Drug Market Research Articles

Structural and social changes due to the COVID-19 pandemic and their impact on engagement in substance use disorder treatment services: a qualitative study among people with a recent history of injection drug use in Baltimore, Maryland

BackgroundSubstance use disorder treatment and recovery support services are critical for achieving and maintaining recovery. There are limited data on how structural and social changes due to the COVID-19 pandemic impacted individual-level experiences with substance use disorder treatment-related services among community-based samples of people who inject drugs.MethodsPeople with a recent history of injection drug use who were enrolled in the community-based AIDS Linked to the IntraVenous Experience study in Baltimore, Maryland participated in a one-time, semi-structured interview between July 2021 and February 2022 about their experiences living through the COVID-19 pandemic (n = 28). An iterative inductive coding process was used to identify themes describing how structural and social changes due to the COVID-19 pandemic affected participants’ experiences with substance use disorder treatment-related services.ResultsThe median age of participants was 54 years (range = 24–73); 10 (36%) participants were female, 16 (57%) were non-Hispanic Black, and 8 (29%) were living with HIV. We identified several structural and social changes due the pandemic that acted as barriers and facilitators to individual-level engagement in treatment with medications for opioid use disorder (MOUD) and recovery support services (e.g., support group meetings). New take-home methadone flexibility policies temporarily facilitated engagement in MOUD treatment, but other pre-existing rigid policies and practices (e.g., zero-tolerance) were counteracting barriers. Changes in the illicit drug market were both a facilitator and barrier to MOUD treatment. Decreased availability and pandemic-related adaptations to in-person services were a barrier to recovery support services. While telehealth expansion facilitated engagement in recovery support group meetings for some participants, other participants faced digital and technological barriers. These changes in service provision also led to diminished perceived quality of both virtual and in-person recovery support group meetings. However, a facilitator of recovery support was increased accessibility of individual service providers (e.g., counselors and Sponsors).ConclusionsStructural and social changes across several socioecological levels created new barriers and facilitators of individual-level engagement in substance use disorder treatment-related services. Multilevel interventions are needed to improve access to and engagement in high-quality substance use disorder treatment and recovery support services among people who inject drugs.

Berbamine ameliorates DSS-induced colitis by inhibiting peptidyl-arginine deiminase 4-dependent neutrophil extracellular traps formation

Ulcerative colitis (UC) is a chronic inflammatory bowel disease with immune dysregulation affecting colon inflammatory response. Recent studies have highlighted that neutrophil extracellular traps (NETs) play an important role in the pathogenesis of UC. Berbamine (BBM), one of the bioactive ingredients extracted from Chinese herbal medicine Berberis vulgaris L, has attracted intensive attentions due to its significant anti-inflammatory activity and a marketing drug for treating leukemia in China. However, the exact role and potential molecular mechanism of BBM against UC remains elusive. In the present study, our results showed that BBM could markedly improve the pathological phenotype and the colon inflammation in mice with dextran sulfate sodium (DSS)-induced colitis. Then, comprehensive approaches combining network pharmacology and molecular docking analyses were employed to predict the therapeutic potential of BBM in treating UC by peptidyl-arginine deiminase 4 (PAD4), a crucial molecule involved in NETs formation. The molecular docking results showed BBM had a high affinity for PAD4 with a binding energy of −9.3 kcal/mol Moreover, PAD4 expression and NETs productions, including citrullination of histone H3 (Cit-H3), neutrophil elastase (NE), myeloperoxidase (MPO) in both neutrophils and colonic tissue were reduced after BBM administration. However, in the mice with DSS-induced colitis pretreated with GSK484, a PAD4-specific inhibitor, BBM could not further reduce disease related indexes, expression of PAD4 and NETs productions. Above all, the identification of PAD4 as a potential target for BBM to inhibit NETs formation in colitis provides novel insights into the development of BBM-derived drugs for the clinical management of UC.

