Prevalence of New Psychoactive Substances (NPS) and conventional drugs of abuse (DOA) in high risk populations from Paris (France) and its suburbs

Larabi, Islam Amine; Fabresse, Nicolas; Etting, Isabelle; Nadour, L.; Pfau, Grégory; Raphalen, Jean-Herlé; Pelletier, Philippe; Edel, Yves; Alvarez, Jean‐Claude

doi:10.1016/j.drugalcdep.2019.06.011

Cited by 55 publications

(45 citation statements)

References 45 publications

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“…The prevalence rate for recent NPS use in the present study was lower than in previous studies with other drug using groups, i.e., injecting drug users from Hungary and Scotland ( 15 , 16 ), drug using patients in France ( 17 ), patients with substance use disorders in Scotland ( 4 ), or Swedish patients in opioid maintenance treatment ( 20 ). Moreover, cathinones are more prevalent in other studies ( 17 ). Regional or national differences between drug markets, including legal regulations, might play a role here.…”

Section: Discussioncontrasting

confidence: 84%

“…Although administration of NPS is mainly via non-injecting routes ( 14 ), data from Hungary ( 15 ) and Scotland ( 16 ) suggest that persons who inject drugs might also inject NPS. In a sample of drug dependent and/or acutely intoxicated patients from hospitals in Paris and its suburbs ( 17 ), prevalence of NPS use was 29%, according to hair analysis. In that study, ketamine was subsumed under NPS and constituted more than half of the consumed substances.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Novel Psychoactive Substance (NPS) Use in Patients Admitted to Drug Detoxification Treatment

et al. 2020

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Background About 15 years ago, a diverse group of new recreational psychotropic substances began to emerge, which were marketed for example as “legal highs,” “research chemicals,” or “designer drugs.” These substances were later subsumed under the label “Novel Psychoactive Substances” (NPS). Important NPS classes are cathinones, synthetic cannabimimetics, phenethylamines, and herbal drugs. The health care system for psychotropic substance use disorders (SUDs) traditionally focused on a few substances, such as alcohol, heroin, cocaine, amphetamines, or cannabis. Users of illicit substances often engage in polydrug use. However little is known about the prevalence of NPS use within the group of “classical” illicit substance users. Objective We investigated lifetime and recent use of NPS and other drugs in patients who underwent in-patient detoxification treatment from illicit drugs in Germany. Methods In a multicenter study with eight participating facilities, patients admitted to treatment underwent a standardized interview at admission, concerning their past and current substance use. The interview comprised classical substances of abuse, NPS, and rarely used substances such as LSD. In addition, participating sites had the opportunity to analyze their patients’ routine drug screenings by means of gas chromatography/mass spectrometry (GC/MS), which permitted detection of NPS. Results Interviews from 295 patients could be analyzed. Most patients were opiate dependent and multiple substance users. About 32% reported use of synthetic cannabimimetics during lifetime, but usually only a few times. An important reason for their use was that NPS were not detected by drug testing in prisons or drug treatment facilities. Cathinones, herbal drugs or other NPS had rarely been used during lifetime. NPS use during the last 30 days before admission was nearly zero. This was confirmed by urine analysis results. In contrast, lifetime and current use of opiates, alcohol, cocaine, benzodiazepines, and cannabis was high. In addition, 18% reported of regular unprescribed pregabalin use during lifetime, and 20% had recently used pregabalin. Conclusion Patients admitted to drug detoxification treatment showed multiple substance use, but this did not include NPS use. The diversion of legal medications such as pregabalin in this group is a serious concern.

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Section: Discussioncontrasting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Prevalence of Novel Psychoactive Substance (NPS) Use in Patients Admitted to Drug Detoxification Treatment

et al. 2020

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“…The system derived from a previously described method 23 . Chromatography was performed on a Dionex Ultimate 3000 pump (ThermoFisher, Les Ulis, France) using a Hypersyl Gold PFP column (100 × 2.1 mm i.d., particle size 1.9 μm) preheated at 30°C.…”

Section: Methodsmentioning

confidence: 99%

“…One hundred thirty‐seven hair samples (134 samples screened during 2019 and 3 hair samples previously screened positive for fentanyl) were considered to verify the applicability of the present method after undergoing screening for common opioids, cocaine, amphetamines, and NPS using a previously described method 23 . Cannabis has not been sought systematically as its screening requires a different extraction procedure in acidic conditions and a need for a second strand of hair, which was not available in all cases.…”

Section: Methodsmentioning

confidence: 99%

Development and validation of liquid chromatography‐tandem mass spectrometry targeted screening of 16 fentanyl analogs and U‐47700 in hair: Application to 137 authentic samples

