New psychoactive substances as part of polydrug abuse within opioid maintenance treatment revealed by comprehensive high-resolution mass spectrometric urine drug screening

Heikman, Pertti; Sundström, Mira; Pelander, Anna; Ojanperä, Ilkka

doi:10.1002/hup.2512

Cited by 47 publications

(33 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this new era of NPS, opiate‐dependent patients have also started to substitute heroin and other opiates for a longer period with cathinones (Heikman, Sundström, Pelander, & Ojanperä, ). Cathinone‐derivatives, such as mephedrone ( 4‐methylmethcathinone ), pentedrone ( 2‐(methylamino)‐1‐phenylpentan‐1‐one ), methylone ( 3,4‐methylenedioxy‐N‐methylcathinone ), 4‐MEC ( 4‐methylethcathinone ), and MDPV ( 3,4‐methylenedioxypyrovalerone ) had been sold as products not intended for human consumption (e.g., bath salts, food plants, fertilizers, or research chemicals) in order to circumvent drug use legislation.…”

Section: Introductionmentioning

confidence: 99%

Novel psychoactive substance use among treatment‐seeking opiate users: The role of life events and psychiatric symptoms

Kapitány-Fövény

Farkas

Pataki

et al. 2017

Human Psychopharmacology

View full text Add to dashboard Cite

Objective Over the past 5 years, a shift to the use of novel psychoactive substances (NPS) has been observed among opioid users. The aim of this study was to assess the potential reasons for NPS use among treatment‐seeking patients receiving opiate substitution therapy. Method A structured questionnaire was filled out by a sample of 198 opiate dependent patients of Hungary's National Institute of Psychiatry and Addiction. This questionnaire assessed demographics, treatment characteristics, lifetime substance use, potential reasons for NPS use, negative life events (Life Events Scale), and psychiatric symptoms (Brief Symptom Inventory). Results The most frequent reasons for NPS use were curiosity, replacing other drugs, and easy availability. The majority of the respondents used synthetic cathinones and chose practical reasons, not psychopharmacological preferences. A series of binary logistic regressions indicated that lifetime amphetamine use (OR = 4.64, 95% CI [2.16, 9.96]) and more severe psychiatric symptoms (OR = 1.89, 95% CI [1.18, 3.04]) may predict NPS use. Time spent in treatment was a minor protective factor (OR = 0.92, 95% CI [0.86, 0.99]). Conclusion Synthetic cathinones might still substitute amphetamine‐derivatives, although these NPS are no longer legal. There is a need for the regular screening of psychiatric symptoms and the use of family therapy among participants on opioid substitution programs.

show abstract

Section: Introductionmentioning

confidence: 99%

Novel psychoactive substance use among treatment‐seeking opiate users: The role of life events and psychiatric symptoms

Kapitány-Fövény

Farkas

Pataki

et al. 2017

Human Psychopharmacology

View full text Add to dashboard Cite

show abstract

“…In a recent review of the rising national prevalence of psychoactive polypharmacy among outpatient psychiatrists, other researchers note that many of these medication combinations are not evidence-based and come with increased risk and unknown clinical benefit (Mojtabai and Olfson, 2010). In patients with OUD, potential additional risks of polypharmacy exist such as de-stabilization of OUD recovery (Caviness et al, 2013; Heikman et al, 2016; Wilens et al, 2015). However, these risks must be balanced with the need to manage patients’ mood, sleep and pain symptoms to continue to keep them engaged in buprenorphine treatment.…”

Section: Discussionmentioning

confidence: 99%

Psychoactive medications and disengagement from office based opioid treatment (obot) with buprenorphine

