Prevalence Of New Psychoactive Substances Research Articles

Prevalence of new psychoactive substances in the context of assessment of driving ability—Effects on road safety?

Abstract Hintergrund Ein Nachweis neuer psychoaktiver Stoffe (NPS) erfolgt bei Fragestellungen im Kontext von Beurteilungen einer Fahrsicherheit oder einer Fahreignung in der Regel nur selten, nicht zuletzt aufgrund einer fehlenden Beauftragung. Bei Aufträgen zu forensisch-toxikologischen Analysen durch Behörden beschränkt man sich zumeist auf ein Panel der gängigsten Substanzen bzw. Substanzklassen und selbst bei Auffälligkeiten im Straßenverkehr wird häufig nicht auf solche Substanzen untersucht, insbesondere dann, wenn ggf. schon eine einzige andere Substanz nachgewiesen wurde. Auch bei Abstinenzkontrollen im Bereich von Fahreignungsbegutachtungen wird in der Regel nur ein festgelegtes polytoxikologisches Screening auf die gängigsten berauschenden Mittel an Urin- bzw. Haarproben durchgeführt, sodass ein Umstieg auf die hierbei nicht erfassten NPS nicht ausgeschlossen ist. Material und Methoden Es wurden die Ergebnisse einer bereits publizierten Studie [7, 21], in der 1037 Urin- und Haarproben im Kontext von drogenbedingten Fahreignungsbegutachtungen retrospektiv auf NPS untersucht wurden, im Hinblick auf den Ausgang der initialen Begutachtung bzw. des Abstinenzkontrollprogramms betrachtet. Ergebnisse In 4,2 % der Proben konnten NPS nachgewiesen werden. Zwei Klienten mit einem positiven NPS-Befund wurde im Rahmen der Begutachtung eine günstige Eignungsvoraussetzung attestiert, während 32 Klienten ihr Abstinenzkontrollprogramm erfolgreich abschließen konnten, obwohl ihre Proben NPS enthielten. Diskussion Die Ergebnisse legen somit nahe, dass ein messbarer Anteil von Verkehrsteilnehmern einen fortgesetzten Konsum berauschender Mittel in Form von NPS betreibt. Dies kann in der Folge auch mit negativen Auswirkungen auf die Verkehrssicherheit verbunden sein.

Wastewater analysis for new psychoactive substances and cocaine and cannabis in a Northern Ireland Prison

The global drug market has been significantly impacted by the emergence of new psychoactive substances, leading to challenges in creating effective legislative controls and their use within recreational drug consumption. This research explores the prevalence of new psychoactive substances and non-medicinal and medicinal compounds within a prison facility in Northern Ireland. Wastewater samples collected from seven different manholes within the prison were analysed for 37 target compounds including the two most found illicit substances: benzoylecgonine (primary metabolite of cocaine) and cannabis. Using solid phase extraction with Oasis HLB and liquid-chromatography-time-of-flight-mass spectrometry across a gradient of 9 min, our analysis revealed that benzoylecgonine was the sole compound consistently present in all collected samples. Following this finding, our target compound selection was broadened to encompass medicinal compounds and employing qualitative analysis we re-evaluated the samples and discovered the presence of buprenorphine, benzodiazepines, methadone, morphine, and codeine. Finally, the study explored the application of enzymatic beta-glucuronidase hydrolysis to the samples. This final phase yielded significant findings, indicating the presence of codeine and nordiazepam at higher peak intensities, thereby shedding light on the potential implications of this enzymatic process.

Festivals following the easing of COVID-19 restrictions: Prevalence of new psychoactive substances and illicit drugs

