Diverse Psychotropic Substances Detected in Drug and Paraphernalia Samples Submitted to Drug Checking Services in Toronto, Ontario, Canada, October 2019-April 2020

Abstract BackgroundThe opioid overdose crisis has generated innovative harm reduction and drug market monitoring strategies. In Toronto, Ontario, Canada, a multi-site drug checking service (DCS) pilot project was launched in October 2019. The project provides people who use drugs with information on the chemical composition of their substances, thereby increasing their capacity to make more informed decisions about their drug use and avoid overdose. DCS also provides real-time market monitoring to identify trends in the unregulated drug supply. MethodsSample data were obtained through analyses of drug and used paraphernalia samples submitted anonymously and free of charge to DCS in downtown Toronto from October 10, 2019 to April 9, 2020, representing the first six months of DCS implementation. Analyses were conducted in clinical laboratories using ultra high performance liquid chromatography-high resolution mass spectrometry (UPLC-HRMS), and liquid chromatography or gas chromatography-mass spectrometry (LC-MS, GC-MS) techniques. ResultsOverall, 555 samples were submitted, with 49% (271) of samples that were found to contain high-potency opioids, of which 87% (235) also contained stimulants. Benzodiazepines or related drugs were also found in 21% (116) of all samples, and synthetic cannabinoids in 1% (7) of all samples. Negative effects (including overdose) were reported for 12% (69) of samples submitted for analysis.ConclusionsToronto’s DCS identified a range of high-potency opioids with stimulants, benzodiazepines and related drugs, and a synthetic cannabinoid, AMB-FUBINACA. This information can inform a range of evidence-informed overdose prevention efforts.

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Diverse psychotropic substances detected in drug and drug administration equipment samples submitted to drug checking services in Toronto, Ontario, Canada, October 2019–April 2020

Harm Reduction Journal ◽

10.1186/s12954-021-00585-2 ◽

2022 ◽

Vol 19 (1) ◽

Author(s):

Kristy M. Scarfone ◽

Nazlee Maghsoudi ◽

Karen McDonald ◽

Cristiana Stefan ◽

Daniel R. Beriault ◽

...

Keyword(s):

Drug Administration ◽

Synthetic Cannabinoids ◽

Drug Market ◽

Pilot Project ◽

Gas Chromatography Mass Spectrometry ◽

People Who Use Drugs ◽

High Potency ◽

Psychotropic Substances ◽

Market Monitoring ◽

Drug Checking

Abstract Background The overdose crisis has generated innovative harm reduction and drug market monitoring strategies. In Toronto, Ontario, Canada, a multi-site drug checking service (DCS) pilot project was launched in October 2019. The project provides people who use drugs with information on the chemical composition of their substances, thereby increasing their capacity to make more informed decisions about their drug use and avoid overdose. DCS also provides real-time market monitoring to identify trends in the unregulated drug supply. Methods Sample data were obtained through analyses of drug and used drug administration equipment samples submitted anonymously and free of charge to DCS in downtown Toronto from October 10, 2019, to April 9, 2020, representing the first six months of DCS implementation. Analyses were conducted in clinical laboratories using liquid chromatography- and/or gas chromatography-mass spectrometry (LC–MS, GC–MS) techniques. Results Overall, 555 samples were submitted, with 49% (271) of samples that were found to contain high-potency opioids, of which 87% (235) also contained stimulants. Benzodiazepine-type drugs were found in 21% (116) of all samples, and synthetic cannabinoids in 1% (7) of all samples. Negative effects (including overdose, adverse health events, and extreme sedation) were reported for 11% (59) of samples submitted for analysis. Conclusions Toronto’s DCS identified a range of high-potency opioids with stimulants, benzodiazepine-type drugs, and a synthetic cannabinoid, AMB-FUBINACA. This information can inform a range of evidence-informed overdose prevention efforts.

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Xylazine detected in unregulated opioids and drug administration equipment in Toronto, Canada: clinical and social implications

Harm Reduction Journal ◽

10.1186/s12954-021-00546-9 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Jeanette M. Bowles ◽

Karen McDonald ◽

Nazlee Maghsoudi ◽

Hayley Thompson ◽

Cristiana Stefan ◽

...

Keyword(s):

Mass Spectrometry ◽

High Resolution Mass Spectrometry ◽

Gas Chromatography Mass Spectrometry ◽

Opioid Overdose ◽

Drug Markets ◽

Dynamic Nature ◽

The North ◽

Rapid Responses ◽

Increased Risk ◽

Drug Checking

Abstract Background The North American opioid overdose crisis is driven in large part by the presence of unknown psychoactive adulterants in the dynamic, unregulated drug supply. We herein report the first detection of the psychoactive veterinary compound xylazine in Toronto, the largest urban center in Canada, by the city’s drug checking service. Methods Toronto’s Drug Checking Service launched in October 2019. Between then and February 2021, 2263 samples were submitted for analysis. The service is offered voluntarily at harm reduction agencies that include supervised consumption services. Samples were analyzed using gas chromatography–mass spectrometry or liquid chromatography-high resolution mass spectrometry. Targeted and/or untargeted screens for psychoactive substances were undertaken. Results In September 2020, xylazine was first detected by Toronto’s Drug Checking Service. Among samples analyzed from September 2020 to February 2021 expected to contain fentanyl in isolation (610) or in combination with methamphetamine (16), xylazine was detected in 46 samples (7.2% and 12.5% of samples, respectively). Samples were predominantly drawn from used drug equipment. Three of the samples containing xylazine (6.5%) were associated with an overdose. Conclusion We present the first detection of xylazine in Toronto, North America’s fourth-largest metropolitan area. The increased risk of overdose associated with use of xylazine and its detection within our setting highlights the importance of drug checking services in supporting rapid responses to the emergence of potentially harmful adulterants. These data also highlight the clinical challenges presented by the dynamic nature of unregulated drug markets and the concomitant need to establish regulatory structures to reduce their contribution to overdose morbidity and mortality.

