New methodologies for faster study of new psychoactive substances: A proposal

IntroductionNew psychoactive substances (NPS) are substances that have recently become available, and are not worldwide regulated. They often intend to mimic the effect of controlled drugs, becoming a public health concern. In 2014, 101 substances were reported for the first time in the EU, which may require to be studied and risk-assessed by the scientific community. The EMCDDA recognizes it as an emerging topic where research is most needed, as the scientific community is struggling to keep pace with the speed at which new substances appear. On the one hand, case reports and internet-based surveys are quickly published but do not provide enough evidence to guide clinical decisions. On the other hand, classical high-reliability methodologies such as Cohort and Clinical studies take too long and their cost is too high to be of much use for the study of NPS. We propose an intermediate methodology to tackle this unmet need.RationaleGonzález and colleagues described a set of highly educated, experimental users of NPS with extensive knowledge and consumption of substances. These users usually look for drug checking of the substances they intend to consume. We suggest we could benefit from the collaboration of such users, and the possibility of obtaining analytical confirmation, to retrieve information about NPS in a quick and reliable fashion.Outline of methodologyRecluting of subjects that submit NPS to a drug checking facility. Analysis of the samples for analytical confirmation. Check inclusion criteria and propose inclusion in the study. Give structured forms for reporting effects and adverse events.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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“Flakka”: an Emerging Trend Or a Mass Media Phenomenon? Presence of alpha-pvp in Samples Submitted To a Drug Checking Facility

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1609 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S442-S442 ◽

Cited By ~ 1

Author(s):

M. Grifell ◽

P. Quintana ◽

M. Torrens ◽

a. Palma ◽

L. Galindo ◽

...

Keyword(s):

Trend Analysis ◽

Significant Proportion ◽

Drug Market ◽

Gas Chromatography Mass Spectrometry ◽

New Psychoactive Substances ◽

Energy Control ◽

Controlled Drugs ◽

Noradrenaline Reuptake ◽

Drug Checking ◽

Competing Interest

IntroductionNew psychoactive substances (NPS) are drugs that have recently become available, are not worldwide regulated, and often intend to mimic the effect of controlled drugs. α-Pyrrolidinopentiophenone ( alpha-PVP) is a potent stimulant cathinone that is thought to act inhibiting dopamine and noradrenaline reuptake. It has been associated with hallucinations, psychosis and death.ObjectivesTo explore the presence of alpha-PVP from the samples handled to, and analyzed by energy control.To determine whether it is a new trend in recreational settings.Methodsall samples presented to energy control were analyzed.Samples in which alpha-PVP was detected using Gas Chromatography-Mass Spectrometry were selected for study.a Google trend analysis was also performed to asses the media impact of alpha-PVP.ResultsFrom a total of 20,062 samples, 33 contained alpha-PVP (0.16%). The samples containing alpha-PVP were mostly sold as such (40%) despite a significant proportion being sold as MDM a (15%). Google trend analysis showed an abrupt increase of alpha-PVP searches in 2015 reaching 50% of the MDM a-ones.ConclusionOur results suggest presence of alpha-PVP in the drug market may be increasing, especially as adulterant of other drugs. Severe side effects might be even more serious considering that a significant proportion of users may ignore which substance they are actually using. However, the total amount of alpha-PVP analyzed remains small, and does not support the alarming reports published in media.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Presence of 2,5-dimethoxy-4-bromoamphetamine (DOB) among samples brought for drug checking in Spain

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.355 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S171-S171

Author(s):

P. Quintana-Mathé ◽

M. Grifell-Guardia ◽

Á. Palma-Conesa ◽

C. Gil-Lladanosa ◽

I. Fornís-Espinosa ◽

...

Keyword(s):

World Wide ◽

Drug Market ◽

Gas Chromatography Mass Spectrometry ◽

New Psychoactive Substances ◽

Agonist Activity ◽

Psychoactive Substances ◽

Energy Control ◽

Governmental Organization ◽

Drug Checking ◽

Competing Interest

IntroductionNew Psychoactive Substances (NPS) appear to be increasing in popularity because they mimic the effect of traditional drugs. DOB is a world-wide controlled phenethylamine, with agonist activity in 5HT2A receptors. Its effects are comparable to those of LSD, with dosage range 1.0–3.0 mg and duration 18–30 h.ObjectiveTo assess the presence of DOB in the substances submitted to, and analyzed by, energy control.Materials and methodsAll samples presented to Energy Control (EC) from August 2009 to August 2015 were analyzed. EC is a spanish harm-reduction non governmental organization that offers to users the possibility of analyzing the substances they intend to consume. Samples in which DOB was detected using gas chromatography-mass spectrometry were selected for this study.ResultsFrom a total of 20,062 samples, 13 contained DOB (0,06%), with no clear variations among the years studied. The samples were mostly sold as DOC(8), DOB(2) and LSD(2). Nine out of total 13 samples presented as blotter.ConclusionResults suggest that availability of DOB in the Spanish drug market is anecdotic. Nonetheless, a number of the samples containing DOB were not sold as such, increasing the possibility of side effects, as users may ignore which substance they are actually using. When a patient presents at an Emergency Department with persistent hallucinogenic symptomatology after ingesting a blotter, psychiatrist should be aware of long-lasting psychedelics such as DOB.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Development of legal highs