The market for illicit drugs and new psychoactive substances (NPS) has grown significantly and people attending festivals have been identified as being at high risk (high extent and frequency of substance use). Traditional public health surveillance data sources have limitations (high costs, long implementation times, and ethical issues) and wastewater-based epidemiology (WBE) can cost-effectively support surveillance efforts. Influent wastewater samples were analyzed for NPS and illicit drug consumption collected during New Year period (from 29-Dec-2021 to 4-Jan-2022) and a summer Festival (from 29-June-2022 to 12-July-2022) in a large city in Spain. Samples were analyzed for phenethylamines, cathinones, opioids, benzodiazepines, plant-based NPS, dissociatives, and the illicit drugs methamphetamine, MDA, MDMA, ketamine, heroin, cocaine, and pseudoephedrine by liquid chromatography mass spectrometry. High consumption rates of specific NPS and established illicit drugs were identified at the peak of each event. Furthermore, a dynamic change in NPS use (presence and absence of substances) was detected over a period of six months. Eleven NPS, including synthetic cathinones, benzodiazepines, plant-based NPS and dissociatives, and seven illicit drugs were found across both the New Year and summer Festival. Statistically significant differences (p < 0.05) were seen for 3-MMC (New Year vs summer Festival), eutylone (New Year vs summer Festival), cocaine (summer Festival vs normal week and summer Festival vs New Year), MDMA (New Year vs normal week and summer Festival vs normal week), heroin (summer Festival vs New Year) and pseudoephedrine (summer Festival vs New Year). This WBE study assessed the prevalence of NPS and illicit drugs at festivals following the reduction of the COVID-19 pandemic restrictions highlighting the high use of specific substances at the peak of each event. This approach identified in a cost-effective and timely manner without any ethical issues the most used drugs and changes in use patterns and, thus, can complement public health information.

A New Multi-Analyte LC-MS-MS Screening Method for the Detection of 120 NPSs and 49 Drugs in Hair.

Liquid chromatography coupled with mass spectrometry (LC-MS) has been increasingly used for screening purposes in forensic toxicology. High versatility and low time/resource consumption are the main advantages of this technology. Numerous multi-analyte methods have been validated in order to face the analytical challenge of new psychoactive substances (NPSs). However, forensic toxicologists must focus the attention also on "classical" NPSs and medicines, such as benzodiazepines (BDZs) and prescription opioids. In this paper, a new method for the simultaneous detection of 169 substances (120 NPSs and 49 other drugs) in hair by LC-MS-MS is described. After the decontamination of hair samples with dichloromethane, a 20-mg aliquot of the sample was mixed with 1 mL of methanol (MeOH; 0.1% of formic acid) and then sonicated at room temperature for 2 h. The mixture was then dried under nitrogen stream and reconstituted with 100 µL of MeOH. LC separation was achieved with a 100-mm-long C18 column in 35 min, and mass acquisition was performed in dynamic multiple reaction monitoring mode and in positive ionization. The analysis results were very sensitive, with the limit of quantification ranging from 0.07 to 10.0pg/mg. Accuracy and precision were always within the acceptable criteria. Matrix effect and recovery rate ranges were from -21.3 to + 21.9% and from 75.0 to 99.3%, respectively. The new method was successfully applied in a preliminary study on the prevalence of NPSs, BDZs and other substances in case of driving license issuance. In 14% of cases, BDZs/antidepressants (mainly trazodone, diazepam/nordiazepam and flunitrazepam) were found. Codeine, ketamine, methylone and mephedrone were also detected.

The versatility of the XRPD for the drug detection

The increasing prevalence of New Psychoactive Substances (NPS) on the drug market exerts considerable pressure on the development of novel detection techniques, especially those suitable for analyses directly on a crime scene. Raman and IR spectroscopy usually fulfil such needs; however, they have limitations (e.g. fluorescence in Raman and sometimes both Raman and IR have difficulties with identifying compounds in certain mixtures). For this reasons, we investigated the potential of X-ray powder diffraction (XRPD) for the identification of drug samples. Beyond identifying the actual controlled substances, this technique might also be very useful in identification of either organic or inorganic cutting agents. The sample crystals were crushed and flattened on the silicon pod to create a planar surface. Bruker D2 Phaser powder diffractometer with parafocusing Bragg–Brentano geometry using CuKα radiation (λ=1.5418 Å) was used for the measurement. The data were collected by an ultrafast LYNXEYE XE detector and subsequently evaluated using HighScore Plus 3.0e software. First, a series of 8 NPS standards was used to verify whether XRPD can distinguish between substances with similar chemical structures. The obtained XRPD patterns confirmed this ability. Subsequently, to verify the ability of XRPD to identify substances in real samples, a series of seized samples provided by Czech police was analysed by XRPD. The comparison of the obtained diffraction data with the patterns of the respective standards enabled their identification. Moreover, results from the analyses of cocaine street samples showed that XRPD might be able to detect not only the cocaine itself, but also the present cutting agents in a single run analysis. With respect to the physical basis of how the XRPD works, in case of mixtures, some signals in the diffraction pattern may overlap. However, if the overlap is only partial, identification of compounds in the unknown sample might still be possible with a proper database. XRPD was able to distinguish all the NPS despite their similar molecular structures and to identify each of the seized substances. Furthermore, XRPD was able to identify the main cutting agent in several samples of seized cocaine. These results show that XRPD could be a valuable analytical tool for the detection of both the unknown compounds and cutting agents in illicit drug samples.