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Determination of the Synthetic Cannabinoids JWH-122, JWH-210, UR-144 in Oral Fluid of Consumers by GC-MS and Quantification of Parent Compounds and Metabolites by UHPLC-MS/MS

International Journal of Molecular Sciences ◽

10.3390/ijms21249414 ◽

2020 ◽

Vol 21 (24) ◽

pp. 9414

Author(s):

Nunzia La Maida ◽

Manuela Pellegrini ◽

Esther Papaseit ◽

Clara Pérez-Mañá ◽

Lourdes Poyatos ◽

...

Keyword(s):

Mass Spectrometry ◽

High Performance ◽

Oral Fluid ◽

High Resolution Mass Spectrometry ◽

Synthetic Cannabinoids ◽

Screening Method ◽

Forensic Toxicology ◽

Gas Chromatography Mass Spectrometry ◽

Limit Of Quantification

The consumption of synthetic cannabinoids (SCs) has significantly increased in the last decade and the analysis of SCs and their metabolites in human specimens is gaining interest in clinical and forensic toxicology. A pilot study has been carried out using a combination of an initial last generation gas chromatography-mass spectrometry (GC-MS) screening method for the determination of JWH-122, JWH-210, UR-144) in oral fluid (OF) of consumers and an ultra-high performance liquid chromatography high resolution mass spectrometry (UHPLC-HRMS) confirmatory method for the quantification of the parent compounds and their metabolites in the same biological matrix. OF samples were simply liquid-liquid extracted before injecting in both chromatographic systems. The developed methods have been successfully validated and were linear from limit of quantification (LOQ) to 50 ng/mL OF. Recovery of analytes was always higher than 70% and matrix effect always lower than 15% whereas intra-assay and inter-assay precision and accuracy were always better than 16%. After smoking 1 mg JWH-122 or UR-144 and 3 mg JWH-210, maximum concentration of 4.00–3.14 ng/mL JWH-122, 8.10–7.30 ng/mL JWH-210 ng/mL and 7.40 and 6.81 ng/mL UR-144 were measured by GC-MS and UHPLC-HRMS respectively at 20 min after inhalation. Metabolites of JWH 122 and 210 were quantified in OF by UHPLC-HRMS, while that of UR144 was only detectable in traces. Our results provide for the first time information about disposition of these SCs and their metabolites in consumers OF. Last generation GC-MS has proven useful tool to identify and quantify parent SCs whereas UHPLC-HRMS also confirmed the presence of SCs metabolites in the OF of SCs consumers.

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UHPLC-HRMS and GC-MS Screening of a Selection of Synthetic Cannabinoids and Metabolites in Urine of Consumers

Medicina ◽

10.3390/medicina56080408 ◽

2020 ◽

Vol 56 (8) ◽

pp. 408 ◽

Cited By ~ 2

Author(s):

Manuela Pellegrini ◽

Emilia Marchei ◽

Esther Papaseit ◽

Magí Farré ◽

Simona Zaami

Keyword(s):

Mass Spectrometry ◽

Formic Acid ◽

Mobile Phase ◽

High Performance ◽

High Resolution Mass Spectrometry ◽

Synthetic Cannabinoids ◽

Screening Method ◽

Ammonium Formate ◽

Gas Chromatography Mass Spectrometry ◽

Accurate Analysis

Background and Objectives: The use of synthetic cannabinoids has increased around the world. As a result, the implementation of accurate analysis in human biological matrices is relevant and fundamental. Two different analytical technologies, ultra-high-performance liquid chromatography-high-resolution mass spectrometry (UHPLC-HRMS) and high-sensitivity gas chromatography-mass spectrometry (GC-MS) were used for the determination of three synthetic cannabinoids JWH-122, JWH 210, UR-144 and their metabolites in urine of consumers. Materials and Methods: Sample preparation included an initial hydrolysis with β-glucuronidase and liquid-liquid extraction. The UHPLC-HRMS method included a Kinetex 2.6 u Biphenyl 100A (100 × 2.1 mm, 2.6 μm) (Phenomenex, Italy) column with a gradient mobile phase consisting of mobile phase A (ammonium formate 2mM in water, 0.1% formic acid) and mobile phase B (ammonium formate 2mM in methanol/acetonitrile 50:50 (v/v), 0.1% formic acid) and a full-scan data-dependent MS2 (ddMS2) mode was used (mass range 100–1000 m/z). The GC-MS method employed an ultra-Inert Intuvo GC column (HP-5MS UI, 30 m × 250 µm i.d, film thickness 0.25 µm; Agilent Technologies, Santa Clara, CA, USA) and electron-impact (EI) mass spectra were recorded in total ion monitoring mode (scan range 40–550 m/z). Results: Both methods have been successfully used for screening of parent synthetic cannabinoids and their metabolites in urine samples of consumers. Conclusions: The screening method applied JWH-122, JWH-210, UR-144 and their metabolites in urine of consumers can be applied to other compounds of the JWH family.

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