scholarly journals New Psychoactive Substances and Suicidality: A Systematic Review of the Current Literature

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 580
Author(s):  
Stefania Chiappini ◽  
Alessio Mosca ◽  
Andrea Miuli ◽  
Maria Chiara Santovito ◽  
Laura Orsolini ◽  
...  
Keyword(s):  
Mental Health ◽  
Synthetic Cannabinoids ◽  
Cochrane Library ◽  
New Psychoactive Substances ◽  
Psychoactive Substances ◽  
Clinical Issue ◽  
The Past ◽  
Synthetic Opioids ◽  
Online Databases ◽  
Health Related

Background and Objectives: Over the past twenty years a large number of new psychoactive substances (NPS) have entered and modified the recreational drug scene. Their intake has been associated with health-related risks, especially so for vulnerable populations such as people with severe mental illness, who might be at higher risk of suicidality or self-injurious behavior. This paper aims at providing an overview of NPS abuse and the effects on mental health and suicidality issues, by performing a literature review of the current related knowledge, thereby identifying those substances that, more than others, are linked to suicidal behaviors. Materials and Methods: A comprehensive and updated overview of the literature regarding suicidality and NPS categories has been undertaken. An electronic search was performed, including all papers published up to March 2021, using the following keywords “NPS” OR “new psychoactive substances” OR “novel psychoactive substances” OR “synthetic cannabinoids” OR “phenethylamines” OR “synthetic cathinones” OR “tryptamines” OR “piperazines” OR “new synthetic opioids” OR “designer benzodiazepines” AND (“suicide” OR “suicidality”) NOT review NOT animal on the PubMed, Cochrane Library, and Web of Science online databases. Results: Suicidality and self-injurious behavior appear to be frequently associated with some NPS such as cathinones, synthetic cannabinoids, and new synthetic opioids. The results are organized according to the substances recorded. Conclusion: The growing use of NPS has become a significant clinical issue, causing increasing concern and challenges for clinicians working in both mental health and emergency departments. Thus, considering the associations between NPS and suicidality or self-injurious behaviors, areas where suicide-prevention efforts and strategies might be focused are the early detection, monitoring, and restriction of NPS.

scholarly journals Novel Synthetic Opioids: The Pathologist’s Point of View

2018 ◽  
Vol 8 (9) ◽  
pp. 170 ◽  
Author(s):  
Paolo Frisoni ◽  
Erica Bacchio ◽  
Sabrine Bilel ◽  
Anna Talarico ◽  
Rosa Gaudio ◽  
...  
Keyword(s):  
Synthetic Cannabinoids ◽  
Point Of View ◽  
New Psychoactive Substances ◽  
Psychoactive Substances ◽  
Synthetic Drugs ◽  
Synthetic Opioids ◽  
Opioid Intoxication ◽  
Fentanyl Analogs ◽  
The Central Nervous System ◽  
Novel Synthetic Opioids

Background: New Psychoactive Substances (NPS) constitute a broad range of hundreds of natural and synthetic drugs, including synthetic opioids, synthetic cannabinoids, synthetic cathinones, and other NPS classes, which were not controlled from 1961 to 1971 by the United Nations drug control conventions. Among these, synthetic opioids represent a major threat to public health. Methods: A literature search was carried out using public databases (such as PubMed, Google Scholar, and Scopus) to survey fentanyl-, fentanyl analogs-, and other synthetic opioid-related deaths. Keywords including “fentanyl”, “fentanyl analogs”, “death”, “overdose”, “intoxication”, “synthetic opioids”, “Novel Psychoactive Substances”, “MT-45”, “AH-7921”, and “U-47700” were used for the inquiry. Results: From our literature examination, we inferred the frequent implication of fentanyls and synthetic opioids in side effects, which primarily affected the central nervous system and the cardiovascular and pulmonary systems. The data showed a great variety of substances and lethal concentrations. Multidrug-related deaths appeared very common, in most reported cases. Conclusions: The investigation of the contribution of novel synthetic opioid intoxication to death should be based on a multidisciplinary approach aimed at framing each case and directing the investigation towards targeted toxicological analyses.

scholarly journals Molecular Networking: A Useful Tool for the Identification of New Psychoactive Substances in Seizures by LC–HRMS

