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1.
Harm Reduct J ; 21(1): 111, 2024 Jun 07.
Article in English | MEDLINE | ID: mdl-38849866

ABSTRACT

BACKGROUND: In response to the devastating drug toxicity crisis in Canada driven by an unregulated opioid supply predominantly composed of fentanyl and analogues, safer supply programs have been introduced. These programs provide people using street-acquired opioids with prescribed, pharmaceutical opioids. We use six core components of safer supply programs identified by people who use drugs to explore participant perspectives on the first year of operations of a safer supply program in Victoria, BC, during the dual public health emergencies of COVID-19 and the drug toxicity crisis to examine whether the program met drug-user defined elements of an effective safer supply model. METHODS: This study used a community-based participatory research approach to ensure that the research was reflective of community concerns and priorities, rather than being extractive. We interviewed 16 safer supply program participants between December 2020 and June 2021. Analysis was structured using the six core components of effective safer supply from the perspective of people who use drugs, generated through a prior study. RESULTS: Ensuring access to the 'right dose and right drugs' of medications was crucial, with many participants reporting success with the available pharmaceutical options. However, others highlighted issues with the strength of the available medications and the lack of options for smokeable medications. Accessing the safer supply program allowed participants to reduce their use of drugs from unregulated markets and manage withdrawal, pain and cravings. On components related to program operations, participants reported receiving compassionate care, and that accessing the safer supply program was a non-stigmatizing experience. They also reported receiving support to find housing, access food, obtain ID, and other needs. However, participants worried about long term program sustainability. CONCLUSIONS: Participants in the safer supply program overwhelmingly appreciated it and felt it was lifesaving, and unlike other healthcare or treatment services they had previously accessed. Participants raised concerns that unless a wider variety of medications and ability to consume them by multiple routes of administration became available, safer supply programs would remain unable to completely replace substances from unregulated markets.


Subject(s)
COVID-19 , Harm Reduction , Opioid-Related Disorders , Humans , COVID-19/epidemiology , Analgesics, Opioid/supply & distribution , Analgesics, Opioid/adverse effects , Female , Male , Community-Based Participatory Research , Public Health , Adult , Emergencies , Canada , SARS-CoV-2 , Fentanyl/supply & distribution , Illicit Drugs/supply & distribution , Middle Aged
2.
Forensic Sci Int ; 360: 112074, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38823217

ABSTRACT

Synthetic cathinones, which are novel psychoactive substances, have caused major social problems worldwide. A substance called 2-methyl-4'-(methylthio)-2-morpholinopropiophenone (MMMP), which is employed as a commercial industrial photoinitiator for triggering polymerization, has a basic cathinone backbone; however, few reports regarding MMMP have been published. In the current study, three potential metabolites of MMMP-namely hydroxy-MMMP (HO-MMMP), HO-MMMP-sulfoxide (HO-MMMP-SO), and HO-MMMP-sulfone (HO-MMMP-SO2)-were successfully synthesized, and MMMP and these three potential metabolites were used as standards to establish an analytic method based on liquid chromatography-tandem mass spectrometry for the quantitative analysis of urine. This analytic method and related parameters-including dynamic range, limit of quantification, selectivity, precision, accuracy, carryover effect, matrix effect, interference, and dilution integrity-were optimized and validated. Forty urine samples from 1,691 individuals who abused drugs were determined to contain MMMP, HO-MMMP, HO-MMMP-SO, or HO-MMMP-SO2; the results of this study indicate that approximately 2.37 % of drug abusers in Taiwan consumed MMMP in 2023. These 40 urine samples were analyzed to investigate the metabolism of MMMP in humans. The results indicate that HO-MMMP-SO is the main metabolite in human urine. This study recommends HO-MMMP-SO with a concentration of 2 ng/mL as a target and cutoff value, respectively, for identifying individuals who have consumed MMMP.


Subject(s)
Psychotropic Drugs , Tandem Mass Spectrometry , Humans , Psychotropic Drugs/urine , Psychotropic Drugs/analysis , Chromatography, Liquid , Propiophenones/urine , Substance Abuse Detection/methods , Illicit Drugs/analysis , Morpholines/urine , Morpholines/analysis , Limit of Detection
3.
Learn Mem ; 31(5)2024 May.
Article in English | MEDLINE | ID: mdl-38862166

ABSTRACT

Drug addiction and the circuitry for learning and memory are intimately intertwined. Drugs of abuse create strong, inappropriate, and lasting memories that contribute to many of their destructive properties, such as continued use despite negative consequences and exceptionally high rates of relapse. Studies in Drosophila melanogaster are helping us understand how drugs of abuse, especially alcohol, create memories at the level of individual neurons and in the circuits where they function. Drosophila is a premier organism for identifying the mechanisms of learning and memory. Drosophila also respond to drugs of abuse in ways that remarkably parallel humans and rodent models. An emerging consensus is that, for alcohol, the mushroom bodies participate in the circuits that control acute drug sensitivity, not explicitly associative forms of plasticity such as tolerance, and classical associative memories of their rewarding and aversive properties. Moreover, it is becoming clear that drugs of abuse use the mushroom body circuitry differently from other behaviors, potentially providing a basis for their addictive properties.