Prevalence of cathinones and other new psychoactive substances in hair of parents and children of families with known or suspected parental abuse of conventional illegal drugs

BackgroundHair analysis of parents and their children was regularly used since 2011 as a diagnostic tool in a social support project for families with known or suspected abuse of conventional illegal drugs and revealed a high incidence of cocaine, cannabinoids, amphetamines, ecstasy and heroin. In this context, the prevalence of new psychoactive substances (NPS) in these families should be important for a realistic estimate of the situation. MethodsThe extracts of 1537 hair samples from 318 children (age 1–14 years), 44 adolescents and 611 adults, which were collected and tested for conventional drugs between June 2016 and April 2021 and frozen at −20 °C, were reanalyzed by a validated LC-MS/MS method (limits of quantitation 5–24 pg/mg) for 33 cathinones, 10 phenylethylamines, 5 piperazines including the antidepressant trazodone, 2 tryptamines, 9 designer benzodiazepines, 4 synthetic opioids and 4 ketamine-like substances including phencyclidine. ResultsBetween one and up to five from 42 of these substances were detected in 227 samples (14.8%). The most frequently detected substances were benzedrone (62x), α-pyrrolidinovalerophenone (41x), N-ethylamphetamine (29x), dimethyltryptamine (13x) and pyrovalerone (11x). The quantification was possible only for 34 results of 15 drugs and the remaining majority of the results were unambiguously identified below LLOQ. The relative frequency of conventional drugs in the 227 NPS positive samples was higher than in all 1310 NPS negative samples for cocaine (69.6% vs. 56.0%), heroin (6-acetylmorphine 8.8% vs. 4.9%), amphetamine (16.3% vs. 7.7%) and MDMA (16.3% vs. 7.0%) but was similar for THC (38.3% vs. 36.3%) and benzodiazepines (1.8% vs. 1.7%). The high prevalence of N-ethylamphetamine can be explained as a byproduct of the illicit amphetamine synthesis from benzaldehyde and nitroethane rather than as a separate drug or as a combined metabolite of amphetamine and ethanol. The isolated appearance of 3-trifluoromethylphenylpiperazine in 9 hair samples collected in January 2017 can be caused either by its use as an NPS or by its formation as a metabolite of the medical drug flibanserin. The results were compared within 17 families whose members were tested at the same time and showed positive NPS results. The detected drugs agreed between both parents only in about half of the cases whereas the drugs found in children’s hair was always detected also in hair of one or both parents. ConclusionThe re-testing of hair extracts for NPS after long-time storage in frozen state enables an impression about the relative high prevalence in the tested population group, despite the limitation by partial degradation of the substances and the corresponding impossibility in quantitative assessments. In addition to conventional drugs, the hair test for these substances should be useful in unclear cases of child’s welfare endangerment and in family law.

Prevalence of new psychoactive substances (NPS) in Brazil based on oral fluid analysis of samples collected at electronic music festivals and parties

BackgroundNew psychoactive substances (NPS) use is a worldwide public health issue. Knowing the prevalence of NPS guides public health and legal policies to address the problem. The objective of this study was to identify NPS in Brazil through the analysis of oral fluid (OF) samples collected at parties and electronic music festivals. MethodsAnonymous questionnaires and oral fluid samples were collected from volunteers (≥18 years) who reported the consumption of at least one illicit psychoactive substance in the last 24 h. Oral fluid sample collections occurred at eleven parties and two electronic music festivals over 16 months (2018–2020). Questionnaire answers were matched to oral fluid toxicological results. ResultsOf 462 oral fluid samples, 39.2 % were positive for at least one NPS by liquid chromatography‒tandem mass spectrometry (LC–MS/MS). The most prevalent NPS was ketamine (29.4 %), followed by methylone (6.1 %) and N-ethylpentylone (4.1 %); however, MDMA was the most commonly identified (88.5 %) illicit psychoactive substance. More than one drug was identified in 79.9 % of samples, with two (34.2 %) and three (23.4 %) substances most commonly observed. Only 5 % of volunteers reported recent NPS consumption. ConclusionMDMA is still the most common party and electronic music festival drug, although NPS were identified in more than one-third of oral fluid samples.