Weinstein

Cheng

Quinn

et al. 2017

Drug and Alcohol Dependence

View full text Add to dashboard Cite

Background The prevalence of psychoactive medications (PAMs) use in patients enrolled in Office Based Opioid Treatment (OBOT) and its association with engagement in this care is largely unknown. Objective To describe the use of PAMs, including those medications with emerging evidence of misuse (“emerging PAMs” - gabapentin, clonidine and promethazine) among patients on buprenorphine, and its association with disengagement from OBOT. Methods This is a retrospective cohort study of adults on buprenorphine from January, 2002 to February, 2014. The association between use of PAMs and 6-month disengagement from OBOT was examined using multivariable logistic regression models. A secondary analysis exploring time-to-disengagement was conducted using Cox regression models. Results At OBOT entry, 43% of patients (562/1308) were prescribed any PAM; including 17% (223/1308) on an emerging PAM. In separate adjusted analyses, neither the presence of any PAM (adjusted odds ratio [AOR] 1.07, 95% CI [0.78, 1.46]) nor an emerging PAM (AOR 1.28 [0.95, 1.74]) was significantly associated with 6-month disengagement. The results were similar for the Cox model (any PAM (adjusted hazard ratio [AHR] 1.16, 95% CI [1.00, 1.36]), emerging PAM (AHR 1.18 [0.98, 1.41])). Exploratory analyses suggested gabapentin (AHR 1.30 [1.05 – 1.62]) and clonidine (AHR 1.33 [1.01 – 1.73]) specifically, may be associated with an overall shorter time to disengagement. Conclusions Psychoactive medication use is common among patients in buprenorphine treatment. No significant association was found between the presence of any psychoactive medications, including medications with emerging evidence of misuse, and 6-month disengagement from buprenorphine treatment.

show abstract

“…Although now controlled together with MDPV and methylone under schedule 2 of the United Nations Convention on Psychotropic Substances 1971 (UNODC, ), and technically no longer an NPS, mephedrone still requires monitoring and investigating, especially because mephedrone‐related dependence and fatalities continue to occur on a regular basis (PHE, ; ISD, ; ONS, ; NRS, ; NISRA, ). Synthetic cathinones have been widely prevalent among clubbers, high‐risk drug users such as heroin‐injecting users, MSM (i.e., men who have sex with men), and abstinence treatment entrants (EMCDDA, ; Heikman, Sundström, Pelander, & Ojanperä, ). ‘Slamming’ (i.e., intravenous administration) cathinones became very popular in group sex because it improves mood and induces sexual disinhibition (Batisse, Grégoire, Marillier, Fortias, & Djezzar, ).…”

Section: Introductionmentioning

confidence: 99%

Intended and unintended use of cathinone mixtures

Guirguis

Corkery

Stair

et al. 2017

Human Psychopharmacology

View full text Add to dashboard Cite

Introduction Cathinones are one of the most popular categories of new psychoactive substances (NPS) consumed. Cathinones have different pharmacological activities and receptor selectivity for monoamine transporters based on their chemical structures. They are incorporated into NPS mixtures and used with other NPS or ‘traditional’ drugs. Cathinone use represents significant health risks to individuals and is a public health burden. Methods Evidence of poly‐NPS use with cathinones, seizure information, and literature analyses results on NPS mixtures was systematically gathered from online database sources, including Google Scholar, Scopus, Bluelight, and Drugs‐Forum. Results and discussion Results highlight the prevalence of NPS with low purity, incorporation of cathinones into NPS mixtures since 2008, and multiple members of the cathinone family being present in individual UK‐seized samples. Cathinones were identified as adulterants in NPS marketed as being pure NPS, drugs of abuse, branded products, herbal blends, and products labelled “not for human consumption.” Toxicity resulting from cathinone mixtures is unpredictable because key attributes remain largely unknown. Symptoms of intoxication include neuro‐psychological, psychiatric, and metabolic symptoms. Proposed treatment includes holistic approaches involving psychosocial, psychiatric and pharmacological interventions. Conclusion Raising awareness of NPS, education, and training of health care professionals are paramount in reducing harms related to cathinone use.

show abstract

New psychoactive substances as part of polydrug abuse within opioid maintenance treatment revealed by comprehensive high-resolution mass spectrometric urine drug screening

Abstract: A widespread occurrence of abused substances beyond the ordinary was revealed. Identifying these patients is essential as polydrug abuse is a safety risk to the patient and may cause attrition from OMT.

Cited by 47 publications

References 41 publications

Novel psychoactive substance use among treatment‐seeking opiate users: The role of life events and psychiatric symptoms

Novel psychoactive substance use among treatment‐seeking opiate users: The role of life events and psychiatric symptoms

Psychoactive medications and disengagement from office based opioid treatment (obot) with buprenorphine

Intended and unintended use of cathinone mixtures

Contact Info

Product

Resources

About