italy
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Kobidze G, Sprega G, Montanari E, Taoussi O, Bambagiotti G, Fede MS, Di Trana A, Pichini S, Busardò FP, Tini A, Chankvetadze B, Faro AFL. The first LC-MS/MS stereoselective bioanalytical methods to quantitatively detect 9R- and 9S-hexahydrocannabinols and their metabolites in human blood, oral fluid and urine. J Pharm Biomed Anal 2024; 240:115918. [PMID: 38181553 DOI: 10.1016/j.jpba.2023.115918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/01/2023] [Accepted: 12/10/2023] [Indexed: 01/07/2024]
Abstract
A sensitive LC-MS/MS method for the simultaneous quantification of the (9 R)- and (9 S)- hexahydrocannabinols (HHCs), and their metabolites, in human urine, oral fluid (OF) and blood samples were developed, validated and used to the biological samples of volunteers. The analytes were extracted from 100 μL human samples. An isocratic elution mode with methanol was used for chromatographic separation of (9 R)- and (9 S)-HHC on an immobilized amylose tris(3-chloro-5-methylphenylcarbamate)-based chiral column Lux i-Amylose-3. The flow-rate of the mobile phase was 0.5 mL/min. An isocratic elution mode of methanol and water (80/20, v/v) was used for chromatographic separation of metabolites of (9 R)- and (9 S)-HHC on a Lux AMP chiral column (with a proprietary chiral selector) at a flow rate of 0.5 mL/min. MS/MS analysis was performed in positive ionization mode for HHC epimers, while in negative ionization mode was used for metabolites of HHCs. The calibration curves for HHCs and their metabolites in human samples ranged from 0.25- 240 ng mL-1 and 1 - 100 ng mL-1, respectively, with determination coefficients (r2) of ≥ 0.99. All analytes were stable at room temperature, 4 °C, in the autosampler (+10 °C) and -20 °C for 24 h, after three freeze/thaw cycles, and when stored at -20 °C up to one week after quality control (QC) sample preparation (concentration differences less than 20% with respect to time zero response), in blood, urine and OF.
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Affiliation(s)
- Giorgi Kobidze
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Giorgia Sprega
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Eva Montanari
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Omayema Taoussi
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Giulia Bambagiotti
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Maria Sofia Fede
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Annagiulia Di Trana
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy.
| | - Anastasio Tini
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Bezhan Chankvetadze
- Tbilisi State University, Institute of Physical and Analytical Chemistry, School of Exact and Natural Sciences, 0179 Tbilisi, Georgia
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
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8
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Coriale G, Ceccanti M, Fiore M, Tarani F, Micangeli G, Menghi M, Minutillo A, Berretta P, Ferraguti G, Iannitelli A, Parlapiano G, Paparella R, Messina MP, Vitali M, Fiorentino D, Pichini S, Tarani L. Delay in the fine-tuning of locomotion in infants with meconium positive to biomarkers of alcohol exposure: a pilot study. Riv Psichiatr 2024; 59:52-59. [PMID: 38651773 DOI: 10.1708/4259.42358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Prenatal alcohol exposure causes a variety of impairments to the fetus called Fetal Alcohol Spectrum Disorders (FASD). Since it is very difficult to identify women that consume alcohol during pregnancy, different methods have been studied to evaluate alcohol exposure. Ethyl Glucuronide (EtG) and Fatty Acid Ethyl Esters (FAEEs) are commonly used to measure alcohol consumption in individuals at-risk for alcohol abuse, including pregnant women. MATERIALS AND METHODS We conducted a study of two cohorts of 1.5 year-old infants (of mothers without a history of alcohol abuse) with or without meconium samples positive to both EtG and FAEEs and we evaluated their cognitive-behavioral development by the Griffiths Mental Developmental Scale (GMDS) method. Our protocol included 8 infants with meconium positive to alcohol metabolites (EtG and FAEEs) and 7 with meconium negative to alcohol metabolites. RESULTS None of the 8 alcohol metabolites positive meconium infants exhibited distinctive facial features and growth retardation of severe FASD, showing that other factors may contribute to the FASD onset but elevations in EtG and FAEEs in the meconium were significantly associated with disrupted neurodevelopment and adaptive functions within the first year and a half of life. Indeed, we found out that infants with meconium positive for both EtG and FAEEs, although without displaying any FASD morphological features, had a delay in the fine regulation of their own locomotory capabilities. CONCLUSIONS Further analyses and larger studies are needed to estimate the right link between prenatal alcohol exposure and the different range of disorders connected but this study provides an additional step in the field of FASD in order to suggest early treatments for at-risk newborns and infants.
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Affiliation(s)
| | - Mauro Ceccanti
- SITAC, Società Italiana per il Trattamento dell'Alcolismo e le sue Complicanze, Rome, Italy
| | - Marco Fiore
- Institute of Biochemistry and Cell Biology (IBBC-CNR), Department of Sensory Organs, Sapienza University of Rome, Italy
| | - Francesca Tarani
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Italy
| | - Ginevra Micangeli
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Italy
| | - Michela Menghi
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Italy
| | - Adele Minutillo
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome
| | - Paolo Berretta
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome
| | | | - Angela Iannitelli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Giovanni Parlapiano
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Italy
| | - Roberto Paparella
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Italy
| | - Marisa Patrizia Messina
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Italy
| | | | | | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome
| | - Luigi Tarani
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Italy
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9
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Di Trana A, Di Giorgi A, Sprega G, Carlier J, Kobidze G, Montanari E, Taoussi O, Bambagiotti G, Fede MS, Lo Faro AF, Tini A, Busardò FP, Pichini S. Disposition of Hexahydrocannabinol Epimers and Their Metabolites in Biological Matrices following a Single Administration of Smoked Hexahydrocannabinol: A Preliminary Study. Pharmaceuticals (Basel) 2024; 17:249. [PMID: 38399464 PMCID: PMC10892555 DOI: 10.3390/ph17020249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/22/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
In 2023, hexahydrocannabinol (HHC) attracted the attention of international agencies due to its rapid spread in the illegal market. Although it was discovered in 1940, less is known about the pharmacology of its two naturally occurring epimers, 9(R)-HHC and 9(S)-HHC. Thus, we aimed to investigate the disposition of hexahydrocannabinol epimers and their metabolites in whole blood, urine and oral fluid following a single controlled administration of a 50:50 mixture of 9(R)-HHC and 9(S)-HHC smoked with tobacco. To this end, six non-user volunteers smoked 25 mg of the HHC mixture in 500 mg of tobacco. Blood and oral fluid were sampled at different time points up to 3 h after the intake, while urine was collected between 0 and 2 h and between 2 and 6 h. The samples were analyzed with a validated HPLC-MS/MS method to quantify 9(R)-HHC, 9(S)-HHC and eight metabolites. 9(R)-HHC showed the highest Cmax and AUC0-3h in all the investigated matrices, with an average concentration 3-fold higher than that of 9(S)-HHC. In oral fluid, no metabolites were detected, while they were observed as glucuronides in urine and blood, but with different profiles. Indeed, 11nor-9(R)-HHC was the most abundant metabolite in blood, while 8(R)OH-9(R) HHC was the most prevalent in urine. Interestingly, 11nor 9(S) COOH HHC was detected only in blood, whereas 8(S)OH-9(S) HHC was detected only in urine.
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Affiliation(s)
- Annagiulia Di Trana
- National Centre on Addiction and Doping, National Institute of Health, 00161 Rome, Italy;
| | - Alessandro Di Giorgi
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Giorgia Sprega
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Jeremy Carlier
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Giorgi Kobidze
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Eva Montanari
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Omayema Taoussi
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Giulia Bambagiotti
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Maria Sofia Fede
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Alfredo Fabrizio Lo Faro
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Anastasio Tini
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Francesco Paolo Busardò
- Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, 60126 Ancona, Italy; (A.D.G.); (G.S.); (J.C.); (G.K.); (E.M.); (O.T.); (G.B.); (M.S.F.); (A.F.L.F.); (A.T.); (F.P.B.)
| | - Simona Pichini
- National Centre on Addiction and Doping, National Institute of Health, 00161 Rome, Italy;
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10
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Di Trana A, Montana A, Lo Faro AF, Busardò FP, Pichini S. Molecular Insights of New Psychoactive Substances (NPS) 2.0. Int J Mol Sci 2023; 24:17492. [PMID: 38139320 PMCID: PMC10743891 DOI: 10.3390/ijms242417492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
The New Psychoactive Substances (NPS) phenomenon represents an ever-changing global issue, with a number of new molecules entering the illicit market every year in response to international banning laws [...].
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Affiliation(s)
- Annagiulia Di Trana
- National Centre on Addiction and Doping, National Institute of Health, 00161 Rome, Italy;
| | - Angelo Montana
- Department of Biomedical Science and Public Health, University Politecnica delle Marche, 60121 Ancona, Italy; (A.M.); (A.F.L.F.)
| | - Alfredo Fabrizio Lo Faro
- Department of Biomedical Science and Public Health, University Politecnica delle Marche, 60121 Ancona, Italy; (A.M.); (A.F.L.F.)
| | - Francesco Paolo Busardò
- Department of Biomedical Science and Public Health, University Politecnica delle Marche, 60121 Ancona, Italy; (A.M.); (A.F.L.F.)
| | - Simona Pichini
- National Centre on Addiction and Doping, National Institute of Health, 00161 Rome, Italy;
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11
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Di Trana A, La Maida N, Froldi R, Scendoni R, Busardò FP, Pichini S. The new synthetic benzimidazole opioid etonitazepipne: an emerging fatal harm and a challenge for laboratory medicine. Clin Chem Lab Med 2023; 61:e200-e202. [PMID: 37067537 DOI: 10.1515/cclm-2023-0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/31/2023] [Indexed: 04/18/2023]
Affiliation(s)
- Annagiulia Di Trana
- National Centre on Addiction and Doping, Istituto Superiore di Sanità Rome, Italy
| | - Nunzia La Maida
- National Centre on Addiction and Doping, Istituto Superiore di Sanità Rome, Italy
| | - Rino Froldi
- Institute of Legal Medicine, Department of Law, University of Macerata, Macerata, Italy
| | - Roberto Scendoni
- Institute of Legal Medicine, Department of Law, University of Macerata, Macerata, Italy
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche" of Ancona, Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità Rome, Italy
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12
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Marchei E, Gomez-Ruiz LM, Acosta-López A, Ramos-Gutiérrez RY, Varela-Busaka MB, Lombroni C, Andreu-Fernandez V, Pichini S, Garcia-Algar O. Assessment of alcohol consumption in mexican pregnant women by hair testing of ethyl glucuronide. Alcohol 2023; 111:59-65. [PMID: 37302618 DOI: 10.1016/j.alcohol.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/09/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
There are no studies that have utilized both biomarkers and self-reported data to evaluate maternal alcohol use during pregnancy in Mexico. Therefore, we aimed to describe the prevalence of alcohol consumption in a cohort of 300 Mexican pregnant women. We used a validated ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method to measure hair ethyl glucuronide (EtG) in hair segments that corresponded to the first and second half of pregnancy. We compared the hair EtG values to a self-reported questionnaire on maternal drinking habits and evaluated whether the gestational alcohol use was associated with psychotropic drug use. Based on the EtG measurements, 263 women (87.7%) were alcohol-abstinent during the entire pregnancy, while 37 (12.3%) had used alcohol at least once during the pregnancy. Of these, only two women were found to have problematic alcoholic behavior during the entire pregnancy. No significant differences in sociodemographic characteristics were observed between alcohol-abstinent women and women with drinking habits. The self-reporting data and hair EtG gave heterogeneous results: although 37 women had self-reported alcohol use during pregnancy, only 54.1% of these women tested positive for hair EtG. Of the women who tested positive for hair EtG, 54.1% tested positive for psychoactive substances. In our cohort, the use of drugs of abuse was independent of gestational drinking. This study provided the first objective evidence of prenatal ethanol consumption in a cohort of Mexican pregnant women.