Subject(s)
Memory , Mushroom Bodies , Animals , Memory/drug effects , Memory/physiology , Mushroom Bodies/physiology , Mushroom Bodies/drug effects , Learning/physiology , Learning/drug effects , Substance-Related Disorders , Drosophila melanogaster/physiology , Humans , Drosophila/physiology , Illicit Drugs/pharmacology
4.
AAPS J ; 26(4): 70, 2024 Jun 11.
Article in English | MEDLINE | ID: mdl-38862871

ABSTRACT

Synthetic cathinones represent one of the largest and most abused new psychoactive substance classes, and have been involved in numerous intoxications and fatalities worldwide. Methcathinone analogues like 3-methylmethcathinone (3-MMC), 3-chloromethcathinone (3-CMC), and 4-CMC currently constitute most of synthetic cathinone seizures in Europe. Documenting their consumption in clinical/forensic casework is therefore essential to tackle this trend. Targeting metabolite markers is a go-to to document consumption in analytical toxicology, and metabolite profiling is crucial to support investigations. We sought to identify 3-CMC, 4-CMC, and 4-bromomethcathinone (4-BMC) human metabolites. The substances were incubated with human hepatocytes; incubates were screened by liquid chromatography-high-resolution tandem mass spectrometry and data were mined with Compound Discoverer (Themo Scientific). 3-CMC-positive blood, urine, and oral fluid and 4-CMC-positive urine and saliva from clinical/forensic casework were analyzed. Analyses were supported by metabolite predictions with GLORYx freeware. Twelve, ten, and ten metabolites were identified for 3-CMC, 4-CMC, and 4-BMC, respectively, with similar transformations occurring for the three cathinones. Major reactions included ketoreduction and N-demethylation. Surprisingly, predominant metabolites were produced by combination of N-demethylation and ω-carboxylation (main metabolite in 3-CMC-positive urine), and combination of ß-ketoreduction, oxidative deamination, and O-glucuronidation (main metabolite in 4-CMC-positive urine). These latter metabolites were detected in negative-ionization mode only and their non-conjugated form was not detected after glucuronide hydrolysis; this metabolic pathway was never reported for any methcathinone analogue susceptible to undergo the same transformations. These results support the need for comprehensive screening strategies in metabolite identification studies, to avoid overlooking significant metabolites and major markers of consumption.


Subject(s)
Hepatocytes , Humans , Hepatocytes/metabolism , Hepatocytes/drug effects , Tandem Mass Spectrometry/methods , Propiophenones/pharmacokinetics , Propiophenones/metabolism , Chromatography, Liquid/methods , Substance Abuse Detection/methods , Methamphetamine/analogs & derivatives , Methamphetamine/metabolism , Methamphetamine/administration & dosage , Methamphetamine/pharmacokinetics , Psychotropic Drugs/pharmacokinetics , Psychotropic Drugs/metabolism , Psychotropic Drugs/administration & dosage , Metabolomics/methods , Alkaloids/metabolism , Illicit Drugs
5.
J Pharm Biomed Anal ; 245: 116175, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-38728951

ABSTRACT

New psychoactive substances (NPS) are uncontrolled analogues of existing drugs or newly synthesized chemicals that exhibit psychopharmacological effects. Due to their diverse nature, composition, and increasing prevalence, they present significant challenges to the healthcare system and drug control policies. In response, healthcare system laboratories have developed analytical methods to detect NPS in biological samples. As a Regional Reference Centre, the Sicilian CRQ Laboratory (Regional Laboratory for Quality Control) developed and conducted an External Quality Assessment (EQA) study to assess, in collaboration with the Istituto Superiore di Sanità (ISS), the ability of different Italian laboratories to identify NPS and traditional drugs of abuse (DOA) in biological matrices. Two blood samples were spiked with substances from various drug classes, including synthetic cannabinoids, cathinones, synthetic opiates, and benzodiazepines, at concentrations ranging from 2 to 10 ng/mL. The blood samples were freeze-dried to ensure the stability of DOA and NPS. Twenty-two laboratories from the Italian healthcare system participated in this assessment. The information provided by the laboratories during the registration in an in-house platform included a general description of the laboratory, analytical technique, and the chosen panels of analytes. The same platform was employed to collect and statistically analyze the data and record laboratory feedback and comments. The evaluation of the results revealed that the participating laboratories employed three different techniques for analyzing the samples: GC-MS, LC-MS, and immunoenzymatic methods. Approximately 90 % of the laboratories utilized LC-MS techniques. Around 40 % of false negative results were obtained, with the worst results in the identification of 5-chloro AB PINACA. The results showed that laboratories that used LC-MS methods obtained better specificity and sensitivity compared to the laboratories using other techniques. The results obtained from this first assessment underscore the importance of external quality control schemes in identifying the most effective analytical techniques for detecting trace molecules in biological matrices. Since the judicial authorities have not yet established cut-off values for NPS, this EQA will enable participating laboratories to share their analytical methods and expertise, aiming to establish common criteria for NPS identification.


