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Detection of new psychoactive substances (NPS) use across Europe

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Detection of new psychoactive substances (NPS) use across Europe

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  1. Detection of new psychoactive substances (NPS) use across Europe Sara Castiglioni, Ettore Zuccato, Noelia Salgueiro-González, Emma Gracia Lor Lisbon, 25th October 2017 - LX Addiction

  2. Identification and Assessment of New Psychoactive Substances: A European Network New Psycoactive Substances (NPS) are substances not controlled by the international drug control conventions, which may pose public health threat NPS have similar structure of drugs under international control such as cannabis, cocaine, heroin, MDMA (“ecstasy”), amphetamine

  3. Identification and Assessment of New Psychoactive Substances: A European Network How many? EMCDDA EU Early Warning System (EWS) were established to identify these substances in the market in a short time and evaluate health risks Cooperation with UNODC, Europol, EMA, WHO EMCDDA–Europol 2016 Annual Report on the implementation of Council Decision 2005/387/JHA

  4. Identification and Assessment of New Psychoactive Substances: A European Network NPS classes EMCDDA–Europol 2016 Annual Report on the implementation of Council Decision 2005/387/JHA

  5. Identification and Assessment of New Psychoactive Substances: A European Network The route of NPS EMCDDA– New Psycoactive Substances in Europe • High number of substances • Mostly not controlled • Appear very fast in the market • Used in specific subpopulations • Mixed in unknown cocktails • Potential high toxic effects Very difficult to assess prevalence of use Few information available

  6. Identification and Assessment of New Psychoactive Substances: A European Network Wastewater – Based Epidemiology (WBE) Measurement of excretion residues (biomarker) in urban wastewater Evaluation of consumption or exposure to substances • Almost all substanceswe consume • are excreted unchanged or as a mixture of metabolites in urine and/faeces • Excreted substances entry in sewer network • Enter sewage treatment plants • Sampling and analysis untreated wastewater

  7. Identification and Assessment of New Psychoactive Substances: A European Network WBE Advantages and Challenges for NPS • Ability to provide: • Challenges: • Objective estimates • Limited use • Lots of substances • Low levels in wastewater • Near real-time estimates • Updatedinformation • Human metabolism unknown • Difficult identify biomarkers • Qualitative and quantitative • data Identification of NPS Evaluation of use WBE needs to be tested

  8. Identification and Assessment of New Psychoactive Substances: A European Network Preliminary Investigations Europe González-Mariño et al., ES&T , 2016 Australia Chen et al., Forensic Science International, 2013

  9. Identification and Assessment of New Psychoactive Substances: A European Network Aim of the study Identification and Assessment of New Psycoactive Substances in Europe using WBE • Select substances (NPS) to be investigated • Develop a method to screen the presence of NPS (qualitative analyses) • Develop a method to measure NPS(quantitative analyses) • Monitor wastewater samples from different countries Assess the use of New Psycoactive Substances in Europe Spatial and Temporal Trends

  10. Identification and Assessment of New Psychoactive Substances: A European Network NPS Selection Sources Alerts Reports of new substances (December 2013-March 2016) DATABASE 193 substances phenethylamines, arilcicloexilamine - ketamine analogues, piperidine, tryptamine, synthetic cathinones, synthetic cannabinoids, synthetic opioids, aminorex derivates, natural psychoactive substances, benzodiazepines Alerts (Europe and Italy) + Italy seizure list + Notifications in Italy (intoxications) (October 2013-March 2016) UNODC control list Criteria Frequency of reporting Most recently reported

  11. Identification and Assessment of New Psychoactive Substances: A European Network Samples investigated COST SCORE Monitoring campaign 2016 (March- May) Raw Wastewater Samples Ireland The Netherlands Poland Slovakia Hungary Switzerland Romania 14 European countries Slovenia Serbia Italy Bulgaria Bosnia and Herzegovina Portugal Pooled samples from the weekend

  12. Identification and Assessment of New Psychoactive Substances: A European Network Samples analyses Pooled wastewater sample – Solid Phase Extraction 100 mL (pH 7) 100 mL (pH 2) Oasis MCX Oasis HLB 200 µL (10% MeOH) 200 µL (10% MeOH) Orbitrap Q-Exactive Qualitative Screening No standards available API 5500 QqQ Quantitative Analysis Standards available

  13. Identification and Assessment of New Psychoactive Substances: A European Network Quantitative Analysis - Results 19 substances searched 9 substances found in wastewater 7 substances searched 1 substance found in wastewater Limits of quantification 0.3 - 2 ng/L

  14. Identification and Assessment of New Psychoactive Substances: A European Network Quantitative Analysis - Results Not found in Bosnia Herzegovina and Ucraine

  15. Identification and Assessment of New Psychoactive Substances: A European Network Quantitative Analysis - Results

  16. Identification and Assessment of New Psychoactive Substances: A European Network Qualitative Analysis – Results (193 substances investigated) Criteria for Identification: Standards needed for confirmation • Accurate Mass • Mass Error < 5 ppm • Presence of Fragments

  17. Identification and Assessment of New Psychoactive Substances: A European Network Conclusions • WBE was applied successfully to monitor the use of NPS • A qualitative screening was performed for about 200 substances • A quantitative analysis was done for > 25 substances • The levels of NPS were lower than those of the “classical” drugs – lower use ? • Differences among countries were assessed • WBE is a good complementary tool to evaluate the use of NPS

  18. Identification and Assessment of New Psychoactive Substances: A European Network Acknowledgements Project Partners 1. Mario Negri Institute (coordinator) 2. University Jaume I 3. Faculdade de Farmacia Universidade de Lisboa 4. Instituto Nacional de Medicina Legal e Ciencias Forenses 5. Institute of Health Sciences “EgasMonitz” 6. (Norwegian Institute of Water Research) EMCDDA Paul Griffith, Liesbeth Vandam, Ana Gallegos Project Collaborators (who kindly provided samples) Igor Bodik (Slovakia); Ester Heath (Slovenia); Katarzyna Styszko (Poland); Erik Emke (The Netherlands); Barbara Kasprzyk-Hordern (UK); Lisa Jones (Ireland); MariyaSkobley and TanyaBodnarchuk (Ucraine); MajaTurkSekulic and JelenaRadonic (Serbia); AndjelkaPetkovic (Serbia); Simone Milanolo (Bosnia Herzegovina); SimionBeldean (Romania); JelyazRangelov and Teodora Todorova (Bulgary); Francesca Pizza (Italy); Francesco Poretti (Switzerland); Miguel Santos (Portugal). Thanks for your attention!