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Affiliation(s)
- Emilia Marchei
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, V.Le Regina Elena 299, 00161 Rome, Italy
| | - Larissa-Maria Gomez-Ruiz
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico; Departamento de Cirugía y Especialidades Médico-quirúrgicas, Universidad de Barcelona, Barcelona, Spain
| | - Aracely Acosta-López
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | - Ruth-Yesica Ramos-Gutiérrez
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | - Mary-Buhya Varela-Busaka
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | - Claudia Lombroni
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, V.Le Regina Elena 299, 00161 Rome, Italy; Univesità Degli Studi di Torino, Via Pietro Giuria 5, 10125, Torino, Italy
| | - Vicente Andreu-Fernandez
- Grup de Recerca Infancia i Entorn (GRIE), Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; Faculty of Health Sciences, Valencian International University (VIU), 46002 Valencia, Spain
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, V.Le Regina Elena 299, 00161 Rome, Italy.
| | - Oscar Garcia-Algar
- Departamento de Cirugía y Especialidades Médico-quirúrgicas, Universidad de Barcelona, Barcelona, Spain; Grup de Recerca Infancia i Entorn (GRIE), Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; Neonatology Unit, Hospital Clinic-Maternitat, ICGON, BCNatal, C/Sabino Arana 1, 08028 Barcelona, Spain.
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13
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La Maida N, Di Giorgi A, Pellegrini M, Ceccanti M, Caruso S, Ricci G, Neri I, Lana S, Minutillo A, Berretta P, Busardò FP, Pichini S. Erratum to Reduced prevalence of fetal exposure to alcohol in Italy: a nationwide survey American Journal of Obstetrics & Gynecology MFM. Volume 5, Issue 6, June 2023, 100944. Am J Obstet Gynecol MFM 2023; 5:101059. [PMID: 37481461 DOI: 10.1016/j.ajogmf.2023.101059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Affiliation(s)
- Nunzia La Maida
- National Centre on Addiction and Doping (Drs. La Maida, Pellegrini, Minutillo, Berretta), Istituto Superiore di Sanità, Rome, Italy
| | - Alessandro Di Giorgi
- Department of Excellence of Biomedical Science and Public Health (Drs. Di Giorgi, Busardò), University "Politecnica delle Marche", Ancona, Italy
| | - Manuela Pellegrini
- National Centre on Addiction and Doping (Drs. La Maida, Pellegrini, Minutillo, Berretta), Istituto Superiore di Sanità, Rome, Italy
| | - Mauro Ceccanti
- Alcohol Addiction Program (Dr. Ceccanti), Latium Region Referral Center, Sapienza University of Rome, Rome, Italy
| | - Salvatore Caruso
- Department of General Surgery and Medical Surgical Specialties (Dr. Caruso), University of Catania, Catania, Italy
| | - Giuseppe Ricci
- Institute for Maternal and Child Health (Dr, Ricci), IRCCS Burlo Galofaro, Trieste, Italy; Department of Medicine (Dr, Ricci), Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Isabella Neri
- Department of Medical and Surgical Sciences for Children and Adults (Dr, Neri), University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - Sheherazade Lana
- Institute for Maternal and Child Health IRCCS Burlo Garofolo (Dr. Lana), Trieste, Italy
| | - Adele Minutillo
- National Centre on Addiction and Doping (Drs. La Maida, Pellegrini, Minutillo, Berretta), Istituto Superiore di Sanità, Rome, Italy
| | - Paolo Berretta
- National Centre on Addiction and Doping (Drs. La Maida, Pellegrini, Minutillo, Berretta), Istituto Superiore di Sanità, Rome, Italy
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Science and Public Health (Drs. Di Giorgi, Busardò), University "Politecnica delle Marche", Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping (Dr. Pichini), Istituto Superiore di Sanità, V. Le Regina Elena 299, 00161 Rome, Italy.
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14
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Lo Faro AF, Sprega G, Berardinelli D, Tini A, Poyatos L, Pichini S, Farrè M, Farkas T, Busardò FP, Giunashvili L, Chankvetadze B. Development of enantioselective high-performance liquid chromatography-tandem mass spectrometry method for quantitative determination of methylone and some of its metabolites in oral fluid. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1228:123824. [PMID: 37487291 DOI: 10.1016/j.jchromb.2023.123824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/26/2023]
Abstract
In the present study an enantioselective high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed for the first time for quantitative determination of the recreational drug of abuse methylone and its major metabolites in oral fluid. The simultaneous chemo- and enantioseparation of methylone and its major metabolites was performed on a polysaccharide-based chiral column based on amylose tris(5-chloro-3-methylphenylcarbamate) as chiral selector (Lux i-Amylose-3) with methanol containing 0.4 % (v/v) aqueous ammonium hydroxide as mobile phase. The time required for enantioselective analysis of methylone and its 2 major metabolites was 15 min. This method was fully validated following the Organization of Scientific Area Committees (OSAC) for Forensic Science guidelines. This method was applied for the enantioselective determination of methylone and its metabolites in oral fluid and enantioselectivity in metabolism and pharmacokinetic of the parent compound and metabolites was observed. While the first enantiomer of methylone was found at higher concentration, both metabolites shown greater concentration for the second enantiomer. The results revealed that MET undergoes an enantioselective biotransformation to its metabolites HMMC and MDC, with S-(-)-MET more rapidly metabolized and eliminated from the body.
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Affiliation(s)
- Alfredo Fabrizio Lo Faro
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Giorgia Sprega
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Diletta Berardinelli
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Anastasio Tini
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Lourdes Poyatos
- Servei de Farmacologia Clínica, Hospital Universitari Germans Trias i Pujol (HUGTiP, IGTP)- Universitat Autònoma de Barcelona, Unitat Docent HUGTiP, Badalona, Spain
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Magì Farrè
- Servei de Farmacologia Clínica, Hospital Universitari Germans Trias i Pujol (HUGTiP, IGTP)- Universitat Autònoma de Barcelona, Unitat Docent HUGTiP, Badalona, Spain
| | - Tivadar Farkas
- Phenomenex Inc., 411 Madrid Ave., Torrance, 90501 CA, USA
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy.
| | - Lasha Giunashvili
- Tbilisi State University, Institute of Physical and Analytical Chemistry, School of Exact and Natural Sciences, 0179 Tbilisi, Georgia
| | - Bezhan Chankvetadze
- Tbilisi State University, Institute of Physical and Analytical Chemistry, School of Exact and Natural Sciences, 0179 Tbilisi, Georgia
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15
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Bisconti M, De Palma A, Pacifici R, Rotolo MC, Pichini S, Brascia D, Trabucco X, Pellegrini M, Carrozzi L, Pistelli F, Marulli G. Spontaneous Pneumothorax Secondary to Bullous Lung Emphysema Positive for Cannabinoids upon Toxicological Examination. J Clin Med 2023; 12:4956. [PMID: 37568358 PMCID: PMC10419578 DOI: 10.3390/jcm12154956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/27/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Cannabis can be related to respiratory diseases, but the relationship between smoking marijuana and the development of a pneumothorax has scarcely been investigated. We aimed to analyze, in patients with a history of cannabis smoking abuse submitted to lung apicectomy for a primary spontaneous pneumothorax (PSP), the correlation between the presence of cannabinoids in the resected lung and the detection of bullous emphysema within the same tissue. Patients undergoing lung apicectomy for a PSP were prospectively enrolled, and the correlation between the presence of cannabinoids in the resected lung tissue and histological finding of bullous emphysema was investigated with Fisher's exact test. There were 21 male patients, with a median age of 27 years. The cannabinoids found by the toxicological examination in surgical specimens were mainly delta-9-tetrahydrocannabinol (THC), cannabinol (CBN), and cannabidiol (CBD). In 14/21 patients, cannabinoids were detected in the resected lung tissue, and bullous emphysema was present in 13/14 of these (93%), while bullous emphysema was found in only 1/7 (14%) of the remaining patients who were negative for cannabinoids in the lung tissue, and the difference was found to be statistically significant (p < 0.0009). Our study demonstrated the presence of bullous emphysema in most cannabinoid-positive patients and its absence in most of those who were cannabinoid-negative, supporting the correlation between cannabinoids in the lung tissue and bullous emphysema with the development of a "secondary" spontaneous pneumothorax.
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Affiliation(s)
- Mario Bisconti
- Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.B.); (D.B.); (G.M.)
- Unit of Pneumology, Hospital “Vito Fazzi”, 73100 Lecce, Italy
| | - Angela De Palma
- Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.B.); (D.B.); (G.M.)
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy; (R.P.); (M.C.R.); (S.P.); (M.P.)
| | - Maria Concetta Rotolo
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy; (R.P.); (M.C.R.); (S.P.); (M.P.)
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy; (R.P.); (M.C.R.); (S.P.); (M.P.)
| | - Debora Brascia
- Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.B.); (D.B.); (G.M.)
| | - Xenia Trabucco
- Unit of Pathology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Manuela Pellegrini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy; (R.P.); (M.C.R.); (S.P.); (M.P.)
| | - Laura Carrozzi
- Unit of Pneumology, University of Pisa, 56126 Pisa, Italy; (L.C.); (F.P.)
| | - Francesco Pistelli
- Unit of Pneumology, University of Pisa, 56126 Pisa, Italy; (L.C.); (F.P.)
| | - Giuseppe Marulli
- Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.B.); (D.B.); (G.M.)
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16
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Nuñez-Montero M, Lombroni C, Maida NL, Rotolo MC, Pichini S, Papaseit E, Hladun O, Ventura M, Poyatos L, Pérez-Mañá C, Farré M, Marchei E. GC-MS/MS Determination of Synthetic Cathinones: 4-chloromethcathinone, N-ethyl Pentedrone, and N-ethyl Hexedrone in Oral Fluid and Sweat of Consumers under Controlled Administration: Pilot Study. Int J Mol Sci 2023; 24:ijms24119387. [PMID: 37298339 DOI: 10.3390/ijms24119387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/19/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
This study presents a validated GC-MS/MS method for the detection and quantification of 4-chloromethcathinone or clephedrone (4-CMC), N-ethyl Pentedrone (NEP), and N-ethyl Hexedrone (NEH, also named HEXEN) in oral fluid and sweat and verifies its feasibility in determining human oral fluid concentrations and pharmacokinetics following the administration of 100 mg of 4-CMC orally and 30 mg of NEP and NEH intranasally. A total of 48 oral fluid and 12 sweat samples were collected from six consumers. After the addition of 5 μL of methylone-d3 and 200 μL of 0.5 M ammonium hydrogen carbonate, an L/L extraction was carried out using ethyl acetate. The samples, dried under a nitrogen flow, were then derivatized with pentafluoropropionic anhydride and dried again. One microliter of the sample reconstituted in 50 μL of ethyl acetate was injected into GC-MS/MS. The method was fully validated according to international guidelines. Our results showed how, in oral fluid, the two cathinones taken intranasally were absorbed very rapidly, within the first hour, when compared with the 4-CMC which reached its maximum concentration peak in the first three hours. We observed that these cathinones were excreted in sweat in an amount equivalent to approximately 0.3% of the administered dose for 4-CMC and NEP. The total NEH excreted in sweat 4 h after administration was approximately 0.2% of the administered dose. Our results provide, for the first time, preliminary information about the disposition of these synthetic cathinones in the consumers' oral fluid and sweat after controlled administration.