Subject(s)
Psychotropic Drugs , Quality Control , Substance Abuse Detection , Psychotropic Drugs/blood , Humans , Substance Abuse Detection/methods , Substance Abuse Detection/standards , Italy , Laboratories/standards , Illicit Drugs/blood , Illicit Drugs/analysis
6.
Crit Care Nurs Clin North Am ; 36(2): 211-221, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38705689

ABSTRACT

Substance abuse is a widespread problem in the United States and worldwide. This use within the pregnant population is thought to reflect a pattern similar to the general population, with estimates of 10% to 15% of pregnant women experiencing substance abuse. Illicit substance use during pregnancy has increased substantially during the past decade in the United States. During the past decade, novel or atypical substances have emerged and become increasingly popular. Occurrences of toxicity and untoward fetal effects from designer drug use must be kept high on the watch list for all who practice in maternal-fetal, newborn, and emergency departments.


Subject(s)
Analgesics, Opioid , Illicit Drugs , Psychotropic Drugs , Substance-Related Disorders , Humans , Pregnancy , Female , Substance-Related Disorders/epidemiology , Analgesics, Opioid/adverse effects , Psychotropic Drugs/adverse effects , United States/epidemiology , Illicit Drugs/adverse effects , Pregnancy Complications , Infant, Newborn
7.
Cien Saude Colet ; 29(5): e06882023, 2024 May.
Article in Portuguese, English | MEDLINE | ID: mdl-38747769

ABSTRACT

The aim of this study was to analyze the factors associated with concurrent alcohol, tobacco and illicit drug use among Brazilian schoolchildren aged 13-17. We conducted a cross-sectional study using data from the 2019 National School-Based Health Survey. The outcome was use of the three substances during the last 30 days. Hierarchical multiple logistic regression was carried out with independent variables grouped into four blocks: sociodemographic characteristics; family context; behavioral aspects; and stressors. Variables with p<0.05 were retained in the final model. The prevalence of concurrent substance use was 3.3%. Being male, living in the Midwest, South and Southeast, skipping school without parent permission, parents not knowing what their children do in their free time, having parents who smoke, having experienced physical aggression from parents, feeling that life is not worth living, trying drinking and illicit drugs before the age of 13, and having friends who drink alcohol, smoke and use drugs in their presence remained associated with the outcome in the final model. The findings reveal high prevalence of concurrent alcohol, cigarette and illicit drug use among adolescents and that poly use is associated with sociodemographic, family, and behavioral factors and stressors.


Objetivou-se analisar os fatores associados ao policonsumo de álcool, tabaco e drogas ilícitas, entre adolescentes escolares brasileiros de 13 a 17 anos. Estudo transversal, com dados da Pesquisa Nacional de Saúde do Escolar (2019). A variável desfecho foi o relato de consumo das três substâncias nos últimos 30 dias. As variáveis independentes foram agrupadas em quatro blocos: características sociodemográficas; contexto familiar; situações estressoras; aspectos comportamentais. Foi realizada análise de regressão logística múltipla hierarquizada, permanecendo no modelo final as variáveis com p<0,05. A prevalência de policonsumo em adolescentes escolares foi 3,3%. No modelo final, sexo masculino, morar na região Centro-Oeste, Sul e Sudeste, faltar a escola sem permissão, pais não saberem o que fazem no tempo livre, ter pais fumantes, sofrer agressão física pelos pais, sentir que a vida não vale a pena ser vivida, experimentar bebida alcoólica e drogas ilícitas antes dos 13 anos, ter amigos que bebem bebida alcoólica, fumam e usam drogas na sua presença permaneceram associados ao desfecho. Os dados mostram alta prevalência de policonsumo de três substâncias entre adolescentes e sua associação a fatores sociodemográficos, familiares, comportamentais e a eventos estressantes.