The study of marketing opportunities for the use of the raw material of feverfew (Tanacetum parthenium L.) in the pharmacotherapy of musculoskeletal system diseases

Aim. To form a modern idea of the market structure and trends in the consumption of drugs for the pharmacotherapy of rheumatoid arthritis, to determine the possible potential for use of plant raw material of feverfew (Tanacetum parthenium). Materials and methods. The study was conducted using the structural analysis, logical and graphical methods, and marketing analysis methods. Results. It was found that in the pre-war period the market for drugs affecting the musculoskeletal system developed quite vigorously – its growth rate in the period of 2020-2021 ranged from 16 to 29 % in natural units and from 20 to 30 % in monetary terms. According to the structure of producing countries, the market was significantly import-dependent. The market for synthetic drugs was quite saturated, represented by various dosage forms – tablets, powder for suspension, injection solutions (ampoules), granules, capsules, sachets, alcohol solutions, oil solutions, suppositories, oral suspensions, transdermal patches, gels, ointments. The research was conducted taking into account the study of marketing opportunities for the use of the raw material of Tanacetum parthenium in the pharmacotherapy of diseases of the musculoskeletal system since this raw material had certain advantages compared to synthetic analogs. It should be noted that the market of herbal medicines for the treatment of the musculoskeletal system diseases or the prevention of their manifestations is very limited and is represented by a minimum number of product items and one representative of the medicinal flora – Symphytum officinale. In addition, 90 % of the market for this group of drugs belongs to foreign manufacturers. Although research of the market for biological supplements indicates a certain demand for products based on the medicinal plant raw material. Conclusions. Based on the trends identified, we can state the positive development of the market for drugs that affect the musculoskeletal system, the prospects for the development of drugs based on the medicinal plant raw material, including Tanacetum parthenium.

Determine the pharmacokinetics (half-life, volume of distribution and clearance) of AMB-FUBINACA in rats plasma using GC–MS / MS

BackgroundSeveral novel synthetic cannabinoids, including methyl 2-(1-(4-fluorobenzyl)-1Hindazole-3-carboxamido)-3-methylbutanoate (AMB-FUBINACA), have recently surfaced on the illicit drug market. To determine the pharmacokinetic properties (half-life, volume of distribution, and clearance) of AMB-FUBINACA in rats plasma, a straightforward, quick, and highly sensitive analytical approach was developed. MethodsEighteen Wistar rats were divided into two groups: one control (saline vehicle) and one treatment group (AMB-FUBINACA at 50 mg/kg). Blood samples (400 μL) were withdrawn via catheters immediately before (t = 0) and at 30, 60, 90, 120, and 240 min following injection. Samples were collected into 1 mL tuberculin syringes, then transferred to 1.5 mL plastic tubes containing 5 μL of 1000 IU/mL K3-EDTA (Thomas Scientific). Place the EDTA tubes containing samples in a centrifuge and spin at 1000 g for 10 min at 4 °C. The top layer is the plasma fraction, which is decanted into cryovials and stored at −20 °C until analysis. The gas chromatography tandem mass spectrometry (GC–MS/MS) method was optimized and validated, combined with liquid-liquid extraction, to analyze AMB-FUBINACA in rat plasma. ResultsThe research method successfully met the validation requirements set by the FDA, demonstrating selectivity and linear calibration curves within a concentration range of 0.5–1000 ng/ml. The correlation coefficient (r2) was determined to be 0.99, indicating a strong linear relationship. The analyte's limit of quantitation (LOQ) was determined to be 1–5 ng/mL. Subsequently, the method was successfully applied to investigate the pharmacokinetics of AMB-FUBINACA in rats' blood samples. Following oral administration, AMB-FUBINACA was rapidly absorbed, with a plasma half-life (t1/2) of 5.91 h, a volume of distribution (Vd) of 203.13 l, and a plasma clearance of 23.81122 L/h. ConclusionThese findings contribute to the understanding of AMB-FUBINACA's pharmacokinetics and pharmacodynamics.