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Affiliation(s)
- Melani Nuñez-Montero
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Claudia Lombroni
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
- Department of Chemistry, Univesità degli Studi di Torino, Via Pietro Giuria 5, 10125 Torino, Italy
| | - Nunzia La Maida
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Maria Concetta Rotolo
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Esther Papaseit
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Olga Hladun
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Mireia Ventura
- Energy Control, Associació Benestar i Desenvolupament, 08012 Barcelona, Spain
| | - Lourdes Poyatos
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Clara Pérez-Mañá
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Magí Farré
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Emilia Marchei
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
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Di Giorgi A, Sprega G, Poyatos L, Papaseit E, Pérez-Mañá C, Di Trana A, Varì MR, Busardò FP, Pichini S, Zaami S, Lo Faro AF, Farré M. Sweat Testing for the Detection of Methylone after Controlled Administrations in Humans. Int J Mol Sci 2023; 24:ijms24087395. [PMID: 37108557 PMCID: PMC10138602 DOI: 10.3390/ijms24087395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/02/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
The aim of this study was to determine the excretion of methylone and its metabolites in sweat following the ingestion of increasing controlled doses of 50, 100, 150 and 200 mg of methylone to twelve healthy volunteers involved in a clinical trial. Methylone and its metabolites 4-hydroxy-3-methoxy-N-methylcathinone (HMMC) and 3,4-methylenedioxycathinone (MDC) were analyzed in sweat patches by liquid chromatography-tandem mass spectrometry. Methylone and MDC were detected in sweat at 2 h and reached their highest accumulation (Cmax) at 24 h after the administration of 50, 100, 150 and 200 mg doses. In contrast, HMMC was not detectable at any time interval after each dose. Sweat proved to be a suitable matrix for methylone and its metabolites' determination in clinical and toxicological studies, providing a concentration that reveals recent drug consumption.
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Affiliation(s)
- Alessandro Di Giorgi
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Giorgia Sprega
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Lourdes Poyatos
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallés, Spain
| | - Esther Papaseit
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallés, Spain
| | - Clara Pérez-Mañá
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallés, Spain
| | - Annagiulia Di Trana
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Maria Rosaria Varì
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Università La Sapienza, 00161 Rome, Italy
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Magí Farré
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallés, Spain
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18
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Busardò FP, Pichini S, Kintz P. GHB-facilitated sexual assaults: How to proper assess a single GHB exposure in hair. Drug Test Anal 2023. [PMID: 36990969 DOI: 10.1002/dta.3475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/22/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023]
Affiliation(s)
- Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Pascal Kintz
- Institut de Médecine légale, Strasbourg University, Strasbourg, France
- X-Pertise Consulting, Oberhausbergen, France
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19
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Sprega G, Di Giorgi A, Poyatos L, Papaseit E, Pérez-Mañá C, Tini A, Pichini S, Busardò FP, Lo Faro AF, Farré M. Usefulness of Oral Fluid for Measurement of Methylone and Its Metabolites: Correlation with Plasma Drug Concentrations and the Effect of Oral Fluid pH. Metabolites 2023; 13:metabo13040468. [PMID: 37110127 PMCID: PMC10143603 DOI: 10.3390/metabo13040468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
The aim of this study was to investigate methylone and its metabolites concentration in oral fluid following controlled increasing doses, focusing on the effect of oral fluid pH. Samples were obtained from a clinical trial where twelve healthy volunteers participated after ingestion of 50, 100, 150 and 200 mg of methylone. Concentration of methylone and its metabolites 4-hydroxy-3-methoxy-N-methylcathinone (HMMC) and 3,4-methylenedioxycathinone in oral fluid were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Pharmacokinetic parameters were estimated, and the oral fluid-to-plasma ratio (OF/P) at each time interval was calculated and correlated with the oral fluid pH using data from our previous study in plasma. Methylone was detected at all time intervals after each dose; MDC and HMMC were not detectable after the lowest dose. Oral fluid concentrations of methylone ranged between 88.3-503.8, 85.5-5002.3, 182.8-13,201.8 and 214.6-22,684.6 ng/mL following 50, 100, 150 and 200 mg doses, respectively, peaked between 1.5 and 2.0 h, and were followed by a progressive decrease. Oral fluid pH was demonstrated to be affected by methylone administration. Oral fluid is a valid alternative to plasma for methylone determination for clinical and toxicological studies, allowing for a simple, easy and non-invasive sample collection.
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Affiliation(s)
- Giorgia Sprega
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Alessandro Di Giorgi
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Lourdes Poyatos
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallés, Spain
| | - Esther Papaseit
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallés, Spain
| | - Clara Pérez-Mañá
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallés, Spain
| | - Anastasio Tini
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Magí Farré
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallés, Spain
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20
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La Maida N, Di Giorgi A, Pellegrini M, Ceccanti M, Caruso S, Ricci G, Neri I, Lana S, Minutillo A, Berretta P, Busardò FP, Pichini S. Reduced prevalence of fetal exposure to alcohol in Italy: a nationwide survey. Am J Obstet Gynecol MFM 2023; 5:100944. [PMID: 36972834 DOI: 10.1016/j.ajogmf.2023.100944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 03/28/2023]
Affiliation(s)
- Nunzia La Maida
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Alessandro Di Giorgi
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche", Ancona, Italy
| | - Manuela Pellegrini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Mauro Ceccanti
- Alcohol Addiction Program, Latium Region Referral Center, Sapienza University of Rome, Rome, Italy
| | - Salvatore Caruso
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Giuseppe Ricci
- Institute for Maternal and Child Health, IRCCS Burlo Galofaro, Trieste, Italy; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Isabella Neri
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - Sheherazade Lana
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Adele Minutillo
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Paolo Berretta
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche", Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, V. Le Regina Elena 299, 00161 Rome, Italy.
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21
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Pichini S, Di Trana A, García-Algar O, Busardò FP. Editorial: Drug-drug interactions in pharmacology. Front Pharmacol 2023; 14:1155738. [PMID: 36860292 PMCID: PMC9969126 DOI: 10.3389/fphar.2023.1155738] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Affiliation(s)
- Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy,*Correspondence: Simona Pichini,
| | - Annagiulia Di Trana
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Oscar García-Algar
- Neonatology Unit, Hospital Clinic-Maternitat, ICGON, BCNatal, Barcelona, Spain
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Ancona, Italy
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Lo Faro AF, Tini A, Gottardi J, Pichini S, Carlier J, Giorgetti R, Busardò FP. UHPLC-MS-MS Determination of THC, CBD and Their Metabolites in Whole Blood of Light Cannabis Smokers. J Anal Toxicol 2023; 46:e256-e261. [PMID: 36214389 DOI: 10.1093/jat/bkac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/26/2022] [Accepted: 10/07/2022] [Indexed: 01/26/2023] Open
Abstract
"Light cannabis" is a product legally sold in Europe with Δ9-tetrahydrocannabinol (THC) concentration <0.2% and variable cannabidiol (CBD) content. In this study, we aimed to assess the time courses of THC and metabolites (11-nor-9-carboxy-THC and 11-hydroxy-THC) and CBD and metabolites (CBD-7-oic acid, 7-hydroxy-CBD, 6α-hydroxy-CBD and 6β-hydroxy-CBD) in whole blood of 10 healthy participants after smoking one or four light cannabis cigarettes (0.16% THC and 5.8% CBD). Blood samples were collected 0.5-4 h after administration. Blood analysis was performed by reversed-phase ultra-performance liquid chromatography-tandem mass spectrometry in multiple reaction monitoring mode after glucuronide hydrolysis and liquid-liquid extraction in basic and acidic conditions. The method was validated following the most recent guidelines in toxicology: the method was linear, accurate, precise and sensitive (lower limits of quantification ranged from 0.005 to 0.01 ng/mL); carryover, matrix effect, recovery, process efficiency and dilution integrity were also assessed. As previously reported, the main metabolites of THC were THC-COOH and then 11-OH-THC, and the main metabolites of CBD were 7-OH-CBD and then 7-COOH-CBD. The time of the first collection, which likely occurred after the maximal concentration of most of the analytes, and the short monitoring time, up to 4 h after smoking, limited the evaluation of the pharmacokinetic parameters.
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Affiliation(s)
- Alfredo Fabrizio Lo Faro
- Department of Excellence of Biomedical Sciences and Public Health, Section of Legal Medicine, Unit of Forensic Toxicology, Via Tronto 10A, Ancona, Torrette Ancona (AN) 60126, Italy
| | - Anastasio Tini
- Department of Excellence of Biomedical Sciences and Public Health, Section of Legal Medicine, Unit of Forensic Toxicology, Via Tronto 10A, Ancona, Torrette Ancona (AN) 60126, Italy
| | - Josué Gottardi
- Comedical s.r.l., Via della Cooperazione 29, Trento (TN) 28123, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome 00161, Italy
| | - Jeremy Carlier
- Department of Excellence of Biomedical Sciences and Public Health, Section of Legal Medicine, Unit of Forensic Toxicology, Via Tronto 10A, Ancona, Torrette Ancona (AN) 60126, Italy
| | - Raffaele Giorgetti
- Department of Excellence of Biomedical Sciences and Public Health, Section of Legal Medicine, Unit of Forensic Toxicology, Via Tronto 10A, Ancona, Torrette Ancona (AN) 60126, Italy
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Sciences and Public Health, Section of Legal Medicine, Unit of Forensic Toxicology, Via Tronto 10A, Ancona, Torrette Ancona (AN) 60126, Italy
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Graziano S, Varì MR, Pichini S, Busardò FP, Cassano T, Di Trana A. Hexahydrocannabinol Pharmacology, Toxicology, and Analysis: The First Evidence for a Recent New Psychoactive Substance. Curr Neuropharmacol 2023; 21:2424-2430. [PMID: 37357519 PMCID: PMC10616920 DOI: 10.2174/1570159x21666230623104624] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/11/2023] [Accepted: 05/28/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND During the last two years, hexahydrocannabinol (HHC), the hydrogenated derivative of tetrahydrocannabinol has been freely sold by internet websites as a "legal" replacement to THC and cannabis in a range of highly attractive branded and unbranded products, some of which are sold as "legal highs". Potentially, there could be a large demand for HHC products by individuals in Europe and internationally. METHODS Studies reporting HHC pharmacology, toxicology and analysis were identified from Pubmed and Scopus databases, and official international organizations' websites were considered. RESULTS HHC showed the effects of the typical cannabinoid on the central nervous system, with lower potency than Δ9-THC. A few studies highlighted that 9(R)-HHC is more potent than 9(S)-HHC. This molecule showed an affinity for cannabinoid receptor CB1 both in vitro and in vivo, suggesting a possible therapeutic effect in several pathologies. However, the affinity for the CB1 receptor suggests a possible addiction potential, inducing the users to misuse it. Since actual intoxication cases have not yet been reported, the HHC harmful potential was not described, probably due to the lack of effective analytical methods to detect HHC in biological matrices. Conversely, different analytical assays were developed and validated to separate HHC epimers in natural and non-natural sources. CONCLUSION Similarly to other NPS, the HHC represents a cheaper alternative to the controlled Δ9-THC. Its monitoring is a crucial challenge for toxicological and forensic purposes. To this concern, it is essential to further investigate HHC to support health providers in the identification of related intoxications.
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Affiliation(s)
- Silvia Graziano
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161, Rome, Italy
| | - Maria Rosaria Varì
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161, Rome, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161, Rome, Italy
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Tommaso Cassano
- Department of Medical and Surgical Sciences, University of Foggia, Via Luigi Pinto, c/o Policlinico “Riuniti” di Foggia, 71122, Foggia, Italy
| | - Annagiulia Di Trana
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161, Rome, Italy
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24
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Poyatos L, Pérez-Mañá C, Hladun O, Núñez-Montero M, de la Rosa G, Martín S, Barriocanal AM, Carabias L, Kelmendi B, Taoussi O, Busardò FP, Fonseca F, Torrens M, Pichini S, Farré M, Papaseit E. Pharmacological effects of methylone and MDMA in humans. Front Pharmacol 2023; 14:1122861. [PMID: 36873994 PMCID: PMC9981643 DOI: 10.3389/fphar.2023.1122861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
Methylone is one of the most common synthetic cathinones popularized as a substitute for 3,4-methylenedioxymethamphetamine (MDMA, midomafetamine) owing to its similar effects among users. Both psychostimulants exhibit similar chemistry (i.e., methylone is a β-keto analog of MDMA) and mechanisms of action. Currently, the pharmacology of methylone remains scarcely explored in humans. Herein, we aimed to evaluate the acute pharmacological effects of methylone and its abuse potential in humans when compared with that of MDMA following oral administration under controlled conditions. Seventeen participants of both sexes (14 males, 3 females) with a previous history of psychostimulant use completed a randomized, double-blind, placebo-controlled, crossover clinical trial. Participants received a single oral dose of 200 mg of methylone, 100 mg of MDMA, and a placebo. The variables included physiological effects (blood pressure, heart rate, oral temperature, pupil diameter), subjective effects using visual analog scales (VAS), the short form of the Addiction Research Center Inventory (ARCI), the Evaluation of Subjective Effects of Substances with Abuse Potential questionnaire (VESSPA-SSE), and the Sensitivity to Drug Reinforcement Questionnaire (SDRQ), and psychomotor performance (Maddox wing, psychomotor vigilance task). We observed that methylone could significantly increase blood pressure and heart rate and induce pleasurable effects, such as stimulation, euphoria, wellbeing, enhanced empathy, and altered perception. Methylone exhibited an effect profile similar to MDMA, with a faster overall onset and earlier disappearance of subjective effects. These results suggest that abuse potential of methylone is comparable to that of MDMA in humans. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT05488171; Identifier: NCT05488171.
