Björnstad Kristian, Hultén Peter, Beck Olof, Helander Anders
Department of Clinical Neuroscience, Alcohol laboratory, Karolinska Institutet, Stockholm, Sweden.
Clin Toxicol (Phila). 2009 Jul;47(6):566-72. doi: 10.1080/15563650903037181.
Problems associated with the increasing abuse of plant-derived psychoactive substances have recently attracted attention. This study involved bioanalytical and clinical examinations of intoxication cases suspected to be linked to such plant materials.
Urine samples were collected at emergency wards in Sweden from patients who either admitted or were suspected of ingestion of psychoactive plant materials. The bioanalytical investigation employed a liquid chromatography-tandem mass spectrometry multicomponent method covering 10 plant-derived substances (atropine, dimethyltryptamine, ephedrine, harmaline, harmine, ibogaine, lysergic acid amide, psilocin, scopolamine, and yohimbine) and a gas chromatography-mass spectrometry method for asarone. Routine testing for illicit drugs was also performed.
Over a 4-year period, 103 urine samples collected from mainly young people (age range 13-52 years, median 19) were studied. Among 53 cases where ingestion of any of the 11 plant-derived substances covered in this study was admitted or suspected, 41 (77%) could be confirmed bioanalytically. Nine of the 11 substances tested for were detected, the exceptions being ibogaine and yohimbine. Psilocin, originating from ingestion of hallucinogenic mushrooms, was the most frequent drug accounting for 54% of the cases. The most common means of drug acquisition (56%) was purchase over the Internet.
The patients using psychoactive plant materials were mainly young and commonly used the Internet for drug acquisition. Having access to bioanalytical methods for detection of plant-derived psychoactives is therefore considered important, when providing clinical toxicology service.
与植物源性精神活性物质滥用增加相关的问题近来受到关注。本研究涉及对疑似与此类植物材料有关的中毒病例进行生物分析和临床检查。
在瑞典的急诊病房收集了尿液样本，这些患者要么承认要么被怀疑摄入了精神活性植物材料。生物分析调查采用液相色谱 - 串联质谱多组分方法检测10种植物源性物质（阿托品、二甲基色胺、麻黄碱、骆驼蓬碱、哈马灵、伊博格碱、麦角酰胺、裸盖菇素、东莨菪碱和育亨宾），并采用气相色谱 - 质谱法检测细辛脑。还进行了非法药物的常规检测。
在4年期间，研究了主要来自年轻人（年龄范围13 - 52岁，中位数19岁）的103份尿液样本。在53例承认或疑似摄入本研究涵盖的11种植物源性物质中的任何一种的病例中，41例（77%）通过生物分析得到确认。所检测的11种物质中有9种被检测到，未检测到的是伊博格碱和育亨宾。源自摄入致幻蘑菇的裸盖菇素是最常见的药物，占病例的54%。最常见的获取药物方式（56%）是通过互联网购买。
使用精神活性植物材料的患者主要是年轻人，并且通常通过互联网获取药物。因此，在提供临床毒理学服务时，能够使用生物分析方法检测植物源性精神活性物质被认为很重要。