Exploring a Lux® i-Amylose-3 column in normal phase and polar-organic mode for chiral separation of cathinone derivatives and pyrovalerones using high-performance liquid chromatography.

Each year, new psychoactive substances appear on the global drug market leading to constant changes. Most of these compounds with stimulating effect possess a chiral center, thus leading to two enantiomers with presumably different pharmacological properties. Among them, synthetic cathinones, often misleadingly traded as "bath salts," play an important role. There is little knowledge about the distinct effect of the enantiomers. The aim of this study was to test a commercially available Lux® i-Amylose-3 column by HPLC-UV for enantiorecognition of cathinone derivatives. Overall, 80 compounds were tested in normal phase mode, where 75 substances were separated under initial conditions. After method optimization, at least partial separation was achieved for the remaining compounds. The same set of substances was measured in polar-organic mode, where 63 analytes were resolved into their enantiomers under initial conditions with very short retention times. Both modes showed complementary results for the individual compounds. Furthermore, the tested methods proved to be suitable for differentiation of positional isomers, which can be useful for drug checking programs. All measurements were carried out under isocratic conditions, and intraday and interday repeatability tests were performed.

Qualitative transformations of street-seized ecstasy over a decade: A case study in Rio de Janeiro (Brazil).

The illegal drug market is constantly evolving, with new drugs being created and existing ones being modified. Adulterants are often added to the mix, and the primary substance may be secretly replaced by a new one. Once-known tablets can now be vastly different from what they are sold as, all due to the pursuit of profit and evasion of current drug regulations. These alterations in drug composition pose a threat to society, as their effects are still not well understood. Therefore, it is crucial for police intelligence and public health development to obtain the chemical profiles of illicit drugs. This study presents the chemical fingerprinting of ecstasy tablets seized in the state of Rio de Janeiro (Brazil) between 2012 and 2021. The tablet samples were weighed, extracted, diluted with methanol, and acidified before analysis using gas chromatography high-resolution mass spectrometry and attenuated total reflection Fourier transform infrared spectroscopy. The major constituents found were MDMA and clobenzorex, with fewer occurrences of MDA, MDEA, and 2C-B. The results also indicate that the occurrence of mega-events in the study location impacted the chemical fingerprints of ecstasy. A total of 27 combinations of cutting agents, including caffeine, ephedrine, and anesthetics, were identified. Samples composed of clobenzorex were observed throughout the evaluated period in areas near highways, suggesting that this product is mainly used by truck drivers. These findings can help police intelligence units anticipate the behavior of the illicit market during major events, identify traffic routes, and support public health initiatives.

Implementation opportunities and challenges to piloting a community-based drug-checking intervention for sexual and gender minority men in Vancouver, Canada: a qualitative study

BackgroundIn response to the overdose crisis, a collaborative group of two community-based organizations, a health authority and a research institute in Vancouver, Canada, implemented a pilot community-based drug checking (CBDC) intervention for sexual and gender minority (SGM) men. This study identified key factors that influenced the implementation of the CBDC intervention, including opportunities and challenges.MethodsWe conducted semi-structured interviews with seven pertinent parties involved in the CBDC, including policymakers, researchers and representatives from community-based organizations. These interviews were coded and analyzed using domains and constructs of the Consolidated Framework for Implementation Research.ResultsWhile drug-related stigma was identified as a challenge to deliver drug checking services, participants described the context of the overdose crisis as a key facilitator to engage collaboration between relevant organizations (e.g., health authorities, medical health officers, community organizations) to design, resource and implement the CBDC intervention. The implementation of the CBDC intervention was also influenced by SGM-specific needs and resources (e.g., lack of information about the drug supply). The high level of interest of SGM organizations in providing harm reduction services combined with the need to expand drug checking into community spaces represented two key opportunities for the CBDC intervention. Here, SGM organizations were recognized as valued partners that fostered a broader culture of harm reduction. Participants’ emphasis that knowing the composition of one’s drugs is a “right to know”, particularly in the context of a highly contaminated illicit drug market, emerged as a key implementation factor. Lastly, participants emphasized the importance of involving SGM community groups at all stages of the implementation process to ensure that the CBDC intervention is appropriately tailored to SGM men.ConclusionsThe context of the overdose crisis and the involvement of SGM organizations were key facilitators to the implementation of a drug checking intervention in SGM community spaces. This study offers contextualized understandings about how SGM knowledge and experiences can contribute to implement tailored drug checking interventions.