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Affiliation(s)
- Lourdes Poyatos
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Clara Pérez-Mañá
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
- *Correspondence: Clara Pérez-Mañá, ; Magí Farré,
| | - Olga Hladun
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Melani Núñez-Montero
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Georgina de la Rosa
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Soraya Martín
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
| | - Ana Maria Barriocanal
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
| | - Lydia Carabias
- Department of Pharmacy, Hospital Universitari Germans Trias i Pujol (HUGTiP), Badalona, Spain
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Omayema Taoussi
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Francina Fonseca
- Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
- Addiction Program, Institut de Neuropsiquiatria i Adiccions (INAD), Barcelona, Spain
| | - Marta Torrens
- Addiction Program, Institut de Neuropsiquiatria i Adiccions (INAD), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Magí Farré
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
- *Correspondence: Clara Pérez-Mañá, ; Magí Farré,
| | - Esther Papaseit
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
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Poyatos L, Lo Faro AF, Berardinelli D, Sprega G, Malaca S, Pichini S, Huestis MA, Papaseit E, Pérez-Mañá C, Busardò FP, Farré M. Methylone and MDMA Pharmacokinetics Following Controlled Administration in Humans. Int J Mol Sci 2022; 23:ijms232314636. [PMID: 36498963 PMCID: PMC9736016 DOI: 10.3390/ijms232314636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
The aim of this study is to define, for the first time, human methylone and HMMC plasma pharmacokinetics following controlled administration of 50-200 mg methylone to 12 male volunteers. A new LC-MS/MS method was validated to quantify methylone, MDMA, and their metabolites in plasma. The study was a randomized, cross-over, double-blinded and placebo-controlled study, with a total of 468 plasma samples collected. First, 10 µL of MDMA-d5, MDA-d5 and methylone-d3 internal standards were added to 100 µL of plasma. Two mL of chloroform and ethyl acetate 9:1 (v/v) were then added, mixed well and centrifuged. The supernatant was fortified with 0.1 mL acidified methanol and evaporated under nitrogen. Samples were reconstituted with a mobile phase and injected into the LC-MS/MS instrument. The method was fully validated according to OSAC guidelines (USA). Methylone plasma concentrations increased in a dose-proportional manner, as demonstrated by the increasing maximum concentration (Cmax) and area under the curve of concentrations (AUC). Methylone Cmax values were reported as 153, 304, 355 and 604 ng/mL, AUC0-24 values were reported as 1042.8, 2441.2, 3524.4 and 5067.9 h·ng/mL and T1/2 values as 5.8, 6.4, 6.9 and 6.4 h following the 50, 100, 150 and 200 mg doses, respectively. Methylone exhibited rapid kinetics with a Tmax of 1.5 h for the 50 mg dose and 2 h approximately after all the other doses. HMMC exhibited faster kinetics compared to methylone, with a Cmax value that was 10-14-fold lower and an AUC0-24 value that was 21-29-fold lower. Methylone pharmacokinetics was linear across 50-200 mg oral doses in humans, unlike the previously described non-linear oral MDMA pharmacokinetics. An LC-MS/MS method for the quantification of methylone, MDMA and their metabolites in human plasma was achieved. Methylone exhibited linear pharmacokinetics in humans with oral doses of 50-200 mg.
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Affiliation(s)
- Lourdes Poyatos
- Servei de Farmacologia Clínica, Hospital Universitari Germans Trias i Pujol (HUGTiP, IGTP), Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Diletta Berardinelli
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Giorgia Sprega
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Sara Malaca
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Marilyn A. Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Esther Papaseit
- Servei de Farmacologia Clínica, Hospital Universitari Germans Trias i Pujol (HUGTiP, IGTP), Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | - Clara Pérez-Mañá
- Servei de Farmacologia Clínica, Hospital Universitari Germans Trias i Pujol (HUGTiP, IGTP), Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
- Correspondence: ; Tel.: +39-0712206274
| | - Magí Farré
- Servei de Farmacologia Clínica, Hospital Universitari Germans Trias i Pujol (HUGTiP, IGTP), Universitat Autònoma de Barcelona, 08916 Badalona, Spain
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Busardò FP, La Maida N, Pellegrini M, Di Giorgi A, Montana A, Pichini S. Assessment of prenatal exposure to alcohol and gestational consumption by EtG testing in neonatal meconium and maternal hair and neonatal: First Italian national survey. Toxicologie Analytique et Clinique 2022. [DOI: 10.1016/j.toxac.2022.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pichini S, Graziano S, Varì MR, Pellegrini M, Marchei E, Rotolo MC, Berretta P, Tini A, Di Trana A, Busardò F. The role of analytical pharmacotoxicology in adressing the main functions of the National Early Warning System on NPS. Toxicologie Analytique et Clinique 2022. [DOI: 10.1016/j.toxac.2022.06.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Bambagiotti G, Castaldo P, Tedeschi V, Piccialli I, Lo Faro AF, Busardò FP, Pichini S, Huestis MA, Pannaccione A, Secondo A. Effects of subtoxic 3-methylmethcathinone concentrations on neuronal cell electrical properties. Toxicologie Analytique et Clinique 2022. [DOI: 10.1016/j.toxac.2022.06.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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La Maida N, Di Giorgi A, Pichini S, Busardò FP, Huestis MA. Recent challenges and trends in forensic analysis: Δ9-THC isomers pharmacology, toxicology and analysis. J Pharm Biomed Anal 2022; 220:114987. [PMID: 35985136 DOI: 10.1016/j.jpba.2022.114987] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 10/15/2022]
Abstract
Δ9-tetrahydrocannabinol (Δ9-THC) isomers, especially Δ8-tetrahydrocannabinol (Δ8-THC), are increasing in foods, beverages, and e-cigarettes liquids. A major factor is passage of the Agriculture Improvement Act (AIA) that removed hemp containing less than 0.3 % Δ9-THC from the definition of "marijuana" or cannabis. CBD-rich hemp flooded the market resulting in excess product that could be subjected to CBD cyclization to produce Δ8-THC. This process utilizes strong acid and yields toxic byproducts that frequently are not removed prior to sale and are currently inadequately studied. Pharmacological activity is qualitatively similar for Δ8-THC and Δ9-THC, but most preclinical studies in mice, rats, and monkeys documented greater ∆9-THC potency. Both isomers caused graded dose-response effects on euphoria, blurred vision, mental confusion and lethargy, although Δ8-THC was at least 25 % less potent. The most common analytical methodologies providing baseline resolution of ∆8-THC and ∆9-THC in non-biological matrices are liquid-chromatography coupled to diode-array detection (LC-DAD or LC-PDA), while liquid chromatography coupled to mass spectrometry is preferred for biological matrices. Other available analytical methods are gas-chromatography-mass spectrometry (GC-MS) and quantitative nuclear magnetic resonance (QNMR). Current knowledge on the pharmacology of ∆8-THC and other ∆9-THC isomers are reviewed to raise awareness of the activity of these isomers in cannabis products, as well as analytical methods to discriminate ∆9-THC qualitatively, and quantitatively and ∆8-THC in biological and non-biological matrices.
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Affiliation(s)
- Nunzia La Maida
- Unit of Forensic Toxicology, Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Università la Sapienza, V. Le Regina Elena 366, 00161 Rome, Italy
| | - Alessandro Di Giorgi
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 10/a, 60124, Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, V. Le Regina Elena 299, 00161 Rome, Italy
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 10/a, 60124, Ancona, Italy.
| | - Marilyn A Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA, USA
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Montanari E, Madeo G, Pichini S, Busardò FP, Carlier J. Acute Intoxications and Fatalities Associated With Benzimidazole Opioid (Nitazene Analog) Use: A Systematic Review. Ther Drug Monit 2022; 44:494-510. [PMID: 35149665 DOI: 10.1097/ftd.0000000000000970] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/17/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Synthetic benzimidazole opioids (BOs) are highly potent µ-opioid receptor agonists with heroin-like effects. Isotonitazene was first available in 2019 in the drug market, although new analogs have multiplied recently. The authors aimed to identify BO use trends and gather toxicological data from BO-related cases to assist in clinical and forensic investigations. METHODS A systematic literature search was conducted according to the PRISMA guidelines. PubMed and Scopus databases were accessed in October 2021 to identify scientific reports of BO-related intoxication and fatalities. Publication dates, case descriptions, symptoms, autopsy findings, and concentrations of BOs and metabolites in biological matrices were compiled. RESULTS Data from 8 case reports with 93 fatalities involving isotonitazene ( n = 65), metonitazene ( n = 20), etonitazepyne ( N -pyrrolidino etonitazene) ( n = 8), flunitazene ( n = 4), and/or butonitazene ( n = 1), and 1 acute intoxication involving etonitazepyne were collected. Autopsy findings included pulmonary congestion/high lung weight (66%), cardiomegaly/high cardiac weight (39%), cerebral edema (22%), gastric contents in the airways (22%), and organ congestion (22%). Median peripheral blood concentrations were 1.7 ng/mL for isotonitazene (0.4-9.5 ng/mL, n = 13), 5.4 ng/mL for metonitazene (0.52-33 ng/mL, n = 17), 5.4 ng/mL for etonitazepyne (2.4-8.3 ng/mL, n = 2), 1.3 ng/mL for flunitazene (0.58-2.1 ng/mL, n = 2), and 3.2 ng/mL for butonitazene ( n = 1). Central nervous system depressants were almost always coadministered. CONCLUSIONS Isotonitazene was predominant in cases from 2019 to mid-2020 and was replaced by metonitazene after scheduling in the United States. Typical findings on opioid overdoses have been reported. Peripheral blood concentrations were consistent with a potency similar to that of fentanyl. These results must be interpreted carefully, considering the scarcity of reports on BO-related cases and drug co-exposures.
