A current overview of the pharmacological composition of "La Chimique" consumed in Mayotte: Preliminary results of the CHASSE-MAREE protocol.

Mayotte Island, a French department located in the Mozambique Channel, has for several years been faced with the consumption of "La Chimique" (LC), reputed (but extremely poorly documented) to be a mixture of tobacco and synthetic cannabinoid receptor agonists (SCRAs). One of the objectives of the CHASSE-MAREE protocol is to assess the composition and heterogeneity of LC products through successive LC sample collection campaigns among users. Currently underway, we present here the first analytical results (samples collected in 2022). Between September and December 2022, 80 samples were collected throughout the island over three periods: 70 in the usual form of LC (small folded papers containing a plant-like sample, mostly tobacco), 6 powders, and 4 cigarettes. Analysis was performed using liquid chromatography with high-resolution mass spectrometry. The detected substances (number of detections) included SCRAs (MDMB-4en-PINACA [35], ADB-FUBIATA [25], MDMB-INACA [16], ADB-BUTINACA [15], AFUBIATA [11], 4F-MDMD-BICA [7], CH-PIATA [14], 5C-APINACA [3], BZO-HEXOXIZID [2], and 4F-ABINACA [1]), nicotine (68), tetrahydrocannabinol (THC), cannabinol (CBN), and cannabidiol (CBD) (2), medications (amantadine [11], cyamemazine [6], and acetaminophen [3]), and a designer benzodiazepine (bromazolam [4]). The SCRAs currently in use are varied, and the market for "cooks" (those who prepare LC) is dispersed according to where and when samples are collected. These preliminary results will be supplemented by analysis of samples collected in the first half of 2023 and by an improved description of the current panorama of consumption of LC in Mayotte (mapping, effects felt and dependence, etc.).

Minors and young adult's hospitalizations after "chimique" consumption in Mayotte Island: Which substances are involved?

OBJECTIVES: Over the last 10 years, the use of an unknown drug called "chimique" has emerged, among adolescents and young adults in precarious situations in Mayotte Island. To date, the exact composition of "chimique" is still poorly documented, but seizures made on the Island at the same time indicated that it would be mainly composed of synthetic cannabinoids receptor agonists (SCRAs). The objective of this study was to identify which substances, among those consumed under the name of "chimique", leading to hospital admissions. METHODS: Between 1st march and 30th June 2019, all patients, over 14 years old, hospitalized in the emergency department of Mayotte hospital after use of "chimique" for which the physician required toxicological analysis were included. Blood samples and clinical data were recorded for each patient. Toxicological analyses were performed using high resolution mass spectrometry (UPLC-MS/QTOF). RESULTS: Twelve patients were included: 11 males and 1 female. The mean age was 26 years (median age: 22). There were 2 minors. Clinical presentations varied, mainly psychiatric and neurologic disorders were observed. No death was reported. Toxicological analysis identified psychoactive substances such as THC and/or its metabolites (n=3) and MDMB-4en-PINCA (n=2). The other substances identified were mainly part of the patients' treatment. CONCLUSION: This is the first study conducted in the Indian Ocean confirming the presence of SCRAs in the "chimique". For a while, the consumption of SCRAs in France seemed to be of limited importance. However, their use has become important in the Indian Ocean since the spread of "chimique" in Mayotte. It continues to spread especially in Reunion Island since 2017 under the name of "chamane".

Psychoactive substance use among students: A cross-sectional analysis.

Little is known about psychoactive substance use in students, apart from tobacco, alcohol, and cannabis. This study investigated the prevalence of substance use and overlap between various psychoactive substances in students. This cross-sectional study was conducted in 10 066 students included in the i-Share cohort between January 1, 2015, and December 31, 2017. The baseline questionnaire was the key source of information. Psychoactive substances of interest (PSI) were cannabis, cocaine, amphetamines, nitrous oxide, poppers, and MDMA. Their patterns of use were categorized as lifetime, past year, and current use. The use of other psychoactive substances including alcohol and tobacco was described in PSI users and non-users. Most participants were female (75%), and their average age was 21 years. Lifetime use of at least one PSI was reported by 65.5% of participants. Cannabis was the most frequently used substance both over lifetime (57% of students) and past year (35%), followed by poppers and nitrous oxide (28% and 26% of students over lifetime, respectively). Among polydrug users (n = 1242), 65% used only nitrous oxide and poppers, showing a strong link between these two substances. Regular alcohol use, binge drinking, and current tobacco use were higher in PSI users than in non-users. Substance use was higher than previously found in both French and European studies in young people. Nitrous oxide use was particularly high. Regular alcohol use, binge drinking, and tobacco use could be used as markers to identify students at risk of PSI use to be targeted by prevention programs.