Features of anti-drug work with students of non-medical specialties of higher and secondary professional education in the Kursk region in the conditions of post-pandemic reality

The problem of drug addiction is a problem that affects all spheres of society: economic, political, legal, large-scale, moral. Throughout post-Soviet history, since only the silence of these phenomena was a crisis, drug addiction has been an exclusively youth problem. Works from the 1990s to the early 2000s pointed to a rejuvenation of drug addiction problems: the most progressive drug addiction was in the age group from 15 to 19 years, and in the period from 2000 to 2010, the average age of initiation of drug addiction decreased to 10-14 years [7 ]. From 2012 – 2014 There was a tendency towards a restructuring of the morbidity structure, and it was revealed that the most vulnerable group of the population are people aged 18 to 40 years [6]. The average age of first trial has also shifted towards adulthood [3]. All this indicates that student youth are the most vulnerable to drug addiction risk factors. With the onset of the pandemic and the lockdown, teenagers and young people found themselves in London. Many were forced to be alone for several days due to sudden poisoning, many suffered due to losses at work and their only source of income. At the same time, psychological risk factors associated with drug use have worsened [6]. According to the data obtained by the Russian authorities, due to the reduction in the distribution and availability of narcotic substances in the first two months of the pandemic, there was a rapid decline in the detection of drug-related crimes. However, after some time, the popularity of not only communication on social networks increased, but also the sale of drugs through them among teenagers and students. According to the Ministry of Internal Affairs of the Russian Federation, drug distribution and trafficking have increased in the context of the web, and since the summer of 2020, the volumes of the illegal drug market have recovered and increased to heights [8, 9]. Thus, the period under study is 2022–2023. The youth community approached in the context of the consequences of serious psychological trauma, a shortage of anti-drug information during the covid period and an intensification of the illegal supply of drugs. Prevention 2022 – 2023 – this is largely ―catching up.‖

The impacts of national centralized drug procurement policy on drug utilization of medical institutions: an empirical study in a county-level hospital in China

PurposeUnder the background of the regular implementation of the National Centralized Drug Procurement (NCDP) policy, this study aimed to assess the impacts of the NCDP policy on drug utilization of county-level medical institutions, and probe into the influencing factors of the changes in drug utilization.MethodA pre-post study was applied using inpatient data from a county-level medical institution in Nanjing. Drug utilization behavior of medical institutions of 88 most commonly used policy-related drugs (by generic name, including bid-winning and bid-non-winning brands) was analyzed, and the substitution of bid-winning brands for brand-name drugs after policy intervention was evaluated.ResultsAfter policy intervention, 43.18% of policy-related drugs realized the substitution of bid-winning brands for bid-non-winning brands (6.82% of complete substitution, 36.36% of partial substitution). Meanwhile, 40.90% of policy-related drugs failed to realize brand substitution. Multiple factors affected brand substitution, including: (1) Policy effect: brand substitution was more obvious after the intervention of the first and third round of NCDP. (2) Drug market competition: the greater the price reduction of bid-non-winning brands, the more the drugs for the same indication, the more likely that medical institutions keep using the same brands as they did before policy intervention. (3) Previous drug utilization of medical institutions: brand substitution was more obvious in drugs with large number of prescriptions and weak preference for brand-name drugs.ConclusionThe NCDP policy promoted the substitution of bid-winning brands for bid-non-winning brands. However, the NCDP policy remained to be further implemented in county-level medical institutions. Policy implememtation efforts, drug market competition and drug utilization of medical institutions would affect the implementation of the NCDP policy.