Subject(s)
Alcohol Drinking , Health Surveys , Illicit Drugs , Substance-Related Disorders , Humans , Adolescent , Male , Female , Substance-Related Disorders/epidemiology , Cross-Sectional Studies , Brazil/epidemiology , Prevalence , Illicit Drugs/adverse effects , Alcohol Drinking/epidemiology , Schools , Risk Factors , Sex Factors , Students/statistics & numerical data , Students/psychology , Smoking/epidemiology
9.
Molecules ; 29(9)2024 Apr 29.
Article in English | MEDLINE | ID: mdl-38731551

ABSTRACT

The aim of this study is to solve the problems of the complicated pretreatment and high analytical cost in the detection technology of trace drugs and their metabolites in municipal wastewater. A high-performance magnetic sorbent was fsynthesized for the enrichment of trace drugs and their metabolites in wastewater to develop a magnetic solid-phase extraction pretreatment combined with the acoustic ejection mass spectrometry (AEMS) analytical method. The magnetic nanospheres were successfully prepared by magnetic nanoparticles modified with divinylbenzene and vinylpyrrolidone. The results showed that the linear dynamic range of 17 drugs was 1-500 ng/mL, the recovery was 44-100%, the matrix effect was more than 51%, the quantification limit was 1-2 ng/mL, and the MS measurement was fast. It can be seen that the developed magnetic solid-phase extraction (MSPE) method is a good solution to the problems of the complicated pretreatment and analytical cost in the analysis of drugs in wastewater. The developed magnetic material and acoustic excitation pretreatment coupled with mass spectrometry analysis method can realize the low-cost, efficient enrichment, and fast analysis of different kinds of drug molecules in urban sewage.


Subject(s)
Illicit Drugs , Mass Spectrometry , Sewage , Solid Phase Extraction , Sewage/analysis , Sewage/chemistry , Solid Phase Extraction/methods , Mass Spectrometry/methods , Illicit Drugs/analysis , Water Pollutants, Chemical/analysis , Wastewater/analysis , Wastewater/chemistry , Magnetite Nanoparticles/chemistry
10.
Harm Reduct J ; 21(1): 96, 2024 May 16.
Article in English | MEDLINE | ID: mdl-38755587

ABSTRACT

OBJECTIVES: Research regarding the contribution of specific psychoactive substances to suicidality has yielded equivocal results. The present study examined the prevalence and factors associated with suicidal thoughts and behaviors among a population-based sample of untreated illicit substance users. METHODS: A total of 616 illicit substance users who were recruited from high-risk areas of Shiraz using snowball sampling participated in the study. Eligible participants were individuals aged 18 years and older who regularly used one illicit psychoactive substance (e.g., opioids, heroin, cannabinoids, stimulants, hallucinogens) for at least one year and who had received no treatment for their drug use during the past year. Data were collected regarding socio-demographic characteristics, mental history, and substance use habits. Data regarding suicidal thoughts and behaviors were assessed using the Beck Suicidal Ideation Scale (BSIS) and self-reports of previous suicide attempts. Multiple logistic regression analysis was used to identify independent variables associated with suicidality. RESULTS: Among the participants, 23.6% reported having had suicidal thoughts during the past week and 6.7% reported having attempted suicide during the past year. Methamphetamine was reported as the primary substance of use among approximately half of the participants who attempted suicide during past year (49.2%). Multiple logistic regression analysis showed that current suicidal thoughts were independently associated with having no job, a history of mental health condition, previous suicidal attempts, concurrent use of more than one substance, and using methamphetamine and heroin as the primary substances. Suicidal thoughts were not associated with increased odds of regular opium and cannabis use. CONCLUSION: Both methamphetamine and heroin use are significantly associated with current suicidal thoughts. Evaluation of the risk of suicidality by physicians and mental health care professionals in both community and outpatient settings would be especially appropriate among those individuals using these psychoactive substances.


Subject(s)
Substance-Related Disorders , Suicidal Ideation , Suicide, Attempted , Humans , Male , Female , Adult , Young Adult , Substance-Related Disorders/epidemiology , Substance-Related Disorders/psychology , Suicide, Attempted/statistics & numerical data , Suicide, Attempted/psychology , Adolescent , Iran/epidemiology , Middle Aged , Prevalence , Risk Factors , Illicit Drugs
11.
Article in English | MEDLINE | ID: mdl-38718698