Journal of Psychiatric Intensive Care ◽

10.1017/s1742646415000011 ◽

2015 ◽

Vol 11 (02) ◽

pp. 128-137 ◽

Cited By ~ 1

Author(s):

Brenda Wasunna ◽

Emily Thomas ◽

Sally Morgan

Keyword(s):

Mental Health ◽

Health Effect ◽

Psychiatric Services ◽

Drug Control ◽

New Psychoactive Substances ◽

Psychoactive Substances ◽

Legal Highs ◽

Controlled Drugs ◽

Research Chemicals ◽

Herbal Highs

AbstractNew psychoactive substances (NPS) or ‘legal highs’ are defined as unregulated psychoactive substances including synthetic and/or plant derived substances (marketed as research chemicals, party pills and herbal highs) that are intended to mimic the effects of controlled drugs. Psychiatric services around the country are seeing a rise in the use of NPS complicating mental health presentations. The challenge surrounding these substances is the fact that they are not under the international drug control system and are proving to have a detrimental health effect on users. This article reviews the current literature on this subject and discusses some of the most common examples of NPS and their potential effects on mental health.

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Presence and evolution of a new psychoactive tryptamines branch

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.131 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S117-S118

Author(s):

Á. Palma Conesa ◽

L. Galindo Guarin ◽

M. Grifell Guardia ◽

P. Quintana Mathe ◽

C. Gil Lladanosa ◽

...

Keyword(s):

Mass Spectrometry ◽

Gas Chromatography ◽

Subjective Experience ◽

Scientific Evidence ◽

Gas Chromatography Mass Spectrometry ◽

New Psychoactive Substances ◽

Psychoactive Substances ◽

Energy Control ◽

Competing Interest ◽

Recreational Use

IntroductionNew psychoactive substances (NPS) are substances that have recently appeared on the market and are not under international control. NPS use is experiencing an unprecedented increase. DiPT, 4-HO-DiPT and 4-AcO-DiPT are new psychoactive tryptamines and their effects may differ from those of other psychoactive tryptamines.ObjectiveTo explore the presence of DiPT, 4-HO-DiPT and 4-AcO-DiPT from samples delivered to and analyzed by Spanish harm reduction service Energy Control.Materials and methodsAll samples analyzed from 2009 to 2014 delivered as DiPT, 4-HO-DiPT and 4-AcO-DPT or containing these substances. Analysis was performed by gas chromatography–mass spectrometry.ResultsFrom 17,432 samples, 4-HO-DiPT was found in 16, delivered as 4-HO-DiPT (6); 4-AcO-DiPT (7); DiPT (1); 4-AcO-DMT (1) and cocaine (1). 4-AcO-DiPT was found in 16, delivered as 4-AcO-DiPT (12); 5-MeO-DMT (1); 5-MeO-DiPT (1); 4-AcO-DMT (1) and cocaine (1). Only 4 samples contained DiPT, all presented as DiPT. Nine samples contained both 4-AcO-DiPT and 4-HO-DiPT. During the years of study, 4-HO-DiPT deliverance was increasing (4 samples in 2014) while deliverance of 4-AcO-DiPT and DiPT was decreasing (1 sample in 2014).ConclusionsIncreasing 4-HO-DiPT presence could translate a progressive replacement of 4-AcO-DiPT and DiPT recreational use. Clinical relevance comes from its growing use and the absence of scientific evidence on humans, therefore relying on users subjective experience to predict the effects.Disclosure of interestThe authors declare that they have no competing interest.

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Discriminative Characteristics of Marginalised Novel Psychoactive Users: a Transnational Study

International Journal of Mental Health and Addiction ◽

10.1007/s11469-019-00128-8 ◽

2019 ◽

Vol 18 (4) ◽

pp. 1128-1147

Author(s):

Katalin Felvinczi ◽

Annemieke Benschop ◽

Róbert Urbán ◽

Marie Claire Van Hout ◽

Katarzyna Dąbrowska ◽

...