Illicit Drugs in Surface Waters: How to Get Fish off the Addictive Hook.

The United Nations World Drug Report published in 2022 alarmed that the global market of illicit drugs is steadily expanding in space and scale. Substances of abuse are usually perceived in the light of threats to human health and public security, while the environmental aspects of their use and subsequent emissions usually remain less explored. However, as with other human activities, drug production, trade, and consumption of drugs may leave their environmental mark. Therefore, this paper aims to review the occurrence of illicit drugs in surface waters and their bioaccumulation and toxicity in fish. Illicit drugs of different groups, i.e., psychostimulants (methamphetamines/amphetamines, cocaine, and its metabolite benzoylecgonine) and depressants (opioids: morphine, heroin, methadone, fentanyl), can reach the aquatic environment through wastewater discharge as they are often not entirely removed during wastewater treatment processes, resulting in their subsequent circulation in nanomolar concentrations, potentially affecting aquatic biota, including fish. Exposure to such xenobiotics can induce oxidative stress and dysfunction to mitochondrial and lysosomal function, distort locomotion activity by regulating the dopaminergic and glutamatergic systems, increase the predation risk, instigate neurological disorders, disbalance neurotransmission, and produce histopathological alterations in the brain and liver tissues, similar to those described in mammals. Hence, this drugs-related multidimensional harm to fish should be thoroughly investigated in line with environmental protection policies before it is too late. At the same time, selected fish species (e.g., Danio rerio, zebrafish) can be employed as models to study toxic and binge-like effects of psychoactive, illicit compounds.

Marketing analysis of the Russian pharmaceutical market of oxaliplatin

Relevance. Colon and ovarian cancer occupy leading positions in the structure of morbidity and mortality among malignant neoplasms in Russia. One of the widely used drugs for the treatment of these nosologies is oxaliplatin, but there is no relevant information to assess its availability and share among other antitumor drugs.Objective. Analysis of the Russian pharmaceutical market for oxaliplatin drugs among other antitumor drugs in 2015–2022.Materials and methods. For the analysis, reports from marketing agencies DSM Group and IMS were used, both in value and in physical terms.Results. During the period under study, significant changes occurred in the Russian pharmaceutical market of antitumor drugs: the volume of sales and consumption increased, which was also accompanied by a decrease in the cost of drug units per package (all antitumor drugs) and course of use (oxaliplatin). At the same time, the share of Russian manufacturers of antitumor drugs has increased. In relation to oxaliplatin, during the study period there was almost complete displacement of the original drug from the market by generic drugs. An intensive process of import substitution was also observed: the share of domestic drugs increased by the end of the study period in value and volume terms to 93 and 95%, respectively.Conclusion. Identified changes in the Russian pharmacological market for 2015–2022 reflect an increase accompanied by an increase in the availability of antitumor drugs and, in particular, oxaliplatin.

Conjuncture of illicit Afghan and Chinese drug market

Conjuncture of illicit Afghan and Chinese drug market

Scientific substantiation of the use of iron-containing drugs in veterinary medicine