ABSTRACT

Aerosol microparticles in exhaled breath carry non-volatile compounds from the deeper parts of the lung. When captured and analyzed, these aerosol microparticles constitute a non-invasive and readily available specimen for drugs of abuse testing. The present study aimed to evaluate a simple breath collection device in a clinical setting. The device divides a breath sample into three parallel "collectors" that can be individually analyzed. Urine was used as the reference specimen, and parallel specimens were collected from 99 patients undergoing methadone maintenance treatment. Methadone was used as the primary validation parameter. A sensitive multi-analyte method using tandem liquid chromatography - mass spectrometry was developed and validated as part of the project. The method was successfully validated for 36 analytes with a limit of detection of 1 pg/collector for most compounds. Based on the validation results tetrahydrocannabinol THC), cannabidiol (CBD), and lysergic acid diethylamide (LSD) are suitable for qualitative analysis, but all other analytes can be quantitively assessed by the method. Methadone was positive in urine in 97 cases and detected in exhaled breath in 98 cases. Median methadone concentration was 64 pg/collector. The methadone metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) was detected in 90 % of the cases but below 10 pg/collector in most. Amphetamine was also present in the urine in 17 cases and in exhaled breath in 16 cases. Several other substances were detected in the exhaled breath and urine samples, but at a lower frequency. This study concluded that the device provides a specimen from exhaled breath, that is useful for drugs of abuse testing. The results show that high analytical sensitivity is needed to achieve good detectability and detection time after intake.


Subject(s)
Breath Tests , Limit of Detection , Substance Abuse Detection , Tandem Mass Spectrometry , Humans , Tandem Mass Spectrometry/methods , Substance Abuse Detection/methods , Breath Tests/methods , Chromatography, Liquid/methods , Reproducibility of Results , Methadone/analysis , Methadone/urine , Linear Models , Male , Female , Adult , Illicit Drugs/analysis , Illicit Drugs/urine , Liquid Chromatography-Mass Spectrometry
12.
Sci Total Environ ; 934: 173313, 2024 Jul 15.
Article in English | MEDLINE | ID: mdl-38761952

ABSTRACT

Taiwan, identified as pivotal in the Asian drug trafficking chain, has been experiencing a surge in illicit drug-related issues. Wastewater-based epidemiology (WBE) has emerged as a promising approach for comprehensive evaluation of actual illicit drug usage. This study presents the first WBE investigation of illicit drug consumption in Taiwan based on the analysis of wastewater from four wastewater treatment plants (WWTPs) in the Taipei metropolitan area. Additionally, it demonstrates a high correlation between the amounts of illicit drugs seized and influent concentrations over an extended period of time. The reliability of solid-phase extraction and analysis via high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was validated for 16 illicit drugs (methamphetamine, ketamine, cocaine, codeine, methadone, morphine, meperidine, fentanyl, sufentanil, para-methoxyamphetamine (PMA), para-methoxymethamphetamine (PMMA), 3,4-methylenedioxymethamphetamine (MDMA), cathinone, methcathinone, mephedrone (MEPH), and 4-methylethcathinone (4-MEC)). Methamphetamine, ketamine, and 4-MEC were consistently detected in all wastewater samples, underscoring their prevalence in the Taipei metropolitan area. Biochemical oxygen demand (BOD) and ammonia nitrogen (ammonia N) were employed to reduce uncertainty in estimations of population size during back-calculation of illicit drug consumption. The results indicate that methamphetamine was the most consumed drug (175-740 mg day-1 1000 people-1), followed by ketamine (22-280 mg day-1 1000 people-1). In addition, urban-related WWTPs exhibited higher consumption of methamphetamine and ketamine than did the suburban-related WWTP, indicating distinct illicit drug usage patterns between suburban and urban regions. Moreover, an examination of temporal trends in wastewater from the Dihua WWTP revealed a persistent predominance of ketamine and methamphetamine, consistent with statistical data pertaining to seizure quantities and urine test results. The study provides encouraging insight into spatial and temporal variations in illicit drug usage in the Taipei metropolitan area, emphasizing the complementary role of WBE in understanding trends in illicit drug abuse.


Subject(s)
Illicit Drugs , Wastewater , Water Pollutants, Chemical , Taiwan/epidemiology , Wastewater/chemistry , Illicit Drugs/analysis , Water Pollutants, Chemical/analysis , Substance Abuse Detection/methods , Humans , Environmental Monitoring , Tandem Mass Spectrometry , Cities
13.
J Hazard Mater ; 472: 134609, 2024 Jul 05.
Article in English | MEDLINE | ID: mdl-38759280