Larabi

Martin

Etting

et al. 2020

Drug Testing and Analysis

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This study was to validate a LC–MS/MS method for the determination of 17 new synthetic opioids (NSOs) in hair including 3‐fluorofentanyl, 3‐methylfentanyl, acetylfentanyl, acetylnorfentanyl, alfentanyl, butyrylfentanyl, butyrylnorfentanyl, carfentanil, fentanyl, furanylfentanyl, furanylnorfentanyl, methoxyacetylfentanyl, norcarfentanil, norfentanyl, ocfentanil, sufentanil, and U‐47700, and to apply it to 137 authentic samples. Twenty milligrams of hair was decontaminated in dichloromethane and underwent liquid extraction. 10 μL of the reconstituted residue were injected onto the system. The separation was performed in 12 minutes in a gradient mode at a flow rate of 300 μL/min using a Hypersyl Gold PFP column (100 × 2.1 mm i.d., 1.9 μm) maintained at 30°C. Compounds were detected in positive ionization and MRM modes using a TSQ Endura mass spectrometer (ThermoFisher). The method was validated according to EMA guidelines. The LLOQ was in the range 1–50 pg/mg, and the calibration ranged from the LLOQ‐1000 pg/mg. Intra‐ and inter‐day accuracy (bias) and precision were < 15%. Extraction recoveries of parent drugs and metabolites were 74–120% and 7–62%, respectively. The matrix effect was in the range 59–126% (CVs ≤ 12.9%). Fentanyl was found in six cases at concentrations of < 1–1650 pg/mg (n = 14 segments). Five fentanyl analogs were quantified in two cases: 3‐fluorofentanyl (25–150 pg/mg, n = 5), furanylfentanyl (15–500 pg/mg, n = 5), methoxyacetylfentanyl (500–600 pg/mg, n = 2), acetylfentanyl (1 pg/mg, n = 2), carfentanyl (2.5–3 pg/mg, n = 2). This fully validated method allowed us to test for the first time 3‐fluorofentanyl and norcarfentanil in hair among 15 other NSOs, and brings new data regarding 3‐fluorofentanyl and methoxyacetylfentanyl hair concentrations.

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“…Even if this approach remains scarce and requires some particular skills, it deserves to be considered as a direct and long-term indicator of drug exposure. Some prevalence and analytical data regarding new psychoactive substance (NPS) study by hair testing in high-risk populations are now available [21][22][23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Hair testing for 3-fluorofentanyl, furanylfentanyl, methoxyacetylfentanyl, carfentanil, acetylfentanyl and fentanyl by LC–MS/MS after unintentional overdose

et al. 2019

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Purpose To demonstrate the usefulness of hair testing to determine exposure pattern to fentanyls. Methods A 43-year-old male was found unconscious with respiratory depression 15 min after snorting 3 mg of a powder labeled as butyrylfentanyl. He was discharged from hospital within 2 days without blood or urine testing. Two locks of hair were sampled 1 month (M1 A: 0-2 cm (overdose time frame); B: 2-4 cm; C: 4-6 cm) and 1 year (Y1: A: 0-2 cm; B: 2-4 cm) later to monitor his exposure to drugs of abuse by liquid chromatography-tandem mass spectrometry after liquidliquid extraction. Results Hair analysis at M1 showed a repetitive exposure to 3-fluorofentanyl (A/B/C: 150/80/60 pg/mg) with higher concentration in segment A reflecting the overdose period. The non-detection of butyrylfentanyl was consistent with the analysis of the recovered powder identified as 3-fluorofentanyl. Furanylfentanyl (40/20/15 pg/mg) and fentanyl (37/25/3 pg/mg) were also detected in hair. The second hair analysis at Y1 showed the use of three new fentanyls, with probably repetitive exposures to methoxyacetylfentanyl (A/B: 500/600 pg/mg), and single or few exposures to carfentanil (2.5/3 pg/mg) and acetyl fentanyl (1/1 pg/mg). A decreasing exposure to 3-fluorofentanyl (25/80 pg/mg), and increasing consumption of furanylfentanyl (310/500 pg/mg) and fentanyl (620/760 pg/mg) were also observed despite methadone treatment initiation. The patient claimed not consuming three out of the six detected fentanyls. Conclusions We report single or repetitive exposure to several fentanyls using hair testing. To our knowledge, this is the first demonstration of 3-fluorofentanyl and methoxyacetylfentanyl in hair samples collected from an authentic abuser.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Prevalence of New Psychoactive Substances (NPS) and conventional drugs of abuse (DOA) in high risk populations from Paris (France) and its suburbs

Cited by 55 publications

References 45 publications

Prevalence of Novel Psychoactive Substance (NPS) Use in Patients Admitted to Drug Detoxification Treatment

Prevalence of Novel Psychoactive Substance (NPS) Use in Patients Admitted to Drug Detoxification Treatment

Development and validation of liquid chromatography‐tandem mass spectrometry targeted screening of 16 fentanyl analogs and U‐47700 in hair: Application to 137 authentic samples

Hair testing for 3-fluorofentanyl, furanylfentanyl, methoxyacetylfentanyl, carfentanil, acetylfentanyl and fentanyl by LC–MS/MS after unintentional overdose

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