A toxicologia das Novas Substâncias Psicoativas (NSP)

Analysis of oral fluid samples from 462 attendees at parties and electronic music festivals in three Brazilian states found that MDMA was the most common substance (88% of samples), but 39% contained at least one new psychoactive substance (NPS). Ketamine was the most prevalent NPS (75% of NPS-positive samples), followed by methylone (15%) and N-ethylpentylone (10%). Only 5% of volunteers reported NPS consumption, and 80% of samples contained two or more substances. This is the first Brazilian epidemiological data on NPS consumption via biological sampling in a recreational setting. The study also quantified synthetic cathinones and LSD in oral fluid and identified 11 metabolites of the synthetic cannabinoid ADB-4en-PINACA in vitro, 7 of which were confirmed in post-mortem blood and urine.

Study at a glance

Abstract

New Psychoactive Substances (NPS) emergence of in the global illicit market has grown significantly since the 2000s.Despite the drop in the number of new identifications annually, they still cause severe cases of intoxication, many of them fatal.The present work developed and validated a method for the analysis of more than 100 NPS and conventional drugs of abuse in oral fluid (OF) samples and analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS).462 samples were collected at parties and electronic music festivals in 3 Brazilian states and analyzed using the developed methodology.3,4-methylenedioxymethamphetamine (MDMA, 88%) was still the most identified substance in the samples, but 39% of them contained some NPS.Ketamine (75%) was the most prevalent, followed by methylone (15%) and N-ethylpentylone (10%).Even so, only 5% of the volunteers had reported some NPS consumption.Ingestion of multiple substances was very prevalent, with 80% of samples containing two or more substances.This was the first data published in Brazil containing epidemiological data on NPS consumption through the analysis of biological samples in a recreational context.Samples containing synthetic cathinones were quantified using microextraction by packed sorbent (MEPS), with limit of detection (LOD) of 0.05 ng/mL.Among the 41 samples, methylone, N-ethylpentylone, euthylone, mephedrone and 4-CEC were quantified.Samples containing LSD were quantified, as well as its main biotransformation product, 2-oxo-3-hydroxy-LSD, with LOD of 0.1 ng/mL.This was the first published data quantifying both analytes in authentic oral fluid samples.Also, to meet the need for more information regarding NPS, an in vitro metabolism assay of the synthetic cannabinoid ADB-4en-PINACA was performed using human liver microsomes (HLM) and analyzed with a high-resolution mass spectrometer.Of the 11 metabolites identified in vitro, 7 were confirmed in post mortem blood and urine samples, with the metabolites derived from hydroxylation and hydroxylation followed by internal hydrolysis being the most intense.