ABSTRACT

Simultaneous rapid screening of multiple drugs of abuse in environmental water facilitates effective monitoring and trend assessments. Herein, a novel porphyrin-based metal organic frameworks modified Ti3C2Tx nanosheets (Cu-TCPP/Ti3C2Tx) composite was prepared and utilized as solid-phase microextraction (SPME) coating for the simultaneous analysis of 21 drugs from water samples. The composite was embedded with matrix-compatible polyacrylonitrile binder to prepare a coated blade with thin and uniform coating layer. Ambient mass spectrometry (MS) technique was used to create a coated blade spray-MS (CBS-MS) method for the quantitative determination of drugs in water samples. High throughput and automated sample preparation were achieved with the use of a Concept 96-well plate system, enabling analysis of 21 drugs of abuse within 1 min per sample, while using only 8 µL of organic solvent for desorption and CBS-MS detection. The developed method showed favorable linearity (R2 ≥ 0.9983) in the range of 0.05 to 10 ng mL-1, low limits of detection (1.5-9.0 ng L-1), sufficient recovery (67.6-133.2%), as well as satisfactory precision (RSDs≤13.5%). This study not only delivers a novel and efficient SPME coating composite, but also demonstrates the excellent performance of a high-throughput, efficient, and green analytical method for determination of drugs in environmental water.


Subject(s)
Mass Spectrometry , Metal-Organic Frameworks , Solid Phase Microextraction , Water Pollutants, Chemical , Water Pollutants, Chemical/analysis , Solid Phase Microextraction/methods , Metal-Organic Frameworks/chemistry , Mass Spectrometry/methods , Titanium/chemistry , Limit of Detection , Illicit Drugs/analysis , Environmental Monitoring/methods , Pharmaceutical Preparations/analysis , Pharmaceutical Preparations/chemistry
14.
Health Res Policy Syst ; 22(1): 60, 2024 May 23.
Article in English | MEDLINE | ID: mdl-38783308

ABSTRACT

In January 2023, the province of British Columbia (BC) decriminalized the possession of certain illegal drugs for personal use. The province's primary intent was to reduce the stigma associated with drug use, as well as barriers for people who use drugs (PWUD) to access treatment and supports. However, less than ten months into the decriminalization policy, due to growing concerns about public safety voiced by municipal governments and communities, the provincial government made amendments to the policy to ban the public consumption of illicit drugs in additional locations, and subsequently introduced additional legislation, Bill 34, aimed at regulating public consumption of drugs in public spaces. Some communities have also implemented local bylaws similarly regulating public drug use. Bill 34 and local bylaws may serve as tools to promote community health and safety and minimize direct and indirect harms associated with public drug use. However, such legislation may re-criminalize PWUD and reinforce negative perceptions surrounding drug use, especially if these policies are not paired with strategies to expand the availability and accessibility of critical harm reduction and housing services. Without ample access to these services, limitations on public drug use can potentially displace individuals to areas where they are more likely to use alone, further exposing them to substance use-related harms, and undermining the goals of decriminalization. The potential effects of these restrictions may also disproportionately impact marginalized populations. As of April 2024, Bill 34 remains on hold. Moving forward, it will be important to monitor this bill, as well as other public consumption bylaws and legislation, and their impact on BC's overall decriminalization initiative. Decision-makers are urged to increase engagement with PWUD and relevant stakeholders in the design and implementation of policies pertaining to public consumption to ensure that they effectively address the evolving needs and realities of PWUD, and align with decriminalization goals.


Subject(s)
Harm Reduction , Illicit Drugs , Substance-Related Disorders , Humans , British Columbia , Illicit Drugs/legislation & jurisprudence , Public Health , Public Policy , Drug Users/legislation & jurisprudence , Health Policy , Drug and Narcotic Control/legislation & jurisprudence , Recreational Drug Use
15.
Sci Total Environ ; 935: 173356, 2024 Jul 20.
Article in English | MEDLINE | ID: mdl-38772484

ABSTRACT

Wastewater-based epidemiology (WBE) can provide objective and real time information about the use of addictive substances. A national study was conducted by measuring the most consumed illicit drugs, other drugs whose consumption is not so widespread but has increased significantly in recent years, and benzodiazepines in untreated wastewater from seven wastewater treatment plants (WWTPs) in six Spanish cities. Raw composite wastewater samples were collected from December 2020 to December 2021, a period in which the Spanish and regional governments adopted different restriction measures to contain the spread of the COVID-19 pandemic. Samples were analyzed using a validated analytical methodology for the simultaneous determination of 18 substances, based on solid-phase extraction and liquid-chromatography tandem mass spectrometry. Except for heroin, fentanyl, 6-acetylmorphine and alprazolam, all the compounds were found in at least one city and 9 out of 18 compounds were found in all the samples. In general, the consumption of illicit drugs was particularly high in one of the cities monitored in December 2020, when the restrictions were more severe, especially for cannabis and cocaine with values up to 46 and 6.9 g/day/1000 inhabitants (g/day/1000 inh), respectively. The consumption of MDMA, methamphetamine and mephedrone was notably higher in June 2021, after the end of the state of alarm, in the biggest population investigated in this study. Regarding the use of benzodiazepines, the highest mass loads corresponded to lorazepam. This study demonstrates that WBE is suitable for complementing epidemiological studies about the prevalence of illicit drugs and benzodiazepines during the COVID-19 pandemic restrictions.


