Citation

Larabi IA, Fabresse N, Etting I, Nadour L, Pfau G, Raphalen JH, Philippe P, Edel Y, Alvarez JC. Drug Alcohol Depend. 2019; 204: e107508.

Affiliation

Department of Pharmacology and Toxicology, Versailles Saint-Quentin-en-Yvelines University, Inserm U-1173, Raymond Poincaré Hospital, AP-HP, 104, Raymond Poincaré Blvd., 92380 Garches, France. Electronic address: jean-claude.alvarez@aphp.fr.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.drugalcdep.2019.06.011

PMID

31670189

Abstract

BACKGROUND: The aim of the present study is to describe the prevalence of NPS and conventional DOA in Paris and its suburbs over a six-year period using hair testing approach.

METHOD: Hair was sampled in patients admitted to different departments of Paris hospitals between 2012 and 2017. Two high-risk populations were mainly considered: 1) drug-dependent and 2) acutely intoxicated patients. Segmental hair analysis was performed by validated LC-MS/MS method to screen for DOA and 83 NPS.

RESULTS: 480 patients (280 M/200 F, 15-70 years) were included. 141 patients tested positive for NPS (99 M/42 F; median age: 33). NPS prevalence was 29%, that of amphetamines, cocaine and opioids were 32%, 38.5% and 52%, respectively. 27 NPS were identified, 4-MEC and mephedrone (number of cases n = 24 each) were the most detected cathinones. JWH-122 (n = 1) was the only detected synthetic cannabinoid while ketamine (n = 104) was present in numerous NPS users (67%). 3-fluorofentanyl (n = 1), furanylfentanyl (n = 1), N-ethylpentylone (n = 2), pentedrone (n = 2), mexedrone (n = 1), methcathinone (n = 3), 6-APDB (n = 2), TFMPP (n = 2), 2-CE (n = 1), 3,4-MD-αPHP (n = 1) and dextromethorphan (n = 27) were identified for the first time in hair. Users were found to have more than one NPS in 53% of cases, mostly in combination with conventional DOA. The number of detected NPS rose from 5 in 2012 to 42 in 2017. A broad range of hair concentrations (0.001-318 ng/mg) was found, but the low median concentrations seem to show an occasional exposure more than chronic use.

CONCLUSION: NPS screening should be assessed in routine clinical practice, especially in high-risk populations.

Copyright © 2019 Elsevier B.V. All rights reserved.

Language: en

Keywords

Cathinones; Hair testing; Mass spectrometry; New psychoactive substances; Prevalence