New Psychoactive Substances: Which Biological Matrix Is the Best for Clinical Toxicology Screening?

Abstract

Background: Every year, more new psychoactive substances (NPSs) emerge in the market of the drugs of abuse. NPSs belong to various chemical classes, such as synthetic cannabinoids, phenethylamines, opioids, and benzodiazepines. The detection of NPSs intake using different types of biological matrices is challenging for clinical toxicologists because of their structural diversity and the lack of information on their toxicokinetics, including their metabolic fate.Methods: PubMed-listed articles reporting mass spectrometrybased bioanalytical approaches for NPSs detection published during the past 5 years were identified and discussed. Furthermore, the pros and cons of using common biological matrices in clinical toxicology (CT) settings to screen for NPSs are highlighted in this review article.Results: Twenty-six articles presenting multianalyte screening methods for use in the field of CT were considered. The advantages and disadvantages of different biological matrices are discussed with a particular view of the different analytical tasks in CT, especially emergency toxicology. Finally, an outlook introduces the emerging trends in biosamples used in CT, such as the exhaled breath.Conclusions: Blood and urine represent the most common biological matrices used in a CT setting; however, reports concerning NPSs detection in alternative matrices are also available. Noteworthy, the selection of the biological matrix must depend on the clinician's enquiry because the individual advantages and disadvantages must be considered.

Comparison of reversed-phase, hydrophilic interaction, and porous graphitic carbon chromatography columns for an untargeted toxicometabolomics study in pooled human liver microsomes, rat urine, and rat plasma

“…1) pHLM incubations, a well-characterized in vitro model, which is commonly used in drug metabolism studies, since its ease of use and low variability (Asha & Vidyavathi, 2010 ; Richter et al, 2017 ). 2) Rat urine, a matrix to reflect the complexity of an in vivo model and which is rich in hydrophilic substances (Khamis et al, 2017 ; Wagmann et al, 2022 ). 3) Rat plasma, as a more complex matrix covering a broad spectrum of endogenous compound classes compared to urine.…”

Sample Matrices for Mass Spectrometry–Based Adherence Monitoring: A Systematic Critical Review

“…In particular, the high number of new psychoactive substances in the DOA market prevents the sole application of IA for DOA detection in urine and underlines the importance of MS for abstinence control in the context of SUD. 83 However, it is also expected that MS-based monitoring of medication adherence will gain importance in the future. These analyses are already fixed components of clinical trials.…”

Detecting novel psychoactive substances around the world

“…Both the parent drugs and their metabolites, the latter essential to confirm active drug use, are routinely identified. The choice of the most appropriate specimen and related screening and confirming analytical methods usually depends on their specific advantages and disadvantages [8 ▪ ]. A mindful and well judged approach becomes crucial every time NPS analyses are applied in different emergency and forensic toxicology contexts, including seized products analysis, drug of abuse monitoring, fatal and nonfatal intoxication cases, and antidoping controls [9,10].…”