Subject(s)
Benzodiazepines , COVID-19 , Cities , Illicit Drugs , Illicit Drugs/analysis , COVID-19/epidemiology , Spain/epidemiology , Benzodiazepines/analysis , Humans , Wastewater/chemistry , Water Pollutants, Chemical/analysis , Pandemics , Substance Abuse Detection/methods , SARS-CoV-2
16.
Curr Opin Psychiatry ; 37(4): 258-263, 2024 07 01.
Article in English | MEDLINE | ID: mdl-38818825

ABSTRACT

PURPOSE OF REVIEW: The worldwide spread of novel psychoactive substances (NPS) in the illicit drug market and their continuous increase in number and type, for the purpose of bypassing controlled substance legislation, represents a continuing challenge for forensic scientists, clinicians and enforcement authorities. We aim to provide information regarding the most urgent harms related to NPS consumption in different world regions and the current state of the art for NPS analysis. RECENT FINDINGS: Unfortunately, the identification of NPS in biological samples is controversial, especially when samples are limited, or the drug is promptly and extensively metabolized. This causes a lack of information on their real diffusion in different parts of the world and in different populations. New technologies and instrumental detection of NPS in alternative samples are offering comprehensive information about NPS use. SUMMARY: The lack of detection and underreporting of NPS in biological samples makes it difficult to obtain complete qualitative and quantitative information about NPS prevalence. The most innovative strategies that have been proposed in the last 2 years to assist NPS analysis and possibly facilitate the understanding of the NPS diffusion around the world are presented.


Subject(s)
Illicit Drugs , Psychotropic Drugs , Humans , Substance Abuse Detection/methods , Substance-Related Disorders/epidemiology
17.
Ann Biol Clin (Paris) ; 82(2): 151-173, 2024 06 05.
Article in French | MEDLINE | ID: mdl-38721719

ABSTRACT

Synthetic cannabinoids (CS), or synthetic endocannabinoid receptor agonists, were initially synthesized for basic research into exocannabinoid signaling pathways, as well as in clinical research for their analgesic properties. The use of CS for recreational purposes is a recent phenomenon, but one that has grown very quickly in recent years, since these molecules now represent the main category of new synthetic products (NPS). This literature review aims to bring together current data regarding the use and effects caused by CS in humans. The relationship between the structure and activity of these CSs, the pharmacology and adverse effects of these CSs and finally the different methods of analyzing CSs. A better understanding of this phenomenon is essential to raise awareness among stakeholders in the health field.


Subject(s)
Cannabinoids , Humans , Cannabinoids/adverse effects , Cannabinoids/toxicity , Synthetic Drugs/adverse effects , Synthetic Drugs/chemistry , Synthetic Drugs/toxicity , Illicit Drugs/adverse effects , Illicit Drugs/toxicity , Cannabinoid Receptor Agonists/adverse effects , Animals , Designer Drugs/adverse effects , Designer Drugs/chemistry
18.
J Am Soc Mass Spectrom ; 35(6): 1156-1167, 2024 Jun 05.
Article in English | MEDLINE | ID: mdl-38709655

ABSTRACT

Cannabinoids and opioids are the most prominently used drugs in the world, with fentanyl being the main cause of drug overdose-related deaths. Monitoring drug use in groups as well as in individuals is an important forensic concern. Analytical methods, such as mass spectrometry (MS), have been found most useful for the identification of drug abuse on a small and large scale. Pulsed fiber laser 2D galvoscanner laser-generated nanomaterial (PFL 2D GS LGN) was obtained from monoisotopic silver-109. Nanomaterial was used for laser desorption/ionization mass spectrometry of selected illicit drug standards with standard high-resolution reflectron-based time-of-flight MALDI apparatus. Δ9-THC, 11-OH-THC, 11-COOH-THC, fentanyl, codeine, 6-monoacetylmorphine (6-MAM), heroin, tramadol, and methadone were chosen as test compounds. Illicit drugs were tested in a concentration range from 100 µg/mL to 10 pg/mL, equating to 50 µg to 50 fg per measurement spot. For all analyzed compounds, identification and quantification by silver-109-assisted laser desorption/ionization (LDI) MS was possible, with uncommon [M + 109Ag3]+ and [M - H]+ ions present for certain structures. The results of the quantitative analysis of drugs using silver-109 PFL 2D GS LGN for LDI MS are presented. Laser-generated NPs are proven to be useful for the analysis of selected drugs, with exceptionally good results for fentanyl monitoring in a broad range of concentrations.