2020 ◽  
Vol 8 ◽  
Author(s):  
Flaminia Vincenti ◽  
Camilla Montesano ◽  
Francesca Di Ottavio ◽  
Adolfo Gregori ◽  
Dario Compagnone ◽  
...  
Keyword(s):  
Natural Product ◽  
Illicit Drugs ◽  
Synthetic Cannabinoids ◽  
New Psychoactive Substances ◽  
Nmr Analysis ◽  
Psychoactive Substances ◽  
Molecular Networking ◽  
Fentanyl Analogs ◽  
Global Concern ◽  
Product Search

New Psychoactive Substances (NPS) are a global concern since they are spreading at an unprecedented rate. Despite their commerce still being limited compared to traditional illicit drugs, the identification of NPS in seizures may represent a challenge because of the variety of possible structures. In this study we report the successful application of molecular networking (MN) to identify unexpected fentanyl analogs in two seizures. The samples were extracted with 1 mL of methanol and analyzed with an untargeted data-dependent acquisition approach by LC–HRMS. The obtained data were examined using the MN workflow within the Global Natural Product Search (GNPS). A job was submitted to GNPS by including both seizures and standard mixtures containing synthetic cannabinoids and fentanyls raw files; spectra obtained from standards were used to establish representative networks for both molecular classes. All synthetic cannabinoids in the mixture were linked together resulting in a molecular network despite their different fragmentation spectra. Looking at fentanyls, all the molecules with the typical 188.143 and 105.070 fragments were combined in a representative network. By exploiting the standard networks two unexpected fentanyls were found in the analyzed seizures and were putatively annotated as para-fluorofuranylfentanyl and (iso)butyrylfentanyl. The identity of these two fentanyl analogs was confirmed by NMR analysis. Other m/z ratios in the seizures were compatible with fentanyl derivatives; however, they appeared to be minor constituents, probably impurities or synthetic byproducts. The latter might be of interest for investigations of common fingerprints among different seizures.

Screening of 104 New Psychoactive Substances (NPS) and Other Drugs of Abuse in Oral Fluid by LC–MS-MS

2020 ◽  
Vol 44 (7) ◽  
pp. 697-707
Author(s):  
Kelly Francisco da Cunha ◽  
Karina Diniz Oliveira ◽  
Marilyn A Huestis ◽  
Jose Luiz Costa
Keyword(s):  
Oral Fluid ◽  
Drugs Of Abuse ◽  
Matrix Effects ◽  
Synthetic Cannabinoids ◽  
Screening Method ◽  
Simultaneous Detection ◽  
New Psychoactive Substances ◽  
Major Public Health Problem ◽  
Psychoactive Substances ◽  
Wide Range

Abstract New psychoactive substances (NPS) are a major public health problem, primarily due to the increased number of acute poisoning cases. Detection of these substances is a challenge. The aim of this research was to develop and validate a sensitive screening method for 104 drugs of abuse, including synthetic cannabinoids, synthetic cathinones, fentanyl analogues, phenethylamines and other abused psychoactive compounds (i.e., THC, MDMA, LSD and their metabolites) in oral fluid by liquid chromatography–tandem mass spectrometry (LC–MS-MS). The Quantisal™ oral fluid device was used to collect oral fluid samples. The oral fluid–elution buffer mixture (500-μL sample) was extracted with t-butyl methyl ether, and chromatographic separation was performed on a Raptor™ biphenyl column (100 × 2.1 mm ID, 2.7 μm), with a total run time of 13.5 min. Limits of detection were established at three concentrations (0.05, 0.1 or 1 ng/mL) for most analytes, except for acetyl norfentanyl and mescaline (5 ng/mL). Matrix effects were generally <20% and overall extraction recoveries >60%. The highest matrix effect was observed within the synthetic cannabinoid group (PB22, −55.5%). Lower recoveries were observed for 2C-T (47.2%) and JWH-175 (58.7%). Recoveries from the Quantisal™ device were also evaluated for all analytes (56.7–127%), with lower recoveries noted for 25I-NBOMe, valerylfentanyl and mCPP (56.7, 63.0 and 69.9%, respectively). Drug stability in oral fluid was evaluated at 15, 60 and 90 days and at 25, 4 and −20°C. As expected, greater stability was observed when samples were stored at −20°C, but even when frozen, some NPS (e.g., synthetic cannabinoids) showed more than 20% degradation. The method was successfully applied to the analysis of seven authentic oral fluid samples positive for 17 different analytes. The method achieved good sensitivity and simultaneous detection of a wide range of NPS.

