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

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.

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.

The synthetic cannabinoids: JWH, four years of analysis

2016 ◽  
Vol 33 (S1) ◽  
pp. S115-S116 ◽  
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.

scholarly journals New psychoactive substances: Challenges

2020 ◽  
Vol 7 (3) ◽  
pp. 983-990
Author(s):  
Katarina Crnić ◽  
Mira Kovačević
Keyword(s):  
Synthetic Cannabinoids ◽  
Epidemiological Data ◽  
Physical Symptoms ◽  
New Psychoactive Substances ◽  
Psychoactive Substances ◽  
Diagnostic Laboratory ◽  
Psychotropic Substances ◽  
The Usa ◽  
The Individual ◽  
New Strategies

Introduction: The United Nation Office of Drugs and Crime (UNODC) defines "new psychoactive substances" (NPS) as substances for abuse that are not under the control of the 1961 Convention on Narcotic Drugs or the 1971 Convention on Psychotropic Substances, but may constitute the definition of a group of different substances, which have been developing very rapidly since 2000 and are difficult to identify due to frequent changes in pharmacological and toxicological properties.The health risk assessment of consumers has been insufficiently researched.The use of NPS is reaching epidemic proportions worldwide and poses an increasing danger to the individual and public health. There are several basic groups of NPS, according to their chemical composition and pharmacological properties. All NPS cannot be safely differentiated according to these groups, and their effects, potency and risk profile are not similar to the substances from which they are derived. The highest percentage of abused NPS is from the group of synthetic cathinones and synthetic cannabinoids. Clinicaly, NPS abuse is categorized as acute intoxications, which is more common, because NPS is most often used on certain occasions (outings, musical events) or as an addiction. Acute intoxications with different types of NPS are severe, with numerous mental and physical symptoms, often life-threatening and with fatal outcomes. Adequate diagnosis is uncertain, diagnostic laboratory tests for drugs are generally not applicable to NPS. Symptomatic internal medicine and psychiatric therapy are used in the treatment because there are no specific antidotes, except for the group of synthetic opioids, (naltrexone). Patients with more serious complications are taken care of in intensive care units. Addiction to certain types of NPS is diagnosed and treated according to the principles of treatment of addiction to already known drugs. Methods: The paper presents an overview of available foreign and domestic literature and experiences of various authors on the topic of NPS from the previous 10 years, as well as the latest reports of regulatory bodies in the USA and Europe, in charge of monitoring epidemiological data on NPS. Topic: The main goal of the paper is to draw the attention of the professional public to the problem of the epidemic wave of new psychoactive substances in the world, as well as significant amounts of knowledge and experience and developing new strategies for registration, monitoring, diagnosis and treatment of abuses and dependence on these substances. Conclusion: These facts impose the need to raise the vigilance of the health and legal system according to the presence of NPS on the market and the prevalence of use in the population, their health risks, as well as connecting with European organizations for monitoring NPS and developing new strategies for their control and prevention.

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

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.

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.

scholarly journals What about “Pharming”? Issues Regarding the Misuse of Prescription and Over-the-Counter Drugs

2020 ◽  
Vol 10 (10) ◽  
pp. 736
Author(s):  
Stefania Chiappini ◽  
Fabrizio Schifano
Keyword(s):  
Prescription Drugs ◽  
First Generation ◽  
Drug Misuse ◽  
New Psychoactive Substances ◽  
Psychoactive Substances ◽  
Over The Counter ◽  
Emerging Trends ◽  
Second Generation Antipsychotics ◽  
Other Substances

Recently, a range of prescription and over-the-counter (OTC) drugs have emerged as being used recreationally, either on their own or in combination with other substances, both licit and illicit, including new psychoactive substances (NPS). Among them, the misuse of prescription drugs involves not only traditionally recorded substances, such as benzodiazepines and opioid pain relievers, but also gabapentinoids (e.g., pregabalin and gabapentin); some antidepressants, e.g., bupropion and venlafaxine; some second-generation antipsychotics, e.g., quetiapine and olanzapine. Moreover, the use of some OTC for recreational purposes appears on the increase, especially in vulnerable categories such as young people/youths, including the use of high dosages of the antidiarrheal loperamide; first-generation antihistamines, e.g., promethazine, cyclizine, and diphenhydramine; cough and cold preparations containing dextromethorphan and/or codeine. In this context, the role of the Internet has rapidly increased, playing a significant role both in the diffusion of emerging trends of drug misuse among users and experimenters, and the marketing, sale, and distribution of drugs through online pharmacies. This phenomenon within the context of a rapidly modifying drug scenario is a globally recognized health problem, determining severe adverse consequences, including fatalities, and represents a challenge for clinicians in general, psychiatrists, public health, and drug-control policies.

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