The relevance of this study is conditioned by the need to summarise current knowledge about the use of iron-containing drugs in veterinary medicine and their scientific substantiation. The purpose of this study was to analyse the results of the latest experimental data presented in the literature on the pharmacological and toxicological properties of iron-containing drugs and the specific features of their use in veterinary medicine. The study employed the method of literature analysis with the formulation of relevant substantiated conclusions and their generalisation or comparison. Iron-containing medicines are particularly relevant in modern veterinary medicine for the prevention of iron deficiency anaemia in piglets. The use of iron dextran preparations is a scientifically sound and necessary preventive measure in modern pig production. Furthermore, the study covered new approaches to the development of effective antianaemic drugs for animals of other species, including calves. The study also covered the controversial issues of the use of iron-containing drugs in pregnant females for the prevention of iron deficiency in animals born from them. The analysis of the literature data presented in this study shows a prominent degree of scientific interest in the study of pharmacological and toxicological properties of iron in high valences (specifically, ferrous iron in clathrochelate form) with a view to their use in medicine. The conducted literature review suggests the multidirectional use of iron-containing drugs in various dosage forms in veterinary medicine. The study identified the key trends in the pharmaceutical market of iron-containing drugs registered in Ukraine. In recent years, there has been a growing body of scientifically based evidence indicating the effectiveness of iron-dextran complex in combination with micro- and macronutrients and vitamins. Currently, the use of iron-containing drugs in the world’s veterinary practice, considering their scientifically and experimentally proven pharmacological properties, is extremely promising. The materials of this study are of practical value for expanding the possibilities of using new forms of iron in veterinary medicine

Analysis and Reflection on Investment Status of Innovative Drugs in China

At present, China's innovative drug support policies and market volume are good, but China's innovative drug research and development(R&D) success rate and market share still need to be improved. This is related to the unreasonable investment direction of innovative drugs and the low utilization efficiency of R&D resources. Therefore, the objective of this paper is to evaluate China's present state of investment in innovation drugs and explore how to promote the effectiveness and sustainability of innovative drug investment. Through data analysis, this paper found that the scale and frequency of investment and financing of innovative drugs in China are declining. The problem with China's innovative drug investment is that the valuation of hot projects is too high, the allocation of funds is unreasonable, the investment is not in line with the actual needs of the industry, and only the pursuit of short-term returns. Given the various problems in China's innovative drug investment, the government needs to create a long-term stable environment for the innovative drug investment market and prudently formulate relevant policies to strike a balance between stimulating the market and regulating the market. Entrepreneurs should choose the direction of R&D according to their areas of expertise combined with cutting-edge scientific research progress rather than adjusting the direction of R&D to cater to the preferences of investment institutions. Investment institutions should avoid risks caused by unreasonable capital allocation by strengthening the layout of the pre-investment track and prudently carrying out project valuation analysis.

Broad evidence of xylazine in the UK illicit drug market beyond heroin supplies: Triangulating from toxicology, drug-testing and law enforcement.

Xylazine is a non-opioid sedative which has spread rapidly throughout the US illicit drug supply. This study aimed to describe the spread of xylazine throughout the UK illicit drug supply. Xylazine detections in human biological samples were collated from toxicology laboratories operating in the United Kingdom with the date, location, case type, xylazine concentration and co-detected drugs (with quantifications where performed) detailed, where permitted, by the corresponding coroner. Drug-testing cases positive for xylazine were collated from the Welsh Emerging Drugs and Identification of Novel Substances (WEDINOS) drug-testing postal service with the date, location, purchase intent and co-detected drugs detailed. Drug seizures made by UK law enforcement were communicated by the Office for Health Improvement and Disparities with the date and location detailed. By the end of August 2023, xylazine was detected in 35 cases from throughout toxicology, drug-testing and drug seizure sources covering England, Scotland and Wales. There were no cases reported from Northern Ireland. Xylazine was detected in biological samples from 16 people. In most cases where full toxicology results were provided, xylazine was detected with heroin and/or a strong opioid (n = nine of 11), but this polydrug use pattern was not evident in all cases (n = two of 11), suggesting a wider circulation of xylazine in the UK illicit drug market beyond heroin supplies. Evidence from WEDINOS supports this claim, as all 14 drug samples (100%) submitted from across the UK contained xylazine; however, in none of these cases was heroin the purchase intent but rather counterfeit prescription medication tablets (n = 11 of 14), tetrahydrocannabinol (THC) vapes (n = two of 14) or white powder (n = one of 14). Additional evidence for the spread of illicit xylazine comes from five drug seizures made by law enforcement. Xylazine has penetrated the UK illicit drug market and is not limited to heroin supplies.