Involuntary MDMB-4en-PINACA intoxications following cannabis consumption: clinical and analytical findings.

BACKGROUND AND AIMS: MDMB-4en-PINACA is a synthetic cannabinoid receptor agonist (SCRA) that has recently emerged. Data regarding clinical presentations in the event of intoxication is scarce. This study presents MDMB-4en-PINACA identification in cannabis consumers with clinical and analytical descriptions. METHODS: Between November 2020 and March 2021, all patients with unexpected or unusually severe effects and Poisoning Severity Score (PSS) greater than or equal to 2 after cannabis consumption were included. Blood and/or urine samples were collected for toxicological analysis. When available, drug material samples were also collected for analysis. RESULTS: Between November 2020 and March 2021, 13 patients were included. All cases typically presented with altered mental status (n = 13), and nearly all had returned to a normal or quasi-normal state after around 11 h of observation. Neurological symptoms included headaches (n = 3), hallucinations (3), mydriasis (3), amnesia (2) and seizures (5). Psychiatric symptoms were paranoia (6) and anxiety (2). Digestive symptoms were nausea (2) and vomiting (6). No deaths were recorded. All patients were positive for the SCRA MDMB-4en-PINACA in urine, blood and/or drug material sample. Results from toxicology testing paired with case history showed the potential for MDMB-4en-PINACA to cause or contribute to different clinical disorders. CONCLUSIONS: This study highlights the risk of intoxication by SCRAs when taking low-THC cannabis products. Forensic scientists, public health and public safety officials, law enforcement personnel and clinicians should be aware of the impact that these emergent SCRAs may have in their work, especially MDMB-4en-PINACA.

Reprint of: The effect of the Music Day event on community drug use.

Illicit drugs consumption can be back-calculated based on the analysis of drug residues in wastewater using the wastewater-based epidemiology method. The Music Day, held on June 21 in France since 1982, has grown to global proportions and is now celebrated as World Music Day. This large outdoor event takes place in many cities with people allowed to play music in the streets. As psychotropic drugs are often associated with music events, the goal of this study is to investigate the use of illicit drugs on this day in Bordeaux, the fifth largest urban area in France. Daily sampling campaigns of composite wastewater were carried out for seven days in two wastewater treatment plants in Bordeaux in 2017 (Music Day) and 2018. World Music Day in Bordeaux has no observable effect on illicit drug consumption even if this event has massive public participation: this is the first report of the absence of an illicit drug consumption increase in a festival of such magnitude, corroborating the effect of others' views and opinions, because this event takes place publicly in the street and not among peers. Different hypothesizes are put forward to explain this fact: inappropriate type of event for drug consumption, effect of other festivals, and influence of the event's timing on a weekday.

The effect of the Music Day event on community drug use.

Illicit drugs consumption can be back-calculated based on the analysis of drug residues in wastewater using the wastewater-based epidemiology method. The Music Day, held on June 21 in France since 1982, has grown to global proportions and is now celebrated as World Music Day. This large outdoor event takes place in many cities with people allowed to play music in the streets. As psychotropic drugs are often associated with music events, the goal of this study is to investigate the use of illicit drugs on this day in Bordeaux, the fifth largest urban area in France. Daily sampling campaigns of composite wastewater were carried out for seven days in two wastewater treatment plants in Bordeaux in 2017 (Music Day) and 2018. World Music Day in Bordeaux has no observable effect on illicit drug consumption even if this event has massive public participation: this is the first report of the absence of an illicit drug consumption increase in a festival of such magnitude, corroborating the effect of others' views and opinions, because this event takes place publicly in the street and not among peers. Different hypothesizes are put forward to explain this fact: inappropriate type of event for drug consumption, effect of other festivals, and influence of the event's timing on a weekday.