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Affiliation(s)
- Eva Montanari
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Graziella Madeo
- Brain&Care, Neuromodulation and Clinical Research Unit, Rimini, Italy
| | - Simona Pichini
- Istituto Superiore di Sanità, National Centre on Addiction and Doping, Rome, Italy; and
| | - Francesco Paolo Busardò
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Jeremy Carlier
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
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La Maida N, Mannocchi G, Pichini S, Basile G, Di Giorgi A, Busardò FP, Marchei E. Targeted screening and quantification of synthetic cathinones and metabolites in hair by UHPLC-HRMS. Eur Rev Med Pharmacol Sci 2022; 26:5033-5042. [PMID: 35916799 DOI: 10.26355/eurrev_202207_29289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Synthetic cathinones (SCs) are new psychoactive substances with sympathomimetic effects, which emerged into the illegal drug market to replace controlled stimulants. Since every year more powerful and toxic substances enter the illicit market, there is the need for analytical methodologies able to detect these new compounds in conventional and non-conventional biological matrices. We sought to develop and validate a targeted screening and quantification method for thirty-two parent SCs and two metabolites in hair samples by ultra-high-performance liquid chromatography coupled to high resolution mass spectrometry (UHPLC-HRMS). MATERIALS AND METHODS 20 mg hair samples were soaked in 250 µL of 2 mM ammonium formate, methanol and acetonitrile mixture (50/25/25, v/v/v) and incubated overnight at 40°C. After incubation, the samples were evaporated to dryness under nitrogen stream and reconstituted with 100 µL of mobile phase mix (A:B, 80:20) and 10 µL were injected into UHPLC-HRMS. A Q ExactiveTM Focus Orbitrap Mass spectrometer with full scan and targeted data-dependent MS/MS scan acquisition was used for the screening and quantitation analysis. RESULTS The assay was linear from 5 to 500 pg/mg hair for all the analytes under investigation. Intra-day and inter-day precision were always < 15% and matrix effect and analytical recovery were always within acceptable criteria (±25% and >50%, respectively). The developed method was applied to authentic hair samples from SCs consumers. The most prevalent found SCs were 3,4-Methylenedioxy-α-Pyrrolidinohexanophenone with a concentration range of 6.0-1,000.0 pg/mg along with α-Pyrrolidinohexiophenone (54.0 and 554.0 pg/mg, respectively), 3-Methylmetcathinone (556.0 and 5,000.0 pg/mg) and 4-Methylethcathinone (11.5 and 448.0 pg/mg) CONCLUSIONS: The developed method showed good selectivity, specificity, an easy and low-cost sample preparation and an analysis time compatible with a high throughput laboratory.
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Affiliation(s)
- N La Maida
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche" of Ancona, Ancona, Italy.
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Wille SMR, Desharnais B, Pichini S, Trana AD, Busardò FP, Wissenbach DK, Peters FT. Liquid Chromatography High Resolution Mass Spectrometry in Forensic Toxicology: What Are the Specifics of Method Development, Validation and Quality Assurance for Comprehensive Screening Approaches? Curr Pharm Des 2022; 28:1230-1244. [PMID: 35619258 DOI: 10.2174/1381612828666220526152259] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/12/2022] [Indexed: 11/22/2022]
Abstract
The use of High Resolution Mass Spectrometry (HRMS) has increased over the past decade in clinical and forensic toxicology, especially for comprehensive screening approaches. Despite this, few guidelines of this field have specifically addressed HRMS issues concerning compound identification, validation, measurement uncertainty and quality assurance. To fully implement this technique, certainly in an era in which the quality demands for laboratories are ever increasing due to various norms (e.g. the International Organization for Standardization's ISO 17025), these specific issues need to be addressed. This manuscript reviews 26 HRMS-based methods for qualitative systematic toxicological analysis (STA) published between 2011 and 2021. Key analytical data such as samples matrices, analytical platforms, numbers of analytes and employed mass spectral reference databases/libraries as well as the studied validation parameters are summarized and discussed. The article further includes a critical review of targeted and untargeted data acquisition approaches, available HRMS reference databases and libraries as well as current guidelines for HRMS data interpretation with a particular focus on identification criteria. Moreover, it provides an overview on current recommendations for the validation and determination measurement uncertainty of qualitative methods. Finally, the article aims to put forward suggestions for method development, compound identification, validation experiments to be performed, and adequate determination of measurement uncertainty for this type of wide-range qualitative HRMS-based methods.
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Affiliation(s)
- Sarah M R Wille
- Unit Toxicology, National Institute of Criminalistics and Criminology (NICC), Brussels, Belgium
| | - Brigitte Desharnais
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais St., Montréal, Québec, H2K 3S7, Canada
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Annagiulia Di Trana
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche", Ancona, Italy
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche", Ancona, Italy
| | - Dirk K Wissenbach
- Institute of Forensic Medicine, Jena University Hospital, Jena, Germany
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Varì MR, Ricci G, Cavallo M, Pichini S, Sirignano A, Graziano S. Ketamine: from prescription anaesthetic to New Psychoactive Substance. Curr Pharm Des 2022; 28:1213-1220. [PMID: 35538799 DOI: 10.2174/1381612828666220510115209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/03/2022] [Indexed: 11/22/2022]
Abstract
Discovered in the United States of America (USA) in the 1960s, ketamine was introduced as an anaesthetic drug to specifically replace phencyclidine. Briefly, the substance moved from the medical world to recreational users, since it was discovered that intense psychedelic experiences were obtained with dosages lower than those prescribed for anesthesia. At the end of the 90's, circulated in London nightclubs as a drug itself and as counterfeit 3,4-methylenedioxymethamphetamine tablets. In 1997, the Drug Enforcement Administration (DEA) alerted the United States (US) government to the increasing diffusion of ketamine in American 'clubs', and in 1999, the substance was added to Schedule III of drugs controlled by federal authorities. In 2002, ketamine epidemics moved to Europe, and the European Monitoring Centre for Drugs and Drug Addiction carried out a risk assessment monitoring of the phenomenon. An estimated ninety-nine percent of all global ketamine seizures occurred in Asia. Its growing popularity is due to the fact that this new psychoactive substance is cheaper than other stimulants such as MDMA that the amount used for recreational purposes does not cause respiratory depression and its legal use as a drug makes it widely available for a diversion towards illicit markets. Nevertheless, acute intoxication and several deaths have been related to exclusive ketamine use both in Europe and internationally. Since 2015, there has been and increasing rise of the illicit ketamine market and currently the drug is being used with unprecedented peaks and a consequent significant increase in seizures and clinical cases worldwide.
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Affiliation(s)
- Maria Rosaria Varì
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | | | - Marco Cavallo
- Central Directorate for Antidrug Services, Rome, Italy
| | - Simona Pichini
- 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
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Faro AFL, Venanzi B, Pilli G, Ripani U, Basile G, Pichini S, Busardò FP. Ultra-high-performance liquid chromatography-tandem mass spectrometry assay for quantifying THC, CBD and their metabolites in hair. Application to patients treated with medical cannabis. J Pharm Biomed Anal 2022; 217:114841. [DOI: 10.1016/j.jpba.2022.114841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022]
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Gómez-Ruiz LM, Marchei E, Rotolo MC, Brunetti P, Mannocchi G, Acosta-López A, Ramos-Gutiérrez RY, Varela-Busaka MB, Pichini S, Garcia-Algar O. Prevalence of Licit and Illicit Drugs Use during Pregnancy in Mexican Women. Pharmaceuticals (Basel) 2022; 15:ph15030382. [PMID: 35337179 PMCID: PMC8953434 DOI: 10.3390/ph15030382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 12/15/2022] Open
Abstract
For the first time, the present study employed hair testing to investigate the prevalence of classical drugs of abuse and new psychoactive substances use during gestation in a cohort of 300 Mexican pregnant women. An interview was conducted to collect data on sociodemographic aspects of the patients, and a 9 cm-long hair strand was taken from the back of the head of each mother one month after delivery. A validated ultra-high-performance liquid chromatography−high-resolution mass spectrometry method was used for the screening of classic drugs, new psychoactive substances, and medications in maternal hair. Out of 300 examined hair samples from pregnant women, 127 (42.3%) resulted positive for psychoactive substances: 45 (35.4%) for cannabis only, 24 (18.9%) for methamphetamine only, 13 (10.2%) for cocaine only, 1 (0.3%) for heroin, 1 for N-N-dimethyltryptamine (0.3%), 1 for ketamine (0.8%), and 35 (16.3%) for more than one psychoactive substance. Furthermore, seven samples (2.3%) resulted positive for new psychoactive substances (NPS): two samples for synthetic cannabinoids, two for synthetic cathinones, and three for nor-fentanyl, and 3.3% of women hair resulted positive for anticonvulsant, antidepressant, and antipsychotic medications. Finally, 83 women hair samples (27.7%) tested positive for nicotine. Nonsteroidal anti-inflammatory drugs (NSAIDs) and other painkillers (60.0%), medications for the treatment of nausea and vomiting (12.3%), antihistamines (8.7%) and nasal/sinus decongestants (6.7%), cough suppressants (5.0%), and bronchodilator agents (5.0%) were also detected in pregnant women hair. The gestational use of psychoactive substances and exposure to tobacco smoke, assessed by hair testing, were associated with a significantly younger age and with a low education grade of the mothers (p < 0.005). This study provides a significant preliminary indication of the under-reported gestational consumption of licit and illicit psychoactive and pharmacologically active drugs in a Mexican environment, showing the value of toxicological and forensic analyses in the global effort to determine the health risks caused by classic drugs and new psychoactive substances during pregnancy.
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Affiliation(s)
- Larissa-María Gómez-Ruiz
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara 44600, Mexico; (L.-M.G.-R.); (A.A.-L.); (R.-Y.R.-G.); (M.-B.V.-B.)
- Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Barcelona, 08036 Barcelona, Spain;
| | - Emilia Marchei
- National Centre on Addiction and Doping, Italian National Institute of Health (ISS), V.Le Regina Elena 299, 00161 Rome, Italy; (E.M.); (M.C.R.)
| | - Maria Concetta Rotolo
- National Centre on Addiction and Doping, Italian National Institute of Health (ISS), V.Le Regina Elena 299, 00161 Rome, Italy; (E.M.); (M.C.R.)
| | - Pietro Brunetti
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Scienc-Es and Public Health, Marche Polytechnic University, 60126 Ancona, Italy;
| | | | - Aracely Acosta-López
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara 44600, Mexico; (L.-M.G.-R.); (A.A.-L.); (R.-Y.R.-G.); (M.-B.V.-B.)
| | - Ruth-Yesica Ramos-Gutiérrez
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara 44600, Mexico; (L.-M.G.-R.); (A.A.-L.); (R.-Y.R.-G.); (M.-B.V.-B.)
| | - Mary-Buhya Varela-Busaka
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara 44600, Mexico; (L.-M.G.-R.); (A.A.-L.); (R.-Y.R.-G.); (M.-B.V.-B.)
| | - Simona Pichini
- National Centre on Addiction and Doping, Italian National Institute of Health (ISS), V.Le Regina Elena 299, 00161 Rome, Italy; (E.M.); (M.C.R.)
- Correspondence: ; Tel.: +39-064990-6545
| | - Oscar Garcia-Algar
- Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Barcelona, 08036 Barcelona, Spain;
- Neonatology Unit, Hospital Clinic-Maternitat, ICGON, BCNatal, C/Sabino Arana 1, 08028 Barcelona, Spain
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Busardò FP, Pichini S. Molecular Insights on New Psychoactive Substances (NPSs). Int J Mol Sci 2022; 23:ijms23063282. [PMID: 35328703 PMCID: PMC8948614 DOI: 10.3390/ijms23063282] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Francesco Paolo Busardò
- Analytical Pharmacotoxicology Unit, National Centre on Addiction and Doping, Istituto Superiore di Sanità V.Le Regina Elena 299, 00161 Rome, Italy
- Correspondence: ; Tel.: +39-0712206274
| | - Simona Pichini
- Department of Excellence of Biomedical Sciences and Public Health, “Politecnica delle Marche” University of Ancona, Via Tronto 10/a, 60126 Ancona, Italy;
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Marchei E, Rotolo MC, Mannocchi G, Capomassi A, Gómez-Ruiz LM, Acosta-López A, Ramos-Gutiérrez RY, Varela-Busaka MB, Pichini S, García-Algar Ó. Assessment of licit and illicit drugs consumption during pregnancy by Ultra-High Performance Liquid Chromatography-High Resolution Mass Spectrometry (UHPLC-HRMS) target screening in Mexican women hair. J Pharm Biomed Anal 2022; 211:114607. [DOI: 10.1016/j.jpba.2022.114607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
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Alías-Ferri M, Pellegrini M, Marchei E, Pacifici R, Rotolo MC, Pichini S, Pérez-Mañá C, Papaseit E, Muga R, Fonseca F, Farré M, Torrens M. Synthetic cannabinoids use in a sample of opioid-use disorder patients. Front Psychiatry 2022; 13:956120. [PMID: 35990071 PMCID: PMC9381952 DOI: 10.3389/fpsyt.2022.956120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Cannabis is the most widely consumed illegal drug in the world and synthetic cannabinoids are increasingly gaining popularity and replacing traditional cannabis. These substances are a type of new psychoactive substance that mimics the cannabis effects but often are more severe. Since, people with opioids use disorder use widely cannabis, they are a population vulnerable to use synthetic cannabinoids. In addition, these substances are not detected by the standard test used in the clinical practice and drug-checking is more common in recreational settings. A cross-sectional study with samples of 301 opioid use disorder individuals was carried out at the addiction care services from Barcelona and Badalona. Urinalysis was performed by high-sensitivity gas chromatography-mass spectrometry (GC-MS) and ultra-high-performance liquid chromatography-high -resolution mass spectrometry (UHPLC-HRMS). Any synthetic cannabinoid was detected in 4.3% of the individuals and in 23% of these samples two or more synthetic cannabinoids were detected. Among the 8 different synthetic cannabinoids detected, most common were JWH-032 and JWH-122. Natural cannabis was detected in the 18.6% of the samples and only in the 0.7% of them THC was identified. Several different synthetic cannabinoids were detected and a non-negligible percentage of natural cannabis was detected among our sample. Our results suggest that the use of synthetic cannabinoids may be related to the avoidance of detection. In the absence of methods for the detection of these substances in clinical practice, there are insufficient data and knowledge making difficult to understand about this phenomenon among opioid use disorder population.