Development of legal highs

2015 ◽  
Vol 11 (02) ◽  
pp. 128-137 ◽  
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.

New psychoactive substances: Current health-related practices and challenges in responding to use and harms in Europe

2017 ◽  
Vol 40 ◽  
pp. 84-92 ◽  
Author(s):  
Alessandro Pirona ◽  
Alessandra Bo ◽  
Dagmar Hedrich ◽  
Marica Ferri ◽  
Nadine van Gelder ◽  
...  
Keyword(s):  
New Psychoactive Substances ◽  
Psychoactive Substances ◽  
Current Health ◽  
Health Related

Recent bionalytical methods for the determination of new psychoactive substances in biological specimens

Bioanalysis ◽  
2020 ◽  
Vol 12 (21) ◽  
pp. 1557-1595
Author(s):  
Ana Y Simão ◽  
Mónica Antunes ◽  
Hernâni Marques ◽  
Tiago Rosado ◽  
Sofia Soares ◽  
...  
Keyword(s):  
Acute Toxicity ◽  
Analytical Methods ◽  
Synthetic Cannabinoids ◽  
New Psychoactive Substances ◽  
Screening Methods ◽  
Psychoactive Substances ◽  
Clinical Action ◽  
One Step ◽  
Preparation Techniques

One of the problems associated with the consumption of new psychoactive substances is that in most scenarios of acute toxicity the possibility of quick clinical action may be impaired because many screening methods are not responsive to them, and laboratories are not able to keep pace with the appearance of new substances. For these reasons, developing and validating new analytical methods is mandatory in order to efficiently face those problems, allowing laboratories to be one step ahead. The goal of this work is to perform a critical review regarding bionalytical methods that can be used for the determination of new psychoactive substances (phenylethylamines, cathinones, synthetic cannabinoids, opioids, benzodiazepines, etc), particularly concerning sample preparation techniques and associated analytical methods.

scholarly journals Streets of the ‘spice zombies’: Dependence and poverty stigma in times of austerity

2019 ◽  
Vol 16 (1) ◽  
pp. 97-113 ◽  
Author(s):  
Liviu Alexandrescu
Keyword(s):  
Synthetic Cannabinoids ◽  
Public Spaces ◽  
Cultural Analysis ◽  
New Psychoactive Substances ◽  
The Political ◽  
Psychoactive Substances ◽  
Political Discourses ◽  
The United Kingdom ◽  
The Poor ◽  
National Media

Following the 2016 general ban on new psychoactive substances, synthetic cannabinoids (‘spice’-type drugs) have moved into unregulated street markets and have become popular among homeless populations in the United Kingdom. Images of so-called ‘spice zombies’, rough sleepers in public spaces experiencing severe substance-induced fits, have been used by local and national media to suggest the growing scale of the problem. This article proposes that such depictions should be read through a cultural analysis rooted in the political economy of austerity policies, where the twofold stigma of substance and welfare dependencies directs guilt at the poor, concealing the systemic cruelty of benefits reforms. Through the circulation of such tropes and the ridiculing of a superfluous abject underclass that embodies them, media and political discourses of the ‘broken society’ highlight an evident need for welfare reduction and more generally for the austerity project.

MT-45: A new, dangerous legal high

2014 ◽  
Vol 10 (5) ◽  
pp. 301 ◽  
Author(s):  
Maurizio Coppola, MD ◽  
Raffaella Mondola, MD
Keyword(s):  
Prescription Drugs ◽  
Synthetic Cannabinoids ◽  
Epidemiological Data ◽  
New Psychoactive Substances ◽  
Psychoactive Substances ◽  
Legal Highs ◽  
Smart Drugs ◽  
Research Chemicals ◽  
Medical Emergencies ◽  
Legal High