Prevalence of New Psychoactive Substances in Oral Fluid Samples from French Drivers: A Longitudinal Survey (2016-2020).

Prevalence of New Psychoactive Substances in Oral Fluid Samples from French Drivers: A Longitudinal Survey (2016-2020).

Illicit substances detected through high-resolution MS analysis in urine samples are associated with greater symptom burden in patients with psychosis

BackgroundThe prevalence of new psychoactive substances (NPS) in acute psychotic patients has not been investigated systematically. We applied a highly sensitive and specific mass spectrometry method for detection of NPS as well as traditional drugs of abuse (including illicit or prescription substances) in order to assess their prevalence and associations with symptom severity. Identification of these substances is useful in both the diagnostic process and evaluation of treatment effects. MethodsDemographic data, results from the Positive and Negative Syndrome Score (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) and urine samples from admission were collected from 53 patients recruited into a clinical study of psychosis during 2014-2017. Urine samples were analysed with liquid chromatography high resolution mass spectrometry (LC-QTOF-MS), through both highly specific detection of 191 substances using internal standards and untargeted screening by means of pre-defined libraries. PANSS and CDSS scores in patients with or without drugs of abuse were compared. ResultsPotential drugs of abuse, i.e. drugs that could be used in a controlled therapeutic or a non-prescribed manner, were detected in samples from 20 of the 53 patients. Seven samples contained illicit drugs, but no NPS were detected. In this small patient subgroup, PANSS total score and CDSS score were significantly higher than in patients with negative urine sample results. ConclusionDrug screening could play an important role in the differential diagnostic evaluation of patients admitted with psychotic symptoms. Although no NPS were detected in the study population, we found other substances that were associated with psychotic and depressive symptoms.

Automatic identification of NBOMe illicit psychoactive substances based on combined molecular descriptors

During the last decade, a growing prevalence of new psychoactive substances (NPS) has been noticed by the law enforcement agencies. Although NPS have no medical use due to their very high toxicity, they are often sold on the black market. NBOMe defines a group of toxic amphetamines that has as parent compound 25I-NBOMe, a synthetic derivative of 2C-I (2,5-dimethoxy-4-iodophenetylamine). In this paper, we are presenting a series of Artificial Neural Networks (ANNs) designed to identify the NBOMe class membership based on a mixture of topological and 3D-MoRSE descriptors. For this purpose, the molecular structures of 160 compounds representing NBOMe compounds, narcotics, sympathomimetic amines, potent analgesics, as well as their main precursors have been first optimized. Then a molecular database was formed by computing a large number of topological and 3D-MoRSE descriptors that characterize these structures. This database was used as input for building an ANN system designed to recognize NBOMes. The relevance of the input variables on its classification performance has been assessed and new systems have been built by using different combinations of selected topological and 3D-MoRSE descriptors. The best performing system has been found by comparing various classification efficiency criteria.

Fatalities associated with NPS stimulants in the Greater Cologne area.

This study centres on the prevalence of new psychoactive substances (NPS) stimulant use, and its relevance as a cause of death amongst individuals between the ages of 12 and 35 in the greater Cologne area. An automated solid-phase extraction-liquid chromatography-tandem mass spectrometry method was developed for the determination of 97 stimulants in urine (including conventional stimulants, e.g. amphetamine and MDMA), of which 68 analytes were fully validated for quantification. Samples of urine or kidney tissue (in cases where urine was unavailable) of 268 deceased were collected, during autopsy, between January 2011 and May 2017 and analyzed. Blood (if available) was also investigated in cases where urine/kidney samples were tested positive for NPS. An intake of stimulants (including NPS stimulants) was proven in 50 cases. In 33 cases, only conventional stimulants were detected. A total of 17 cases were tested positive for NPS. Of the 17 NPS-positive cases, 13 were also tested positive for other conventional drugs of abuse (mostly amphetamine and MDMA). In six NPS-positive cases, at least three different NPS were proven to be ingested. Due to the determined blood concentrations, NPS was assigned as the leading cause of death, or of toxicological relevance, in the cause of death in only 5 cases. In two of the cases, NPS was judged to be a component of a multidrug poisoning, but of minor relevance.