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Affiliation(s)
- María Alías-Ferri
- Addiction Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Manuela Pellegrini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Emilia Marchei
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | | | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Clara Pérez-Mañá
- Department of Clinical Pharmacology, Hospital Universitari Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Esther Papaseit
- Department of Clinical Pharmacology, Hospital Universitari Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Robert Muga
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Francina Fonseca
- Addiction Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.,Addiction Program, Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain.,Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
| | - Magi Farré
- Department of Clinical Pharmacology, Hospital Universitari Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Marta Torrens
- Addiction Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain.,Addiction Program, Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain
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Di Trana A, Pichini S, Pacifici R, Giorgetti R, Busardò FP. Synthetic Benzimidazole Opioids: The Emerging Health Challenge for European Drug Users. Front Psychiatry 2022; 13:858234. [PMID: 35401256 PMCID: PMC8990956 DOI: 10.3389/fpsyt.2022.858234] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/15/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Annagiulia Di Trana
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, National Institute of Health, Rome, Italy
| | - Roberta Pacifici
- National Centre on Addiction and Doping, National Institute of Health, Rome, Italy
| | - Raffaele Giorgetti
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Francesco Paolo Busardò
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
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Alías-Ferri M, Marchei E, Pacifici R, Pichini S, Pellegrini M, Pérez-Mañá C, Papaseit E, Muga R, Fonseca F, Farré M, Torrens M. New Synthetic Opioids Use among Patients in Treatment for an Opioid Use Disorder in Barcelona. Eur Addict Res 2022; 28:323-330. [PMID: 35378545 DOI: 10.1159/000524011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/23/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION New synthetic opioids (NSO), a class of new psychoactive substances (NPS), have recently emerged and pose an upcoming global public health challenge. The effects produced by NSO are similar to those from morphine, but they present greater pharmacological potency and abuse potential. Due to the increasing number of fatal overdoses and seizures in which NSO have been detected as heroin substitutes or adulterants, individuals with Opioid Use Disorder (OUD) represent a vulnerable population. The aim of our study was to describe and characterize from a gender perspective a Spanish cohort of potential conscious or unconscious NSO users. METHODS A cross-sectional study was conducted in a cohort of OUD participants under treatment in addiction care services in Barcelona and Badalona, Spain. Clinical evaluation was performed through an ad hoc survey, a scale to evaluate reasons to use an opioid without prescription (range 0-4) and the Wellbeing Index (WHO-5) (range 0-100). Objective consumption of NSO was assessed by urinalysis carried out by two validated methods: high-sensitivity gas chromatography-mass spectrometry (MS) and ultra-high-performance liquid chromatography-high-resolution MS. RESULTS A total of 154 participants with OUD were enrolled. They were mainly men (72.7%), mean age 47.8 years. Methadone was the predominant medication for opioid agonist treatment (mean dose 61.25 mg/day). A total of 32 (20.8%) participants reported having consumed some opioid to become "high" in the previous 3 months. The principal reasons for consuming illicit opioids were Replacing other drugs (mean 2.03) and Availability (mean 1.62), although Low price, was more highly valued by men (p = 0.045) and Shorter effect duration, most highly rated by women (p = <0.001). In the WHO-5, the mean score was 55 (SD = 30.1) without differences by gender. Fentanyl and derivatives or/and metabolites were detected in 7 (6.1%) participants, but illicit/non-prescribed NSOs were found in 5 out of 114 patients (4.4%), and other non-fentanyl opioids in 36 participants (26 men and 10 women). CONCLUSION A non-negligible consumption of NSO-fentanyl's (positive detection in 6.1% of biological samples) was detected. The reasons for using these substances and also the well-being differed between the genders. There is therefore both voluntary and involuntary NSO consumption in our country which highlights the importance of approaching this potential public health problem.
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Affiliation(s)
- Maria Alías-Ferri
- Addiction Research Group, IMIM- Hospital del Mar Medical Research Institute, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Emilia Marchei
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Manuela Pellegrini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Clara Pérez-Mañá
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Esther Papaseit
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Roberto Muga
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Francina Fonseca
- Addiction Research Group, IMIM- Hospital del Mar Medical Research Institute, Barcelona, Spain.,Addiction Program, Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain.,Experimental and Health Sciences Department, Universitat Pompeu Fabra, Barcelona, Spain
| | - Magi Farré
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Marta Torrens
- Addiction Research Group, IMIM- Hospital del Mar Medical Research Institute, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain.,Addiction Program, Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain
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Martínez L, La Maida N, Papaseit E, Pérez-Mañá C, Poyatos L, Pellegrini M, Pichini S, Ventura M, Galindo L, Busardò FP, Farré M. Acute Pharmacological Effects and Oral Fluid Concentrations of the Synthetic Cannabinoids JWH-122 and JWH-210 in Humans After Self-Administration: An Observational Study. Front Pharmacol 2021; 12:705643. [PMID: 34489699 PMCID: PMC8417402 DOI: 10.3389/fphar.2021.705643] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Abstract
Synthetic cannabinoids (SCs) are a group of new psychoactive drugs used recreationally with potential health risks. They are monitored by the EU Early Warning System since 2010 due to severe adverse effects on consumers. JWH-122 and JWH-210 are naphthoylindole SCs and potent cannabinoid receptor CB1 and CB2 agonists. Information about the effects of SCs usually is available from intoxication cases and surveys, and few studies on humans after controlled administration or observational/naturalistic studies using standardized measures of cardiovascular and subjective effects are available. The aim of this study was to evaluate the acute pharmacological effects of JWH-122 and JWH-210 recreational consumption in a 4 h observational study and assess their disposition in oral fluid (OF). Sixteen volunteers self-administered 1 mg dose of JWH-122 (n = 8) or 2.25 mg mean dose of JWH-210 (range 2–3 mg, n = 8) by inhalation (smoking). Physiological parameters including blood pressure (systolic and diastolic), heart rate (HR), and cutaneous temperature were measured. A set of visual analog scales, the 49-item short-form version of the Addiction Research Center Inventory (ARCI), and the Evaluation of the Subjective Effects of Substances with Abuse Potential (VESSPA-SSE) were used for the evaluation of subjective effects. OF was collected at baseline and at 10, 20, and 40 min and 1, 2, 3, and 4 h after self-administration. Statistically significant increases in systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR were observed after JWH-122 self-administration but not after JWH-210 self-administration. JWH-210 self-administration produced significant changes in subjective drug effects, similar to those induced by THC (intensity, high, good effects, and hunger). The subjective effects following JWH-122 consumption were minimal. The maximal effects were mostly observed 20 min after intake. JWH-122 and JWH 210 OF concentration reached a peak 20 min after administration and could not be detected after 3 h. The results demonstrated a different pattern of effects of these two SCs. Due to the limitations of our observational study, further research with a larger sample and controlled studies are needed to better define the acute pharmacological effect and health risk profile of JWH-122 and JWH-210.
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Affiliation(s)
- Lucia Martínez
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Barcelona, Spain.,Clinical Pharmacology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Nunzia La Maida
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche", Ancona, Italy
| | - Esther Papaseit
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Clara Pérez-Mañá
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Lourdes Poyatos
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Manuela Pellegrini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Mireia Ventura
- Energy Control, Associació Benestar i Desenvolupament, Barcelona, Spain
| | - Liliana Galindo
- Energy Control, Associació Benestar i Desenvolupament, Barcelona, Spain.,Department of Psychiatry, University of Cambridge/Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche", Ancona, Italy
| | - Magí Farré
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
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Malaca S, Gottardi M, Pigliasco F, Barco S, Cafaro A, Amadori E, Riva A, Marcenaro M, Striano P, Cangemi G, Pacifici R, Pichini S, Busardò FP. UHPLC-MS/MS Analysis of Cannabidiol and Its Metabolites in Serum of Patients with Resistant Epilepsy Treated with CBD Formulations. Pharmaceuticals (Basel) 2021; 14:ph14070630. [PMID: 34209666 PMCID: PMC8308640 DOI: 10.3390/ph14070630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 12/31/2022] Open
Abstract
Cannabidiol (CBD) is a promising therapeutic agent with analgesic, myorelaxant, and anti-epileptic actions. Recently, a purified form of CBD (Epidiolex®) has been approved by the European Medicines Agency (EMA) for the treatment of two highly-refractory childhood-onset epilepsies (Dravet and Lennox-Gastaut syndrome). Given the interindividual response and the relationship between the dose administered and CBD blood levels, therapeutic drug monitoring (TDM) is a valuable support in the clinical management of patients. We herein report for the first time a newly developed and validated method using ultra-high-performance liquid chromatography coupled with tandem mass spectrometry (UHPLC–MS/MS) to evaluate CBD and its metabolites (i.e., cannabidiol-7-oic acid (7-COOH-CBD), 7-hydroxycannabidiol (7-OH-CBD), 6-α-hydroxycannabidiol (6-α–OH–CBD) and 6-β-hydroxycannabidiol (6-β–OH–CBD)) in serum samples. The method reached the sensitivity needed to detect minimal amounts of analytes under investigation with limits of quantification ranging from 0.5 to 20 ng/mL. The validation results indicated in this method were accurate (average inter/intra-day error, <15%), precise (inter/intra-day imprecision, <15%), and fast (8 min run time). The method resulted to be linear in the range of 1–10,000 ng/mL for CBD-COOH, 1–500 ng/mL for 7-OH-CBD and CBD and 1–25 ng/mL for 6-α–OH–CBD and 6-β–OH–CBD. Serum levels of CBD (88.20–396.31 and 13.19–170.63 ng/mL) as well as of 7-OH-CBD (27.11–313.63 and 14.01–77.52 ng/mL) and 7-COOH-CBD (380.32–10,112.23 and 300.57–2851.82 ng/mL) were significantly higher (p < 0.05) in patients treated with GW pharma CBD compared to those of patients treated with galenic preparations. 6-α–OH–CBD and 6-β–OH–CBD were detected in the first group and were undetectable in the second group. 7-COOH-CBD was confirmed as the most abundant metabolite in serum (5–10 fold higher than CBD) followed by 7-OH-CBD. A significant correlation (p < 0.05) between the dose administrated and a higher bioavailability was confirmed in patients treated with a GW pharma CBD preparation.