Keyword(s):

Public Health ◽

Substance Use ◽

Drug Use ◽

Online Community ◽

Drug Users ◽

Decisive Role ◽

European Countries ◽

Health Concern ◽

New Psychoactive Substances ◽

Controlled Drugs

Abstract New psychoactive substances (NPS) continue to be considered as a major public health concern in many European countries. The study was implemented within the framework of a transnational project of six European countries (Germany, Hungary, Ireland, Netherlands, Poland, Portugal). Our aim here is to report on the distinct and differentiating characteristics of marginalised NPS users. Three subgroups of a total of 3023 adult NPS users (socially marginalised, night life, online community) were examined regarding their socio-demographic characteristics, substance use, and external motives towards NPS use. Poland and Hungary reported higher rates of NPS use in comparison to traditional controlled drugs. The external/contextual motives did not play a central role in the background of NPS use, the least important motives were alleged legality and non-detectability of these substances. Marginalised (defined as those accessing low threshold harm reduction services) users’ substance use patterns are different from the other two groups in terms of showing more intense and riskier drug use. The most important variables which contributed to be categorised as a marginalised NPS user were lower level education, being older, having an unfavourable labour market position and using drugs intravenously. Contextual motives did not play a decisive role in being categorised as a marginalised user when drug use pattern was controlled. These identified discriminative features of marginalised drug users should inform policy makers to develop and implement tailor-made interventions targeting this user group to successfully tackle the elevated public health concerns associated with NPS use.

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The synthetic cannabinoids: JWH, four years of analysis

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.123 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S115-S116 ◽

Cited By ~ 1

Author(s):

L. Galindo ◽

M. Grifell ◽

P. Quintana ◽

A. Palma ◽

J. Tirado ◽

...

Keyword(s):

Cannabinoid Receptors ◽

Scientific Evidence ◽

Synthetic Cannabinoids ◽

Gas Chromatography Mass Spectrometry ◽

New Psychoactive Substances ◽

Psychoactive Substances ◽

Legal Highs ◽

Energy Control ◽

Competing Interest ◽

Herbal Mixtures

IntroductionSince 2004, herbal mixtures for smoking use have been sold under the generic brand “Spice”. Many of them contain synthetic cannabinoids (agonists of the cannabinoid receptors). JWH-018 was one of the first spice drugs. There is no scientific evidence of their effects on humans, except cases of intoxications and users opinions.ObjectiveThe present study describes the presence of the synthetic cannabinoids JWH's and their characteristics in the samples delivered for analysis to the harm reduction NGO Energy Control from 2010 to 2014 in Spain.MethodsFrom 15,814 samples analyzed from 2010 to 2014, those containing synthetic cannabinoids JWH's were studied (n = 47). Analysis was done by gas chromatography–mass spectrometry.ResultsFrom these 47 samples containing JWH, 55% were delivered as “legal highs” (n = 21) and 44% as JWH. Most common presentations were powder 47% and herbals 32%. Samples containing JWH 45%(n = 21) were mixed with more than one kind of JWH or were adulterated and other active principles were found 28% (n = 13) JWH-018, 11% (n = 5) JWH-210, 8% (n = 4) JWH-081 and the 6% WH-250 (n = 3). Origin of the sample was Catalunya 23% (n = 11), other provinces of Spain 46% (n = 22); other EU countries 23% (n = 11) and internet-unknown country 8% (n = 8). From the (n = 47) samples, were delivered (n = 16) in 2012, (n = 12) in 2013, (n = 11) in 2011, (n = 3) in 2010 and (n = 3) in 2014.ConclusionJWH'S represent a low percentage of new psychoactive substances analyzed. Its presence in the market seems decreasing.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Behavioral disorders and new psychoactive substances abuse, a French case series

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1050 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S307-S307 ◽

Cited By ~ 1

Author(s):

M. Marillier ◽

A. Batisse ◽

C. Chevallier ◽

S. Djezzar

Keyword(s):

