Early Warning System for Illicit Drug Use at Large Public Events: Trace Residue Analysis of Discarded Drug Packaging Samples

West, Henry; Fitzgerald, John; Hopkins, Katherine; Li, Eric; Clark, N.J.; Tzanetis, Stephanie; Greene, Shaun L; Reid, Gavin E.

doi:10.1021/jasms.1c00232

Cited by 20 publications

(26 citation statements)

References 66 publications

(107 reference statements)

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“…However, the experimentally observed fragmentation behavior did not match any available reference MS/MS spectra for substances with the proposed molecular formula. Furthermore, the spectrum was significantly different to that of any of the drug compound classes that had previously been observed in this, or our previous studies [40]. Conventional Higher energy Collision induced Dissociation (HCD)-MS/MS at low relative collision energy provided only limited structural information, with a single dominant product ion at m/z 266.15 corresponding to the loss of C2H7N:…”

Section: 2contrasting

confidence: 65%

“…Direct Analysis in Real Time -Mass Spectrometry (DART-MS) and tandem mass spectrometry (MS/MS) of DDP samples Samples were introduced to a Thermo Scientific Q Exactive Plus (Bremen, Germany) mass spectrometer using a Direct Analysis in Real Time (DART) source and a Vapur Interface (IonSense, MA, USA), as previously described [40]. The probe heater was set to 200˚C using nitrogen as the ionizing gas.…”

Section: 3mentioning

confidence: 99%

“…and DDP. Examples include Desorption ElectroSpray Ionization (DESI) [28][29][30], Paper-Spray (PS) [31][32][33], Low Temperature Plasma (LTP) ionization [34], Atmospheric Solids Analysis Probe (ASAP) [35] and Direct Analysis in Real Time (DART) [36][37][38][39][40]. When coupled with high-resolution accurate mass spectrometry and MS/MS techniques, the identification and characterization of unexpected or novel drug substances may potentially be achieved using these approaches, via assignment of the molecular formulae of the observed ions and by similarities in MS/MS fragmentation behavior compared to structurally homologous known substances within an established drug class [41][42][43][44].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, we described the development and application of a DART-MS and -MS/MS approach for rapid and high-throughput trace residue sampling and analysis of discarded drug packaging samples (DPS) as part of an early warning monitoring system for illicit drug use at large public events. This approach was shown to be applicable for the identification and characterization of a wide range of illicit drugs and adulterant substances, including numerous NPS and complex poly-drug mixtures, using laboratory-based instrumentation as well as in 'close-to-real-time' applications using a transportable mass spectrometer housed within a mobile analytical laboratory [40]. Here, we describe the extension of this approach for the identification of substances present within >6,600 DDP samples collected during a six-month pilot study between September 2020 and February 2021 in Melbourne Australia while significant COVID-19 lockdown conditions were in place.…”

Section: Introductionmentioning

confidence: 99%

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Trace Residue Identification, Characterization and Longitudinal Monitoring of the Novel Synthetic Opioid β-U10, from Discarded Drug Paraphernalia

West

Fitzgerald

Hopkins

et al. 2022

Preprint

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Empirical data regarding dynamic alterations in illicit drug supply markets in response to the COVID-19 pandemic, including the potential for introduction of novel drug substances and/or increased poly-drug combinations at the ‘street’ level (i.e., directly proximal to the point of consumption), is currently lacking. Here, a high-throughput strategy employing ambient ionization-mass spectrometry is described for the trace residue identification, characterization and longitudinal monitoring of illicit drug substances found within >6,600 discarded drug paraphernalia (DDP) samples collected during a pilot study of an early warning system for illicit drug use in Melbourne, Australia from August 2020-February 2021, while significant COVID-19 lockdown conditions were imposed. The utility of this approach is demonstrated for the de novo identification and structural characterization of β-U10, a previously unreported naphthamide analogue within the ‘U-series’ of synthetic opioid drugs, including differentiation from its α-U10 isomer without need for sample preparation or chromatographic separation prior to analysis. Notably, β-U10 was observed with 23 other drug substances, most commonly in temporally distinct clusters with heroin, etizolam and diphenhydramine, and in a total of 182 different poly-drug combinations. Finally, longitudinal monitoring of the number and weekly ‘average signal intensity’ (ASI) values of identified substances, developed here as a semi-quantitative proxy indicator of changes in availability, relative purity and compositions of street level drug samples, revealed that increases in the number of identifications and ASI for β-U10 and etizolam coincided with a 50% decrease in the number of positive detections and an order of magnitude decrease in the ASI for heroin.