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Affiliation(s)
- Sara Malaca
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy; (S.M.); (F.P.B.)
| | | | - Federica Pigliasco
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analyses, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (F.P.); (S.B.); (A.C.)
| | - Sebastiano Barco
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analyses, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (F.P.); (S.B.); (A.C.)
| | - Alessia Cafaro
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analyses, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (F.P.); (S.B.); (A.C.)
| | - Elisabetta Amadori
- Pediatric Neurology and Muscolar Diseases Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (E.A.); (A.R.); (P.S.)
- Department of Neurosciences, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa, 16126 Genoa, Italy;
| | - Antonella Riva
- Pediatric Neurology and Muscolar Diseases Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (E.A.); (A.R.); (P.S.)
- Department of Neurosciences, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa, 16126 Genoa, Italy;
| | - Martina Marcenaro
- Department of Neurosciences, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa, 16126 Genoa, Italy;
| | - Pasquale Striano
- Pediatric Neurology and Muscolar Diseases Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (E.A.); (A.R.); (P.S.)
- Department of Neurosciences, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa, 16126 Genoa, Italy;
| | - Giuliana Cangemi
- Chromatography and Mass Spectrometry Section, Central Laboratory of Analyses, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy; (F.P.); (S.B.); (A.C.)
- Correspondence: ; Tel.: +39-(0)1056363289
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy; (R.P.); (S.P.)
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy; (R.P.); (S.P.)
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy; (S.M.); (F.P.B.)
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Tittarelli R, di Luca NM, Pacifici R, Pichini S, Del Rio A, Busardò FP. Commentary - Heroin purity and adulteration: an updated snapshot from the Italian Early Warning System. Eur Rev Med Pharmacol Sci 2021; 24:4461-4466. [PMID: 32374014 DOI: 10.26355/eurrev_202004_21028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Not Available.
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Affiliation(s)
- R Tittarelli
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy.
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Maida NL, Papaseit E, Martínez L, Pérez-Mañá C, Poyatos L, Pellegrini M, Pichini S, Pacifici R, Ventura M, Galindo L, Busardò FP, Farré M. Acute Pharmacological Effects and Oral Fluid Biomarkers of the Synthetic Cannabinoid UR-144 and THC in Recreational Users. Biology (Basel) 2021; 10:257. [PMID: 33805054 PMCID: PMC8064062 DOI: 10.3390/biology10040257] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/21/2021] [Accepted: 03/22/2021] [Indexed: 01/08/2023]
Abstract
Synthetic cannabinoids (SCs) are one of the most frequent classes of new psychoactive substances monitored by the EU Early Warning System and World Health Organization. UR-144 is a SC with a relative low affinity for the CB1 receptor with respect to that for the CB2 receptor. As with other cannabinoid receptor agonists, it has been monitored by the EU Early Warning System since 2012 for severe adverse effects on consumers. Since data for UR-144 human pharmacology are very limited, an observational study was carried out to evaluate its acute pharmacological effects following its administration using a cannabis joint as term of comparison. Disposition of UR-144 and delta-9-tetrahydrocannibinol (THC) was investigated in oral fluid. Sixteen volunteers smoked a joint prepared with tobacco and 1 or 1.5 mg dose of UR-144 (n = 8) or cannabis flowering tops containing 10 or 20 mg THC (n = 8). Physiological variables including systolic and diastolic blood pressure, heart rate and cutaneous temperature were measured. A set of Visual Analog Scales (VAS), the Addiction Research Centre Inventory (ARCI)-49-item short form version and the Evaluation of the Subjective Effects of Substances with Abuse Potential (VESSPA-SSE) were administered to evaluate subjective effects. Oral fluid was collected at baseline, 10, 20, 40 min and 1, 2, 3 and 4 h after smoking, for UR-144 or THC concentration monitoring. Results showed significant statistical increases in both systolic and diastolic blood pressure and heart rate after both UR-144 and cannabis smoking. Both substances produced an increase in VAS related to stimulant-like and high effects, but scores were significantly higher after cannabis administration. No hallucinogenic effects were observed. Maximal oral fluid UR-144 and THC concentrations appeared at 20 and 10 min after smoking, respectively. The presence of UR-144 in oral fluid constitutes a non-invasive biomarker of SC consumption. The results of this observational study provide valuable preliminary data of the pharmacological effects of UR-144, showing a similar profile of cardiovascular effects in comparison with THC but lower intensity of subjective effects. Our results have to be confirmed by research in a larger sample to extensively clarify pharmacological effects and the health risk profile of UR-144.
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Affiliation(s)
- Nunzia La Maida
- Department of Excellence of Biomedical Science and Public Health, University “Politecnica delle Marche” of Ancona, Via Tronto 71, 60124 Ancona, Italy; (N.L.M.); (F.P.B.)
| | - Esther Papaseit
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain; (E.P.); (L.M.); (C.P.-M.); (L.P.); (M.F.)
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Lucia Martínez
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain; (E.P.); (L.M.); (C.P.-M.); (L.P.); (M.F.)
- Clinical Phamacology Department, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Clara Pérez-Mañá
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain; (E.P.); (L.M.); (C.P.-M.); (L.P.); (M.F.)
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Lourdes Poyatos
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain; (E.P.); (L.M.); (C.P.-M.); (L.P.); (M.F.)
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Manuela Pellegrini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, V.Le Regina Elena 299, 00161 Rome, Italy; (S.P.); (R.P.)
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, V.Le Regina Elena 299, 00161 Rome, Italy; (S.P.); (R.P.)
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, V.Le Regina Elena 299, 00161 Rome, Italy; (S.P.); (R.P.)
| | - Mireia Ventura
- Energy Control, Associació Benestar i Desenvolupament, 08041 Barcelona, Spain; (M.V.); (L.G.)
| | - Liliana Galindo
- Energy Control, Associació Benestar i Desenvolupament, 08041 Barcelona, Spain; (M.V.); (L.G.)
- Department of Psychiatry, University of Cambridge/Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB20QQ, UK
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Science and Public Health, University “Politecnica delle Marche” of Ancona, Via Tronto 71, 60124 Ancona, Italy; (N.L.M.); (F.P.B.)
| | - Magí Farré
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain; (E.P.); (L.M.); (C.P.-M.); (L.P.); (M.F.)
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
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Messina MP, D'Angelo A, Battagliese G, Coriale G, Tarani L, Pichini S, Rasio D, Parlapiano G, Fiore M, Petrella C, Vitali M, Ferraguti G, Ceccanti M. Fetal alcohol spectrum disorders awareness in health professionals: implications for psychiatry. Riv Psichiatr 2021; 55:79-89. [PMID: 32202545 DOI: 10.1708/3333.33022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Fetal Alcohol Spectrum Disorders (FASD) are a plethora of malformative conditions leading to mental retardation that affect newborns and children who have been exposed to alcohol during pregnancy or breastfeeding. FASD is a relevant topic for public health in Europe: European area is first in ranking for alcohol use during pregnancy with a prevalence of 25.2%. Italy ranked third among European countries with higher prevalence of FASD (45.0 per 1000 population). Furthermore, FASD could still be underestimated because of numerous undiagnosed and misdiagnosed cases. Aims of the study were to briefly summarize existing evidences about FASD and its psychiatric aspects to assess knowledge, attitudes and practice towards alcohol drinking during pregnancy in an Italian sample of health care professionals in order to provide information about FASD prevention. An anonymous online questionnaire containing the AUDIT-C, T-ACE model and the Drinking Motive Questionnaire was sent to 400 Italian healthcare professionals and students. The survey included socio-demographic information, questions about drinking habits and about knowledge, attitude and practice towards alcohol assumption during pregnancy. Among 320 respondents, 96.3% were women. AUDIT-C revealed that 52.4% were low risk drinkers but 27.6% were hazardous drinkers. The 90.6% of participants denied to ever attended a course about the fetus damage induced by alcohol consumption during pregnancy but 91.3% were willing to participate to professional update initiatives on the topic. Only 19.1% of participants talk regularly about the deleterious effects for the fetus of prenatal alcohol drinking to women and only 51.1% advise the 'zero alcohol' policy. Around 41% of participants tolerates the assumption of low-alcohol beverages. No differences were found between no drinkers and low and hazardous drinkers. In conclusion, data show that only specific and continuing updating for health care professionals about drinking habits may have impactful actions to prevent gestational alcohol intake in order to prevent the main cause of mental retardation in western countries.
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Affiliation(s)
- Marisa Patrizia Messina
- Department of Gynecology, Obstetrics and Urology, Sapienza University Hospital of Rome, Italy
| | - Alessio D'Angelo
- Department of Gynecology, Obstetrics and Urology, Sapienza University Hospital of Rome, Italy
| | | | | | - Luigi Tarani
- Department of Pediatrics, Sapienza University Hospital of Rome, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | | | | | - Marco Fiore
- Institute of Biochemistry and Cell Biology, IBBC-CNR, Rome, Italy
| | - Carla Petrella
- Institute of Biochemistry and Cell Biology, IBBC-CNR, Rome, Italy
| | | | - Giampiero Ferraguti
- Department of Experimental Medicine, Sapienza University Hospital of Rome, Italy
| | - Mauro Ceccanti
- SITAC, Società Italiana per Il Trattamento dell'Alcolismo e delle sue Complicanze, Rome, Italy
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Busardò FP, Pérez-Acevedo AP, Pacifici R, Mannocchi G, Gottardi M, Papaseit E, Pérez-Mañá C, Martin S, Poyatos L, Pichini S, Farré M. Disposition of Phytocannabinoids, Their Acidic Precursors and Their Metabolites in Biological Matrices of Healthy Individuals Treated with Vaporized Medical Cannabis. Pharmaceuticals (Basel) 2021; 14:ph14010059. [PMID: 33451073 PMCID: PMC7828520 DOI: 10.3390/ph14010059] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 12/16/2022] Open
Abstract
Inhalation by vaporization is a useful application mode for medical cannabis. In this study, we present the disposition of Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), their acidic precursors, and their metabolites in serum, oral fluid, and urine together with the acute pharmacological effects in 14 healthy individuals treated with vaporized medical cannabis. THC and CBD peaked firstly in serum and then in oral fluid, with higher concentrations in the first biological matrices and consequent higher area under the curve AUCs. Acidic precursors Δ-9-tetrahydrocannabinolic acid A (THCA) and cannabidiolic acid (CBDA) showed a similar time course profile but lower concentrations due to the fact that vaporization partly decarboxylated these compounds. All THC and CBD metabolites showed a later onset with respect to the parent compounds in the absorption phase and a slower decrease to baseline. In agreement with serum kinetics, THC-COOH-GLUC and 7-COOH-CBD were the significantly most excreted THC and CBD metabolites. The administration of vaporized medical cannabis induced prototypical effects associated with the administration of cannabis or THC in humans, with a kinetic trend overlapping that of parent compounds and metabolites in serum. The pharmacokinetics of cannabinoids, their precursors, and their metabolites in biological fluids of individuals treated with vaporized medical cannabis preparations showed a high interindividual variability as in the case of oral medical cannabis decoction and oil. Inhaled medical cannabis was absorbed into the organism earlier than decoction and oil. Cannabinoids reached higher systemic concentrations, also due to the fact that the acid precursors decarboxylated to parent cannabinoids at high temperatures, and consequently, the physiological and subjective effects occurred earlier and resulted with higher intensity. No serious adverse effects were observed.
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Affiliation(s)
- Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy;
| | - Ana Pilar Pérez-Acevedo
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain; (A.P.P.-A.); (E.P.); (C.P.-M.); (S.M.); (L.P.); (M.F.)
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | | | | | - Esther Papaseit
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain; (A.P.P.-A.); (E.P.); (C.P.-M.); (S.M.); (L.P.); (M.F.)
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Clara Pérez-Mañá
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain; (A.P.P.-A.); (E.P.); (C.P.-M.); (S.M.); (L.P.); (M.F.)
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Soraya Martin
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain; (A.P.P.-A.); (E.P.); (C.P.-M.); (S.M.); (L.P.); (M.F.)
| | - Lourdes Poyatos
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain; (A.P.P.-A.); (E.P.); (C.P.-M.); (S.M.); (L.P.); (M.F.)
