The Detection of Novel Stimulants in Oral Fluid from Users Reporting Ecstasy, Molly and MDMA Ingestion

Krotulski, Alex J; Mohr, Amanda L A; Fogarty, Melissa F; Logan, Barry K.

doi:10.1093/jat/bky051

Cited by 37 publications

(27 citation statements)

References 23 publications

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“…Las cifras elevadas de presión arterial al ingreso pueden resultar del efecto simpaticomimético, si bien luego, en la evolución, el hallazgo de cifras tensionales elevadas fuera del episodio agudo y la hipertrofia ventricular izquierda permiten plantear una hipertensión arterial esencial de base. La ausencia de otros elementos clínicos de estimulación simpática (midriasis, taquicardia) podrían explicarse por la consulta tardía y por un perfil psicoactivo MDMA símil en una primera fase de la intoxicación aguda (15,16) . La dibutilona se metaboliza a butilona (11) .…”

Section: Discussionunclassified

Isquemia miocárdica por consumo de dibutilona

Pascale

Umpiérrez

Menoni

et al. 2020

RMU

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Las catinonas sintéticas son drogas estimulantes de síntesis, comercializadas en el mercado ilegal por sus propiedades estimulantes y perturbadoras del sistema nervioso central, para su uso recreativo, solas, o como adulterantes de cocaína y derivados anfetamínicos. A nivel mundial existe un número creciente de reportes de intoxicaciones agudas y complicaciones por consumo de estas sustancias. En Uruguay fueron detectadas por primera vez en el año 2015, existiendo una información epidemiológica muy limitada. Las catinonas sintéticas no se detectan por las técnicas inmunocromatográficas disponibles en los laboratorios de los servicios de urgencias de nuestro país. Se describe el primer caso de intoxicación por una catinona sintética (dibutilona) en Uruguay, en un paciente de 45 años, por consumo de un polvo vendido como "éxtasis", presentando como complicación un síndrome coronario agudo, con una buena evolución posterior. La confirmación diagnóstica se realizó mediante su detección en orina por cromatografía de gases acoplada a espectrometría de masas. La estructura química de la dibutilona y su mecanismo de acción explican las manifestaciones clínicas y la complicación isquémica por vasoespasmo coronario. En ausencia de una noción clara de exposición y ante la situación epidemiológica actual, la presencia de un cuadro clínico compatible con una droga estimulante y resultado negativo para cocaína y anfetaminas en estudios inmunocromatográficos, debe hacer plantear la sospecha de otros estimulantes de síntesis como las catinonas, tal como ocurrió en este caso.

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Section: Discussionunclassified

Isquemia miocárdica por consumo de dibutilona

Pascale

Umpiérrez

Menoni

et al. 2020

RMU

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“…It should be noted that although prevalence of (known) use of Flakka or other "bath salts" among adolescents is relatively rare, surveys likely underestimate use because these compounds are often used unknowingly as adulterants in drugs such as ecstasy in the US (Oliver et al, 2018). For example, a recent study that saliva-tested EDM festival attendees in Florida found that 30% of ecstasy users tested positive for "bath salts", including some cases of unknown Flakka exposure (Krotulski et al, 2018). Likewise, recent hair-testing studies of ecstasy-using EDM party attendees in New York City found that 50-68% of those testing positive for "bath salts" denied known use, with 2% testing positive for Flakka .…”

Section: Discussionmentioning

confidence: 99%

“Flakka” use among high school seniors in the United States

Palamar

Rutherford

Keyes

2019

Drug and Alcohol Dependence

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Background: Use of synthetic cathinones, commonly referred to as "bath salts", has been associated with tens of thousands of emergency department visits in the US; however, few national studies have estimated prevalence of use and we know very little about use among adolescents. In this study we estimate prevalence and correlates of use of "Flakka" (alpha-PVP), a highly-potent "bath salt" associated with at least 80 deaths in the US. Methods: We analyzed data from the 2016/2017 Monitoring the Future study, which surveyed a nationally representative sample of high school seniors in the US (n=3,786). Bivariable and multivariable models were used to determine demographic and drug-related correlates of use. Results: Overall, 0.8% (95% CI: 0.5-1.2) of high school seniors in 2016/2017 is estimated to have used Flakka in the past year. Students whose parents have less than a high school education were at higher odds for use (aOR=4.12, 95% CI: 1.00-16.94). Flakka users reported high prevalence of use of other drugs, particularly synthetic cannabinoids (85.6%), ketamine (72.3%), marijuana (59.1%), and GHB (47.5%). Flakka use was also associated with use of a higher number of other drugs and higher frequency of use of other drugs, with 51.7% using 4-12 other drugs and 22.4% using 4-12 other drugs >6 times. Conclusions: Students who use multiple drugs are elevated risk for Flakka use, suggesting synthetic cathinone use alone is rare and the use of multiple substances may compound adverse effects of these drugs. Socioeconomic disparities are concerning given reduced access to prevention and intervention.

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“…Delay in the onset of desired effects may encourage users to take more of their pills or use other stimulants or alcohol, potentiating MDMA‐associated harms (Table ). As polysubstance use at music festivals is the norm, pill testing cannot predict inter‐individual variability in drug metabolism and toxicity or the effects of concomitant use of alcohol or other substances. Of 605 MDMA‐related fatalities in the United Kingdom, MDMA was identified as the sole drug in only 17% of post‐mortems .…”

Section: What Causes Deaths Among Pill Users At Music Festivals?mentioning

confidence: 99%

Pill testing at music festivals: is it evidence‐based harm reduction?

Scott

2020

Internal Medicine Journal

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Recent pill-related deaths of young people at music festivals in Australia have led to a concerted push for on-site pill testing as a means for preventing such events. However, whether pill testing (also termed 'safety checking') is an effective harm reduction strategy remains uncertain. This narrative review concludes that pill testing currently lacks evidence of efficacy sufficient to justify publicly funded national roll-out of on-site pill-testing programmes. Australian governments, addiction specialists and public health experts should collaborate in conducting properly designed field studies aimed at confirming clear benefits from such programmes in reducing pill-related harm.

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The Detection of Novel Stimulants in Oral Fluid from Users Reporting Ecstasy, Molly and MDMA Ingestion

Cited by 37 publications

References 23 publications

Isquemia miocárdica por consumo de dibutilona

Isquemia miocárdica por consumo de dibutilona

“Flakka” use among high school seniors in the United States

Pill testing at music festivals: is it evidence‐based harm reduction?

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