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Section: 2contrasting

confidence: 65%

Section: 3mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trace Residue Identification, Characterization and Longitudinal Monitoring of the Novel Synthetic Opioid β-U10, from Discarded Drug Paraphernalia

West

Fitzgerald

Hopkins

et al. 2022

Preprint

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“…Two successful drug checking trials were held in 2018-19 (44); and some states have trialed or currently manage existing local EWS, but these function in varied stages of maturity and capacity for ongoing, systematic data sharing and timely reporting (16,45,46). In Victoria, the State Government issued its rst public drug alert in 2020 about green pills containing N-ethylpentylone (a phenethylamine) with no MDMA/ecstasy present after a research project piloted a mobile testing laboratory at large-scale public events (47,48). The Emerging Drugs Network of Australia (Victoria: EDNAV) was also established in 2020 to improve monitoring of emerging and illicit drug presentations in hospital emergency departments.…”

mentioning

confidence: 99%

Co-Designing High-Risk Drug Alerts for Health and Community Service Practitioners

Brien

Volpe

Grigg

et al. 2022

Preprint

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Background Alerts about drug market changes (e.g., drug strength, purity, adulterations, or other trends) may be useful to assist health and community workers to anticipate, prevent and respond to unexpected adverse drug events. This study aimed to establish factors influencing the successful design and implementation of drug alerts for use in clinical and community settings in Victoria, Australia. Methods We used an iterative, parallel mixed methods participatory design to co-produce drug alert prototypes with practitioners and managers working across alcohol and other drugs and emergency medicine settings. A quantitative needs-analysis survey (n = 184) informed five qualitative co-design workshops (n = 31). Alert prototypes were drafted based on findings and presented for testing of utility and acceptability. Applicable constructs from the Consolidated Framework for Implementation Research helped to identify key barriers and facilitators to successful alert design. Results Timely and reliable alerts about high-risk single substances were important to nearly all practitioners (98%) yet many reported insufficient access to timely information about drug markets and emerging threat (64%). Alerts were useful for increasing exposure to drug market intelligence; facilitating risk communication; and improving capacity for effective responses. Alerts must be ‘shareable’ across a range of settings to meet the needs of diverse professional and public audiences. Practitioners and managers considered themselves ‘conduits’ for information sharing. To maximize engagement and impact, alerts must be attention-grabbing and easily recognisable; available on multiple platforms; published in printable and electronic formats in varying levels of detail; and disseminated using appropriate notification mechanisms. Three clinical drug alert prototypes (SMS prompt, summary flier, and detailed PDF) were developed and considered acceptable and useful for a range of audiences and settings. Discussion Adequate planning and resourcing for effective drug alert design and evaluation arising from jurisdictional and national early warning systems is imperative to their utility. Such systems need to have access to reliable multidisciplinary drug market intelligence for rapid assessment and verification of risk to report timely and effective risk communications. Systems that offer close to real-time detection of adulterants/contaminants (e.g., drug checking services) are best-placed to provide rapid, evidence-based drug market intelligence to inform preventive and responsive action.

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Mass Spectrometry

Sharp

2022

Drug Metabolism Handbook

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Early Warning System for Illicit Drug Use at Large Public Events: Trace Residue Analysis of Discarded Drug Packaging Samples

Cited by 20 publications

References 66 publications

Trace Residue Identification, Characterization and Longitudinal Monitoring of the Novel Synthetic Opioid β-U10, from Discarded Drug Paraphernalia

Trace Residue Identification, Characterization and Longitudinal Monitoring of the Novel Synthetic Opioid β-U10, from Discarded Drug Paraphernalia

Co-Designing High-Risk Drug Alerts for Health and Community Service Practitioners

Mass Spectrometry

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