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy;
- Correspondence: ; Tel.: +39-0649906545
| | - Magí Farré
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), 08916 Badalona, Spain; (A.P.P.-A.); (E.P.); (C.P.-M.); (S.M.); (L.P.); (M.F.)
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain
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Trana AD, Mannocchi G, Pirani F, Maida NL, Gottardi M, Pichini S, Busardò FP. A Comprehensive HPLC-MS-MS Screening Method for 77 New Psychoactive Substances, 24 Classic Drugs and 18 Related Metabolites in Blood, Urine and Oral Fluid. J Anal Toxicol 2020; 44:769-783. [PMID: 32816015 DOI: 10.1093/jat/bkaa103] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 04/23/2020] [Accepted: 08/07/2020] [Indexed: 12/20/2022] Open
Abstract
To date, more than 800 molecules are classified as New Psychoactive Substances (NPS), and it is reported that this number increases every year. Whereas several cases of polydrug consumption that led to acute intoxication and death are reported, a lack of effective analytical screening method to detect NPS and classical drug of abuse in human matrices affects the prompt identification of the probable cause of intoxication in emergency department of hospitals. In this concern, a fast, simple and comprehensive high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS-MS) screening method to detect and quantify 77 NPS, 24 classic drugs and 18 related metabolites has been successfully developed and validated in blood, urine and oral fluid. A small volume (100 µL) of whole blood samples spiked with internal standard deuterated mixture was added to 70 µL of M3® buffer, and after precipitation of blood proteins, the supernatant was evaporated to dryness and reconstituted in 1 mL of mobile phase. Same volume (100 µL) of urine and oral fluid samples spiked with internal standard deuterated mix were only diluted with 500 µL of M3® reagent. One microliter of samples of each matrix was injected into HPLC-MS-MS equipment. The run time lasted 10 min with a gradient mobile phase. Mass spectrometric analysis was performed in positive ion multiple reaction monitoring mode. The method was linear for all analytes under investigation with a determination coefficient always better than 0.99. The calibration range for blood and oral fluid was from limits of quantification (LOQs) to 200 ng/mL, whereas that for urine was LOQs to 1000 ng/mL. Recovery and matrix effect were always higher than 80%, whereas intra-assay and inter-assay precision were always better than 19% and accuracy was always within 19% of target in every matrix. Applicability of the method was verified by analysis of samples from real cases.
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Affiliation(s)
- Annagiulia Di Trana
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, 60124, Ancona, Italy
| | - Giulio Mannocchi
- University of Camerino, Piazza Cavour 19/f, 62032, Camerino, Italy
| | - Filippo Pirani
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, 60124, Ancona, Italy
| | - Nunzia La Maida
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, 60124, Ancona, Italy
| | | | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, 60124, Ancona, Italy
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Menniti-Ippolito F, Ippoliti I, Pastorelli AA, Altieri I, Scalise F, De Santis B, Debegnach F, Brera C, Pacifici R, Pichini S, Pellegrini M, Rotolo MC, Graziano S, Palazzino G, Multari G, Gallo FR, Neri B, Giannetti L, Russo K, Fedrizzi G, Bonan S, Mazzanti G, Moro PA, Salvi E, Firenzuoli F, Valeri A, Moretti U, Traversa G, Silano M, Stacchini P, Boniglia C. Turmeric (Curcuma longa L.) food supplements and hepatotoxicity: an integrated evaluation approach. Ann Ist Super Sanita 2020; 56:462-469. [PMID: 33346172 DOI: 10.4415/ann_20_04_08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Turmeric is the common name for the rhizome of Curcuma longa L. In the recent years, food supplements containing turmeric have been marketed and widely used by an increasing number of consumers. Spontaneous reports of suspected adverse reactions to food supplements are collected within the Phytovigilance system. METHODS An ad hoc multidisciplinary group investigated the suspected cases of hepatotoxicity reported to the Italian Phytovigilance system associated with the assumption of turmeric food supplements with the methodology specific to pharmacovigilance as well as for the evaluation of the quality and safety of food supplements. RESULTS A cluster of 28 spontaneous reports of acute hepatitis, mostly with cholestasis, associated with turmeric products were sent to the Italian Phytovigilance system in the first six months of 2019. In all cases, except one, the causality assessment was at least possible. The suspected products were collected and analysed for the presence of drugs, heavy metals, aflatoxins, pesticides, synthetic dyes and pyrrolizidine alkaloids. CONCLUSION On the basis of the results of all the activities performed by multidisciplinary group, regulatory intervention was taken. This study highlights the importance of developing an integrated evaluation approach for the evaluation of the adverse effects associated with the use of food supplements.
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Affiliation(s)
- Francesca Menniti-Ippolito
- Centro Nazionale per la Ricerca e la Valutazione Preclinica e Clinica dei Farmaci, Istituto Superiore di Sanità, Rome, Italy
| | - Ilaria Ippoliti
- Centro Nazionale per la Ricerca e la Valutazione Preclinica e Clinica dei Farmaci, Istituto Superiore di Sanità, Rome, Italy
| | - Augusto Alberto Pastorelli
- Dipartimento Sicurezza Alimentare, Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Ilaria Altieri
- Dipartimento Sicurezza Alimentare, Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Francesco Scalise
- Dipartimento Sicurezza Alimentare, Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Barbara De Santis
- Dipartimento Sicurezza Alimentare, Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Francesca Debegnach
- Dipartimento Sicurezza Alimentare, Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Carlo Brera
- Dipartimento Sicurezza Alimentare, Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Roberta Pacifici
- Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Simona Pichini
- Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Manuela Pellegrini
- Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | | | - Silvia Graziano
- Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Giovanna Palazzino
- Centro Nazionale per la Ricerca e la Valutazione Preclinica e Clinica dei Farmaci, Istituto Superiore di Sanità, Rome, Italy
| | - Giuseppina Multari
- Centro Nazionale per la Ricerca e la Valutazione Preclinica e Clinica dei Farmaci, Istituto Superiore di Sanità, Rome, Italy
| | - Francesca Romana Gallo
- Centro Nazionale per la Ricerca e la Valutazione Preclinica e Clinica dei Farmaci, Istituto Superiore di Sanità, Rome, Italy
| | - Bruno Neri
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana, Rome, Italy
| | - Luigi Giannetti
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana, Rome, Italy
| | - Katia Russo
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana, Rome, Italy
| | - Giorgio Fedrizzi
- Istituto Zooprofilattico Sperimentale della Lombardia e della Emilia-Romagna, Bologna, Italy
| | - Stefania Bonan
- Istituto Zooprofilattico Sperimentale della Lombardia e della Emilia-Romagna, Bologna, Italy
| | - Gabriela Mazzanti
- Dipartimento di Fisiologia e Farmacologia "Vittorio Erspamer", Sapienza Università di Roma, Rome, Italy
| | - Paola Angela Moro
- Centro Antiveleni di Milano, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Emanuela Salvi
- Centro Nazionale per la Ricerca e la Valutazione Preclinica e Clinica dei Farmaci, Istituto Superiore di Sanità, Rome, Italy
| | - Fabio Firenzuoli
- Centro di Ricerca e Innovazione in Fitoterapia (CERFIT) dell'Azienda Ospedaliero Universitaria Careggi di Firenze, Florence, Italy
| | - Andrea Valeri
- Società Italiana di Omeopatia, Mirandola, Modena, Italy
| | - Ugo Moretti
- Dipartimento di Diagnostica e Sanità Pubblica Sezione di Farmacologia, Università degli Studi di Verona, Verona, Italy
| | | | - Marco Silano
- Dipartimento Sicurezza Alimentare, Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Paolo Stacchini
- Dipartimento Sicurezza Alimentare, Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Concetta Boniglia
- Dipartimento Sicurezza Alimentare, Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
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Malaca S, Lo Faro AF, Tamborra A, Pichini S, Busardò FP, Huestis MA. Toxicology and Analysis of Psychoactive Tryptamines. Int J Mol Sci 2020; 21:E9279. [PMID: 33291798 PMCID: PMC7730282 DOI: 10.3390/ijms21239279] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022] Open
Abstract
Our understanding of tryptamines is poor due to the lack of data globally. Tryptamines currently are not part of typical toxicology testing regimens and their contribution to drug overdoses may be underestimated. Although their prevalence was low, it is increasing. There are few published data on the many new compounds, their mechanisms of action, onset and duration of action, toxicity, signs and symptoms of intoxication and analytical methods to identify tryptamines and their metabolites. We review the published literature and worldwide databases to describe the newest tryptamines, their toxicology, chemical structures and reported overdose cases. Tryptamines are 5-HT2A receptor agonists that produce altered perceptions of reality. Currently, the most prevalent tryptamines are 5-methoxy-N,N-diisopropyltryptamine (5-MeO-DiPT), 5-methoxy-N,N- diallyltryptamine (5-MeO-DALT) and dimethyltryptamine (DMT). From 2015 to 2020, 22 new analytical methods were developed to identify/quantify tryptamines and metabolites in biological samples, primarily by liquid chromatography tandem mass spectrometry. The morbidity accompanying tryptamine intake is considerable and it is critical for clinicians and laboratorians to be informed of the latest data on this public health threat.
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Affiliation(s)
- Sara Malaca
- Department of Excellence of Biomedical Sciences and Public Health, University “Politecnica delle Marche” of Ancona, Via Tronto 10, 60126 Ancona, Italy; (S.M.); (A.F.L.F.); (A.T.)
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence of Biomedical Sciences and Public Health, University “Politecnica delle Marche” of Ancona, Via Tronto 10, 60126 Ancona, Italy; (S.M.); (A.F.L.F.); (A.T.)
| | - Alice Tamborra
- Department of Excellence of Biomedical Sciences and Public Health, University “Politecnica delle Marche” of Ancona, Via Tronto 10, 60126 Ancona, Italy; (S.M.); (A.F.L.F.); (A.T.)
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, V.Le Regina Elena 299, 00161 Rome, Italy;
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Sciences and Public Health, University “Politecnica delle Marche” of Ancona, Via Tronto 10, 60126 Ancona, Italy; (S.M.); (A.F.L.F.); (A.T.)
| | - Marilyn A. Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, 1020 Walnut St, Philadelphia, PA 19144, USA;
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50
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Buja A, Mortali C, Mastrobattista L, De Battisti E, Minutillo A, Pichini S, Grotto G, Genetti B, Vian P, Andreotti A, Baldo V, Pacifici R. Stimulant substance use and gambling behaviour in adolescents. Gambling and stimulant use. Adicciones 2020; 32:273-280. [PMID: 32677692 DOI: 10.20882/adicciones.1312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Gambling is widely recognized as an important public health problem. Despite the rising use of stimulant substances among adolescents, there are still very few studies focusing on whether adolescents' use of stimulants is associated with their gambling behaviour. Therefore, the aim of this study was to investigate the association between gambling habits and consumption of stimulants such as coffee, energy drinks, and new psychoactive substances in a sample of Italian adolescents. A survey was conducted in 2017 with a representative sample of Italians between the ages of 14-17 years, comprising 15,833 students attending 201 secondary schools. Logistic regression analyses were run to assess the association between at-risk/problem gambling (O1) and independent predictors: the model included independent variables (coffee, energy drinks and new psychoactive substance consumption) and covariates (demographic variables, social environment variables and risk-taking behaviour variables). A sensitivity analysis was also conducted to examine a second dependent variable regarding any experience of gambling behaviour (O2). Adolescents who were at-risk gamblers or problem gamblers were significantly more likely to consume energy drinks than non-gamblers or not-at-risk gamblers. A similar pattern was seen for consumption of new psychoactive substances. No significant association emerged with coffee consumption. The sensitivity analysis showed that, compared with non gamblers, the group of gamblers had higher odds for frequent coffee consumption, as well as for consumption of energy drinks and/or new psychoactive substances. Screening for gambling and stimulant use may provide important information, as it may be necessary to take action to reduce stimulant substance use as part of efforts to deal with unhealthy gambling habits.
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