Epidemiological data confirm that the use of new psychoactive substances is on the rise around the world.1 Numerous reports have described medical emergencies associated with the consumption of unconventional drugs of misuse bought in “head” or “smart” shops or online.1 New psychoactive substances, also referred as “legal highs,” “smart drugs,” or “research chemicals,” are a large group of both plant derivatives and synthetic compounds, also in combination, purposefully designed as legal alternatives to illicit substances of abuse. The most popular and widely-spread new psychoactive substances are synthetic cannabinoids and synthetic cathinones, however, various different compounds such as amphetamine-like molecules, arylcyclohexylamines, synthetic hallucinogens, prescription drugs and hormones have been found in recreational products marketed as legal highs.1

scholarly journals New psychoactive substances: psychiatrist's view

2019 ◽  
pp. 57-67
Author(s):  
Andrey Viktorovich Antsyborov ◽  
Irina Vladimirovna Dubatova
Keyword(s):  
Opioid Receptors ◽  
Psychotic Disorders ◽  
Synthetic Cannabinoids ◽  
Designer Drugs ◽  
New Psychoactive Substances ◽  
Psychoactive Substances ◽  
Gaba A ◽  
Psychoactive Effects ◽  
Legal High ◽  
Derivatives Of

Appearing not long ago, new psychoactive substances (designer drugs), including synthetic cannabinoids, derivatives of cathinone, phenethylamines, new stimulants, synthetic opioids, tryptamine derivatives, phencyclidine, piperazine, the GABA (A/B) receptors agonists, have become a serious problem for consumers and for physicians. Consumers of these substances are attracted primarily by the intensity of psychoactive effects, and the «legal high» declared by the black manufacturers, which indicates that significant difficulties in a laboratory identification of new surfactants. Designer drugs, when ingested, can be influenced on many neurotransmitter pathways/receptors: dopamine, cannabinoid (CB1), GABA (A/B), 5-HT2A, glutamate, and k-opioid receptors (KOR), the imbalance of which leads to the development of polymorphic psychotic disorders.

scholarly journals Toward the Interpretation of Positive Testing for Fentanyl and Its Analogs in Real Hair Samples: Preliminary Considerations

2020 ◽  
Vol 44 (4) ◽  
pp. 362-369 ◽  
Author(s):  
A Salomone ◽  
R Bigiarini ◽  
J J Palamar ◽  
C McKnight ◽  
L Vinsick ◽  
...  
Keyword(s):  
High Performance ◽  
Synthetic Cannabinoids ◽  
Mean Value ◽  
New Psychoactive Substances ◽  
Heroin Use ◽  
Synthetic Opioids ◽  
Starting Point ◽  
Hair Samples ◽  
Multiple Drugs ◽  
Hair Testing

Abstract The detection of new psychoactive substances (NPS) in hair has become extensively researched in recent years. Although most NPS fall into the classes of synthetic cannabinoids and designer cathinones, novel synthetic opioids (NSO) have appeared with increasing frequency in the illicit drug supply. While the detection of NSO in hair is now well documented, interpretation of results presents several controversial issues, as is quite common in hair analysis. In this study, an ultra-high-performance liquid chromatography-tandem mass spectrometry method able to detect 13 synthetic opioids (including fentanyl analogs) and metabolites in hair was applied to 293 real samples. Samples were collected in the USA between November 2016 and August 2018 from subjects who had reported heroin use in the past year or had already tested positive to hair testing for common opiates. The range, mean and median concentrations were calculated for each analyte, in order to draw a preliminary direction for a possible cut-off to discriminate between exposure to either low or high quantities of the drug. Over two-thirds (68%) of samples tested positive for fentanyl at concentrations between LOQ and 8600 pg/mg. The mean value was 382 pg/mg and the median was 95 pg/mg. The metabolites norfentanyl and 4-ANPP were also quantified and were found between LOQ and 320 pg/mg and between LOQ and 1400 pg/mg, respectively. The concentration ratios norfentanyl/fentanyl, 4-ANPP/fentanyl and norfentanyl/4-ANPP were also tested as potential markers of active use and to discriminate the intake of fentanyl from other analogs. The common occurrence of samples positive for multiple drugs may suggest that use is equally prevalent among consumers, which is not the case, as correlations based on quantitative results demonstrated. We believe this set of experimental observations provides a useful starting point for a wide discussion aimed to better understand positive hair testing for fentanyl and its analogs in hair samples.

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