Prevalence of New Psychoactive Substances (NPS) and conventional drugs of abuse (DOA) in high risk populations from Paris (France) and its suburbs: A cross sectional study by hair testing (2012–2017)

BackgroundThe 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. MethodHair 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. Results480 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. ConclusionNPS screening should be assessed in routine clinical practice, especially in high-risk populations.

Enantioseparation of novel psychoactive chiral amines and their mixture by capillary electrophoresis using cyclodextrins as chiral selectors

The prevalence of new psychoactive substances (NPS) has been increasing during the last decade as well as their constant growth of availability across the whole world. Regardless of the potential health hazard, NPS (often racemic compounds) are frequently sought after and abused for their psychoactive effects that may differ for individual enantiomers. In this work, capillary electrophoresis was used for the chiral separation of a mixture of eleven psychoactive chiral amines using β-cyclodextrin and carboxymethyl-β-cyclodextrin as chiral selectors at various concentrations. Chiral separation was successful for all the analytes studied. A mixture of these analytes was subsequently analyzed under optimal conditions, i.e., when using 20 mmol/L carboxymethyl-β-cyclodextrin in 50 mmol/L sodium phosphate buffer, pH 2.5. In this case, chiral separation occurred in nine out of eleven analytes. To our best knowledge, we achieved enantioseparations of seven analyzed compounds by CE for the first time.

Current situation on new psychoactive substances abuse among methadone maintenance treatment patients in China

Methadone maintenance treatment (MMT) greatly contributed to the successful outcomes of prevention and control on both AIDS and drug abuse in China. However, the features on drug abuse changed in the past decades, and the prevalence of new psychoactive substances abuse potentially somehow offset the achievement of MMT. This paper concised the information on research and surveys of this issue that targeting on the current situation, characteristics, related factors and relevant public health problem on new psychoactive substances abuse, among patients who have been on MMT, in China.

Prevalence of new psychoactive substances and prescription drugs in the Belgian driving under the influence of drugs population.

Driving under the influence of drugs (DUID) is a worldwide problem. Several countries have adopted DUID legislations which prove their deterrent effect and impact on road safety. However, the use of new psychoactive substances (NPS) and prescription drugs is not known, as the applied roadside screening tests have not yet been adapted for these compounds. In this study, 558 blood samples obtained during roadside controls in Belgium (January to August 2015) after a positive Drugwipe 5S® test and 199 oral fluid (OF) samples obtained from negatively screened test pads were analyzed. The NPS positivity rate was 7% in blood, while it reached 11% in OF. NPS detected were: diphenidine, ketamine, 4-fluoroamphetamine, 2-amino-indane, methoxetamine, α-PVP, methiopropamine, a mix of 5-MAPB/5-EAPB, TH-PVP, mephedrone, methedrone, 4-methylethylcathinone, 5-MeO-DALT, 4-Acetoxy-DiPT, AB Fubinaca, FUB-JWH018, JWH020, trifluoromethylphenylpiperazine, and ethylphenidate. Moreover, 17% of blood samples (and 5% of OF) contained an analgesic drug, 10% (0.5%) a benzodiazepine/hypnotic, 5% (2%) an antidepressant, 2% (3%) an antipsychotic, 2% an antiepileptic drug, and 1% methylphenidate. The presence of NPS in the young (and predominately male) DUID population is proven. Furthermore, a high level of poly-drug use including combinations of NPS, licit, and drugs of abuse was observed. Further research concerning the development of on-site NPS detection techniques should be established. Meanwhile, the effects of combined drug use on driving ability and the physical/psychological signs after NPS use should be performed to improve the on-site DUID detection of NPS by police officers, so they can engage in blood sampling for a general unknown screening.

Changes in the prevalence of new psychoactive substances and their legal status in Japan.

Changes in the prevalence of new psychoactive substances and their legal status in Japan.