International practice of preventing illegal drug trafficking

The scientific article examines issues related to the international practice of preventing the illegal circulation of narcotic drugs. Studying this topic, it was found that currently a significant number of organized criminal groups involved in the illegal circulation of narcotic drugs are international. Raw materials for the production of drugs can be grown in one country, processed in another, transported in transit through a third, and settled in a fourth.Even members of such criminal groups or organizations may have different origins and nationalities, and may speak different languages. That is why the investigation of such crimes becomes much more complicated. It was established that with close and coordinated interaction of the relevant law enforcement agencies of different states, it is most expedient to detain the entire criminal group or organization, and not just a small part of it, which in itself would not be able to stop its criminal activity, and therefore protect the population from the negative influence of narcotics means. It was found out that it is necessary to carefully monitor the state of illegal drug trafficking in neighboring states, as the distribution of narcotic substances and precursors in Ukraine may depend on it, and to take appropriate measures to combat such crimes. We also agree with the opinion of the United Nations, which was published in the World Drug Report 2023, that corruption and drug trafficking are related, mutually reinforcing and complementary crimes. It was established that international experience must be adapted to the specifics of an individual country.External factors affecting the drug market in Ukraine were outlined (war, internally displaced persons, the state of combating illegal drug trafficking in neighboring countries, interaction with foreign law enforcement agencies to prevent illegal drug trafficking). Statistics presented in the United Nations World Drug Report 2023 have been studied and highlighted. Especially vulnerable groups of people for drug addiction have been singled out.

Human metabolism of four synthetic benzimidazole opioids: isotonitazene, metonitazene, etodesnitazene, and metodesnitazene

Following isotonitazene scheduling in 2019, the availability of alternative 2-benzylbenzimidazole opioids (nitazenes) on the global drug market increased, resulting in many fatalities worldwide. Nitazenes are potent µ-opioid receptor agonists with strong narcotic/analgesic effects, and their concentrations in biological matrices are low, making the detection of metabolite biomarkers of consumption crucial to document use in clinical and forensic settings. However, there is little to no data on the metabolism of the most recently available nitazenes, especially desnitro-analogues. The aim of the research was to assess isotonitazene, metonitazene, etodesnitazene, and metodesnitazene human metabolism and identify specific metabolite biomarkers of consumption. The four analogues were incubated with 10-donor-pooled human hepatocytes, and the incubates were analyzed by liquid chromatography-high-resolution tandem mass spectrometry and data mining with Compound Discoverer (Thermo Scientific); the analysis was supported by in silico metabolite predictions with GLORYx open-access software. Metabolites were identified in postmortem blood and/or urine samples from two metonitazene-positive and three etodesnitazene-positive cases following the same workflow, with and without glucuronide hydrolysis in urine, to confirm in vitro results. Twelve, nine, twenty-two, and ten metabolites were identified for isotonitazene, metonitazene, etodesnitazene, and metodesnitazene, respectively. The main transformations were N-deethylation at the N,N-diethylethanamine side chain, O-dealkylation, and further O-glucuronidation. In vitro and autopsy results were consistent, demonstrating the efficacy of the 10-donor-pooled human hepatocyte model to predict human metabolism. We suggest the parent and the corresponding O-dealkyl- and N-deethyl-O-dealkyl metabolites as biomarkers of exposure in urine after glucuronide hydrolysis, and the corresponding N-deethyl metabolite as additional biomarker in blood.