Subject(s)
Illicit Drugs , Lasers , Metal Nanoparticles , Silver , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Substance Abuse Detection , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods , Illicit Drugs/analysis , Illicit Drugs/chemistry , Silver/chemistry , Silver/analysis , Metal Nanoparticles/chemistry , Metal Nanoparticles/analysis , Substance Abuse Detection/methods , Humans , Fentanyl/analysis , Fentanyl/analogs & derivatives , Fentanyl/chemistry , Morphine Derivatives/analysis , Morphine Derivatives/chemistry , Cannabinoids/analysis , Cannabinoids/chemistry
19.
J Pharm Biomed Anal ; 244: 116139, 2024 Jul 15.
Article in English | MEDLINE | ID: mdl-38608509

ABSTRACT

This study aimed to validate a modified QuEChERS method, followed by liquid chromatography-tandem mass spectrometry, for the determination of 51 psychoactive substances and screening of 22 ones in oral fluid from electronic dance music party (EDM) attendees. Unstimulated oral fluid was collected in a polypropylene tube and stored in a glass vial at -20 ºC. The sample was extracted with acetonitrile:water and MgSO4/NaOAc, followed by cleanup with primary secondary amine and MgSO4. The effectiveness of the sample storage conditions was shown to be comparable to when the Quantisal™ buffer was used, with no substantial concentration loss (< 15%) for all the substances after up to 72 hours at -20º C. The method was satisfactorily validated, with limits of detection (LOD) and quantification (LOQ) ranging from 0.04 to 0.5 ng/mL and 0.1-1.5 ng/mL, respectively, and was applied to the analysis of 62 real samples. The main substances detected were 3,4-methylenedioxymethamphetamine (MDMA) (<0.5-829 ng/mL) and/or methylenedioxyamphetamine (MDA) (10.1 - 460.6 ng/mL), found in 27 samples, and cocaine (13.0-407.3 ng/mL) and its metabolites (benzoylecgonine 0.17-214.1 ng/mL; ecgonine methyl ester 1.8-150.1 ng/mL) in eight samples. Methamphetamine (11-439 ng/mL) was detected in eight samples, along with MDMA and MDA; eutylone was detected in two cases (4.7 and 24.1 ng/mL) reported as "ecstasy" ingestion. A comparison between self-reported drug use and results of oral fluid analysis indicated that the use of illicit substances is often underreported among EDM attendees, who are often unaware of the substances they consume.


Subject(s)
Limit of Detection , Psychotropic Drugs , Saliva , Substance Abuse Detection , Tandem Mass Spectrometry , Tandem Mass Spectrometry/methods , Humans , Psychotropic Drugs/analysis , Saliva/chemistry , Chromatography, Liquid/methods , Substance Abuse Detection/methods , Male , Adult , Illicit Drugs/analysis , N-Methyl-3,4-methylenedioxyamphetamine/analysis , Liquid Chromatography-Mass Spectrometry
20.
Science ; 384(6693): eadk6742, 2024 Apr 19.
Article in English | MEDLINE | ID: mdl-38669575

ABSTRACT

Drugs of abuse are thought to promote addiction in part by "hijacking" brain reward systems, but the underlying mechanisms remain undefined. Using whole-brain FOS mapping and in vivo single-neuron calcium imaging, we found that drugs of abuse augment dopaminoceptive ensemble activity in the nucleus accumbens (NAc) and disorganize overlapping ensemble responses to natural rewards in a cell type-specific manner. Combining FOS-Seq, CRISPR-perturbation, and single-nucleus RNA sequencing, we identified Rheb as a molecular substrate that regulates cell type-specific signal transduction in NAc while enabling drugs to suppress natural reward consumption. Mapping NAc-projecting regions activated by drugs of abuse revealed input-specific effects on natural reward consumption. These findings characterize the dynamic, molecular and circuit basis of a common reward pathway, wherein drugs of abuse interfere with the fulfillment of innate needs.


Subject(s)
Homeostasis , Nucleus Accumbens , Reward , Nucleus Accumbens/metabolism , Nucleus Accumbens/drug effects , Animals , Mice , Neurons/metabolism , Illicit Drugs/adverse effects , Ras Homolog Enriched in Brain Protein/metabolism , Ras Homolog Enriched in Brain Protein/genetics , Male , Mice, Inbred C57BL , Proto-Oncogene Proteins c-fos/metabolism , Proto-Oncogene Proteins c-fos/genetics , Signal Transduction , Substance-Related Disorders , Single-Cell Analysis , Cocaine/pharmacology , Calcium/metabolism
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