Targeted and untargeted screening of new psychoactive substances (NPS) and classical drugs of abuse in Paris using hair testing: A 10-years study (2012–2021)

Abstract

To detect and quantify NPS and conventional drugs of abuse (DoA) between 2012 and 2021 in high-risk populations of Paris area, and to describe their characteristics using hair testing based approch and a combination of targeted and untargeted screening by LC-MSMS and LC-HRMS. In all, 939 hair samples collected in addiction ( n = 229, 24%) or intoxications ( n = 337, 36%) settings were segmented whenever possible (A: 0–2 cm; B: 2–4 cm; C: 4–6 cm) and analyzed using a previously published LC-MS/MS and LC-HRMS methods dedicated to the screening of DoA and NPS in hair. Briefly, 20 mg of hair was washed with dichloromethane, dried at room temperature and pulverized. It was hydrolyzed in phosphate buffer (pH 5.0, 95 °C, 10 min) and extracted using hexane/ethyl acetate and chloroforme/isopropanol. Separation were performed in a gradient mode using Hypersil PFP Gold column (100 mm × 2.1 mm, 1.9 μm) for targeted screening and Phenyl hexyl column (100 mm × 2.1 mm, 1.9 μm) for untargeted screening. Triple Quad TSQ Altis in MRM mode and Q Exactive Orbitrap in ddMS2 mode (both from ThermoFisher®) were used as detection systems. NPS were detected 1551 times in 288 cases. Their prevalence was 31% and was lower than that of amphetamines (34%), cocaine (42%) or licit/illicit opioids (51%) measured in the same populations. Consumers were predominantly male (68%) with a median age of 30 years. 51 different NPS were detected with 1 to 15 NPS being consumed per patient within the same period: ketamine (n = 84, 54 pg/mg median), mephedrone (26, 100), dextromethorphan (16, 100), normephedrone (9, 1630), 4-MEC (6, 205), methylone (5, 20), ethylphenidate (5, 9), 3-MMC (5, 330), flubromazepam (4, 192), etizolam (4, 5), α-PVP (4, 67), α-PHP (4, 5895), N-ethylpentylone (4, 50), 5-APB (3, 255), 3-FPM (3, 583), harmine (2, <1), mitragynine (2, <1), MDPV (2, 55), pentylone (2, 9), 2F-DCK (2, 3260), O-PCE (2, 20), 4-FA (2, 560), m-CPP (2, 569), 5F-AKB48 (n = 2, 16), 5F-PB-22 (2, 12), DMT (2, 7), 5-MeO-DMT (2, 5), 3/4-MeO-PCP (2, <1), and one case respectively for N-methyl-2-AI (326 pg/mg), 5-EAPB (60), clonazolam (24), metizolam (4), 4F-PHP (<1), 4-MePPP (10,000), butylone (68), ethcathinone (23,292), DCK (1500), MXE <1), ephenidine (190), 25C-NBOme (2), 25I-NBOme (15), AB-FUBINACA (22), ADB-PINCACA (10), AM-2201 (10), BB-22 (10), CP 47497-C8 homolog (< 1), JWH-019 (27), JWH-200 (13), JWH-250 (40). 4-HO-MiPT and isopentedrone were not quantified (lack of reference standards). Hair concentrations have allowed to distinguish occasional from chronic users. To our knowledge, this is the most comprehensive study based on hair testing demonstrating the use of different types and levels of designer drugs in Paris metropolis from 2012 to 2021. Their prevalence appears to be significant and understated as they are not systematically sought by laboratories.