The Role of the Police Force as a Law Enforcement Agency in Preventing Drug Trafficking in the Sea Routes of North Maluku Province Indonesia

This research aims to examine the role of the police force in enforcing the law on drug trafficking via sea routes in North Maluku Province, Indonesia. It also aims to analyze the factors that hinder the effective law enforcement against drug abuse in North Maluku Province. This was empirical legal research which was conducted by studying the legal reality in the field. Indonesia is a great potential market for drugs. North Maluku province becomes one of the gateways to smuggle drugs into Indonesia via sea routes. Unfortunately, the authorities that have the authority to carry out action or prevention have not performed as expected. Therefore, the involvement of the community, especially fishermen in this area, is a necessity. There must also be the support of other authorities such as the National Narcotics Agency (BNN) and the Indonesian National Navy, to prevent the spread of drugs in North Maluku.

Appearance of hexahydrocannabinols as recreational drugs and implications for cannabis drug testing – focus on HHC, HHC-P, HHC-O and HHC-H

This study investigated the effects of hexahydrocannabinol (HHC) and other unclassified cannabinoids, which were recently introduced to the recreational drug market, on cannabis drug testing in urine and oral fluid samples. After the appearance of HHC in Sweden in 2022, the number of posts about HHC on an online drug discussion forum increased significantly in the spring of 2023, indicating increased interest and use. In parallel, the frequency of false positive screening tests for tetrahydrocannabinol (THC) in oral fluid, and for its carboxy metabolite (THC-COOH) in urine, rose from <2% to >10%. This suggested that HHC cross-reacted with the antibodies in the immunoassay screening, which was confirmed in spiking experiments with HHC, HHC-COOH, HHC acetate (HHC-O), hexahydrocannabihexol (HHC-H), hexahydrocannabiphorol (HHC-P), and THC-P. When HHC and HHC-P were classified as narcotics in Sweden on 11 July 2023, they disappeared from the online and street shops market and were replaced by other unregulated variants (e.g. HHC-O and THC-P). In urine samples submitted for routine cannabis drug testing, HHC-COOH concentrations up to 205 (mean 60, median 27) µg/L were observed. To conclude, cannabis drug testing cannot rely on results from immunoassay screening, as it cannot distinguish between different tetra- and hexahydrocannabinols, some being classified but others unregulated. The current trend for increased use of unregulated cannabinols will likely increase the proportion of positive cannabis screening results that need to be confirmed with mass spectrometric methods. However, the observed cross-reactivity also means a way to pick up use of new cannabinoids that otherwise risk going undetected.

Evaluation of the Activities of Commonly Dispensed Antibiotics at Bayero University Kano Health Care Services Unit

There is a growing concern about the effectiveness of antimicrobials in developing countries. Multifaceted factors contribute to the escalation of antibiotic resistance. The counterfeiting of antibiotic drugs is one facet of this. Antibiotics are the most counterfeited medicines worldwide. However, the WHO Committee for the review of Medicines accentuates surveillance checks even after the marketing of drugs or at the dispensing point. This study evaluated the activities of commonly dispensed antibiotics at Bayero University Kano health care service pharmacy unit. Fourteen brands of different antibiotics with the active ingredients amoxicillin, azithromycin, cefixime, ceftriaxone, ofloxacin, ciprofloxacin, and doxycycline were used. The antibiotic susceptibility testing was carried out using the Kirby Bauer disc diffusion method on clinical isolates of Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae. Typed strains of E. coli (ATCC 25923) and S. aureus (ATCC 25922) were also tested. Ciprofloxacin and ofloxacin-containing formulations had efficacy against all the clinical isolates and typed organisms. All organisms except K. pneumoniae were sensitive to azithromycin. Ceftriaxone was active only against E. coli (both clinical isolate and typed organism). About 71% of the antibiotics tested were not sensitive to the tested organisms. The inactivity observed may be due to the counterfeit or substandard nature of the antibiotics, ineffective storage, or the development of resistance. This necessitates more research to determine the extent of the problem and its causes at a large scale.