Prevalence of new psychoactive substances in Northeast Asia from 2007 to 2015

The proliferation of new psychoactive substances (NPS) has been a global trend in drug abuse and its regulation has been a worldwide concern. There is no doubt that it is necessary to share information related to these emerging substances between countries and continents for the effective regulation of NPS. With efforts for the efficient regulation of NPS, many studies and information have been published for the prevalence of NPS in the United States and other countries in Europe and Oceania. However, there is lack of information available for the prevalence of NPS in Asian and African countries. Therefore, this research was focused on the investigation of legal status of certain NPS in Northeast Asian countries, including China, Japan, South Korea and Taiwan, in order to provide information on the prevalence and trend of emerging NPS in these countries. The results showed that a total of 940 NPS was reported in 4 Northeast Asian countries from 2007 to 2015. Among 940 NPS, 882 NPS are legally restricted in at least one country (94%) and 96 substances were not currently under control (6%) in these countries. The number of controlled NPS that are currently controlled in all 4 countries was only 25 (or 28%) out of 882 NPS. Each substance was categorized in 9 groups according to the classification proposed by the United Nations Office on Drugs and Crime (UNODC). In Northeast Asia, the most commonly controlled NPS were synthetic cannabinoids, synthetic cathinones, and phenethylamines. It was found that Japan is the most proactive country in terms of the NPS regulation with 41% of the total number of controlled NPS in Northeast Asia, followed by South Korea (21%), China (28%), Taiwan (10%). Comparing the number of NPS newly regulated in each country every year, NPS has been broadly scheduled in 2011 and the number of scheduled NPS has dramatically increased from 2013 to 2015. It was shown that Northeast Asia is also in danger of these emerging NPS and the effective regulation across countries is important for the prevention of NPS. Also, this study will bring attention to local law enforcement in the construction of local drug crime prevention network sharing information for these controlled substances.

Guilty by dissociation-development of gas chromatography-mass spectrometry (GC-MS) and other rapid screening methods for the analysis of 13 diphenidine-derived new psychoactive substances (NPSs).

The prevalence of new psychoactive substances (NPSs) in forensic casework has increased prominently in recent years. This has given rise to significant legal and analytical challenges in the identification of these substances. The requirement for validated, robust and rapid testing methodologies for these compounds is obvious. This study details the analysis of 13 synthesised diphenidine derivatives encountered in casework using presumptive testing, thin layer chromatography and gas chromatography-mass spectrometry (GC-MS). Specifically, the validated GC-MS method provides, for the first time, both a general screening method and quantification of the active components for seized solid samples, both in their pure form and in the presence of common adulterants. Graphical Abstract Chemical synthesis and forensic analysis of 13 diphenidine-derived new psychoactive substance(s).

危険ドラッグ流通実態調査における質量分析の役割

危険ドラッグ流通実態調査における質量分析の役割

The prevalence of new psychoactive substances in biological material - a three-year review of casework in Poland.

New psychoactive substances (NPS) pose a challenge for forensic and clinical toxicologists, as well as for legislators. We present our findings from cases where NPS have been detected in biological material. During the three-year period 2012-2014 we found NPS in 112 cases (out of 1058 analyzed), with 75 cases in 2014 alone. The prevalence of all NPS (15.1-17.6%) was similar to amphetamine alone that was detected in 15.1-16.5% of cases. The new drugs found belonged to the following classes: cathinones (88%), synthetic cannabinoids (5%), phenethylamines (3%), piperazines and piperidines (3%), arylalkylamines (1%) and other (1%). The drugs detected were (in the order of decreased frequency): 3-MMC (50), α-pyrrolidinopentiophenone (α-PVP) (23), pentedrone (16), 3',4'-methylenedioxy-α-pyrrolidinobutyrophenone (MDPBP) (12), synthetic cannabinoid UR-144 (7), ethcathinone (5), mephedrone (5), methylenedioxypyrovalerone (MDPV) (4), 4-methylethcathinone (4-MEC) (3), buphedrone (3), desoxypipradrol (2-DPMP) (3), methylone (2) and 2C-B (2). In single cases, 2-methylmethcathinone (2-MMC), 2C-P, eutylone, 25I-NBOMe, meta-chlorophenylpiperazine (mCPP), ephedrone, methiopropamine (MPA), and 5-(2-aminopropyl)benzofuran (5-APB) were found. One NPS was the sole agent in 35% of all cases, and two or more NPS were present in 19% of cases. NPS (one or more) with other conventional drugs (like amphetamines, cannabinoids, cocaine, and benzodiazepines) were detected in most (65%) of the cases. NPS were very often detected in the blood of drivers which was a challenge for toxicologists due to a lack of data on their influence on psychomotor performance. A review of concentrations showed a wide range of values in different types of cases, especially driving under the influence of drugs (DUID) and intoxication.