Psychiatric Disorder ◽

Behavioral Disorders ◽

Stab Wound ◽

Case Series ◽

New Psychoactive Substances ◽

Psychoactive Substances ◽

Sexual Practice ◽

The Past ◽

French Case ◽

Competing Interest

IntroductionRange of drugs has largely increased the past few years, especially with the emergence of the New Psychoactive Substances (NPS) sold online. In front of serious risks they cause on human health, they are more and more regulated by the law.ObjectivesTo describe cases of extreme behavioral disorders and highlight risks of potential forensic complications linked to these consumptions.MethodsWe present a case series of serious auto or hetero-aggressive behavioral disorders related to NPS abuse and notified to the Parisian addictovigilance center.ResultsTwenty cases were identified between 2010 and 2015. Users were exclusively men, with mean age of 35.5 years (min: 20, max: 51). Synthetic cathinones are the predominant class of reported NPS (65%). An association between NPS and sexuality is found in 60% of cases (12); among them cathinones are used by 11 men. We observed 6 deaths among which, 5 were associated to sexual practice. Two cases of consumptions of cathinones induced torture and barbarian acts. Concerning aggressive behavioral disorders, we quote 3 cases of hetero-aggressivity (one by stab wound and 2 others developed an hypersexuality ± exhibitionism) and 9 cases of auto-aggressivity characterized by genital mutilations (1), defenestration (3), suicidal attempt (3), and acute psychiatric disorder with endangering life (2). Only four cases have been confirmed by toxicological analysis.ConclusionBehavioral disorders inducing forensics complications exist with NPS and particularly with cathinones. The problematic is certainly undervalued. A collaboration between addictovigilance and forensic services has to be improved.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Pharmacotherapy of Patients Taking New Psychoactive Substances: A Systematic Review and Analysis of Case Reports

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.669921 ◽

2021 ◽

Vol 12 ◽

Author(s):

Michal Ordak ◽

Aleksandra Zmysłowska ◽

Miłosz Bielski ◽

Daniel Rybak ◽

Maja Tomaszewska ◽

...

Keyword(s):

Case Reports ◽

Synthetic Cannabinoids ◽

Muscle Relaxants ◽

New Psychoactive Substances ◽

Psychoactive Substances ◽

Psychomotor Agitation ◽

Time Period ◽

The World ◽

Research Chemicals ◽

Herbal Highs

Background: In recent years, an increase in the frequency of hospitalizations of patients taking newer and newer psychoactive substances has been observed around the world. Each year, authors publish case reports of patients who consumed previously unknown NPS. Most publications of this type concern the period between 2014 and 2016. However, no publication systematically reviews the pharmacotherapy used in these cases. This study aims to review the case reports of patients taking NPS published between 2010 and 2019, as well as analyzing the pharmacotherapy used.Methods: We searched the Thomson (Web of Knowledge), PubMed/Medline, Science Direct, Scopus and Google Scholar databases. The search was performed using all possible combinations of the term “case report” describing the use of NPS, also referred to as designer medications, internet medications, research chemicals and herbal highs.Results: We analyzed 51 case reports on the intake of various types of NPS. Most of them (p < 0.001) concerned the use of synthetic cannabinoids (41.2%) and cathinones (31.4%). The pharmacotherapy applied primarily (p < 0.001) consisted of administering benzodiazepines to patients (62.7%), most of whom took only this group of medications (25.5%), followed by groups receiving benzodiazepines combined with neuroleptics (15.7%) and muscle relaxants (11.8%). Opioids were administered primarily to patients taking synthetic opioids (p < 0.001). Of the 5 cases of deaths from NPS reported in the literature, three relate specifically to the synthetic opioid MT-45. The later the time period, the more medications patients were administered (p = 0.02).Conclusion: In the pharmacotherapy for NPS poisoning, one should focus primarily on combating psychomotor agitation.

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DATA OF ILLEGAL SUBSTANCE USE IN ROMANIA PROVIDED BY N.A.A. COMPARED WITH THE ANALYSIS OF INDICTMENTS PREPARED BY D.I.I.C.O.T. ORADEA

Social Research Reports ◽

10.33788/srr13.1.2 ◽

2021 ◽

Vol 13 (1) ◽

pp. 18-29

Author(s):

Rares Traian BUSTEAN ◽

Adrian HATOS

Keyword(s):

Substance Use ◽

Organized Crime ◽

Scientific Community ◽

Reliable Data ◽

New Psychoactive Substances ◽

Psychoactive Substances ◽

Prevalence Estimation ◽

Research Activities ◽

Sensitive Issue ◽

Drug Agency

Drug use and New Psychoactive Substances (NPS) use are a sensitive issue due to the consequences that those who admit having this habit may expect to suffer. Part of the scientific community recommends that quantitative descriptions on this topic be verified or possibly supplemented by data obtained from research activities that use more reliable data and methods. In Romania, the prevalence estimation of drug and NPS use is performed by the National Anti – Drug Agency by conducting two studies, one every three years and another conducted every four years, respectively. In order to analyze the accuracy of the results presented in the reports prepared by the National Anti – Drug Agency, in this article we compared these results with those resulted from the analysis of the indictments issued by the Directorate for Investigation of Organized Crime and Terrorism – Oradea Territorial Service in 2013 – 2019. As a result of this comparison, it was found that there are certain significant differences between the information contained in the two data.

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