Guy's and St Thomas' NHS Foundation Trust and King's Health Partners , London , UK.
Clin Toxicol (Phila). 2014 Mar;52(3):160-5. doi: 10.3109/15563650.2014.885982. Epub 2014 Feb 10.
There is increasing interest in the analysis of waste water at sewage treatment plants to monitor recreational drug use. This technique is limited for novel psychoactive substances (NPS) due to limited knowledge on their human and bacterial metabolism and stability in waste water. Small studies have reported the detection of NPS using pooled anonymous urine samples, which eliminates some of these potential confounders.
To determine patterns of recreational drug, including NPS, use by confirming their presence in analysis of pooled urine from portable street urinals across a wide geographical area in central London over a 6-month period.
Pooled anonymous urine samples were collected from 12 four-bay stand-alone portable urinals distributed once a month across central London for six consecutive months. Samples were analysed using high-performance liquid chromatography coupled to high-resolution accurate mass spectrometry (LC-HRAM-MS); acquired data were processed against target compound databases.
With regards to Classical Recreational Drugs, there was consistency of detection of cathine, cocaine, morphine, MDMA over the 6 months, with variability of detection of amphetamine, ketamine and cannabis. With regards to NPS, a total of 13 NPS were detected during the six months. Mephedrone and methylhexaneamine were detected consistently each month. Other commonly detected NPS included methiopropamine (5 months), pipradrol (4 months), cathinone (4 months), 5-(2-aminopropyl)benzofuran (3 months) and 4-methyethcathinone (3 months). Of note, methoxetamine and the synthetic cannabinoid receptor agonists were not detected in any samples.
Previous studies using the same method detected three and five NPS in a nightclub and pissoir setting, respectively, on a single night. The longer sampling time of 6 months has allowed detection of 13 NPS. Of note, mephedrone showed the least month-to-month variation in detection over the 6-month sampling period. With regards to classical recreational drugs, those detected were consistent with use-data from UK population surveys. The only exception is amphetamine which these surveys have shown a steady decline in use since 1996 but our study showed some variation in the frequency of its detection. However, the sampling period was too short and a longer study is needed to detect the trend in decreasing use.
This study demonstrates that analysis of anonymous pooled urine samples from stand-alone urinals can be used to detect and monitor trends in the use of classical recreational drugs and NPS in a large city centre over time. This technique has the potential to be a novel key indicator alongside other existing indicators to provide a more robust picture of the use of recreational drugs including NPS.
越来越多的人关注通过污水处理厂的废水分析来监测娱乐性药物的使用情况。由于对新型精神活性物质（NPS）在人类和细菌中的代谢以及在废水中的稳定性知之甚少，因此该技术对 NPS 的分析受到限制。一些小型研究报告了使用匿名 pooled 尿液样本检测 NPS 的情况，这消除了一些潜在的混杂因素。
通过确认在伦敦市中心广泛地理区域内的 6 个月期间从便携式街头小便池的 pooled 匿名尿液样本中存在这些物质，来确定包括 NPS 在内的娱乐性药物使用模式。
每月一次从伦敦市中心分布的 12 个四隔便携式小便池收集 pooled 匿名尿液样本，连续 6 个月。使用高效液相色谱法-高分辨率精确质量质谱法（LC-HRAM-MS）对样本进行分析；将采集到的数据与目标化合物数据库进行比对。
在 6 个月的时间里，在 Classical Recreational Drugs 方面，持续检测到瓜他碱、可卡因、吗啡和 MDMA，而安非他命、氯胺酮和大麻的检测则存在差异。在 NPS 方面，在六个月内共检测到 13 种 NPS。每月均持续检测到了 4-甲基乙卡西酮和甲卡西酮。其他常见的 NPS 包括二甲氧基甲苯（5 个月）、哌醋甲酯（4 个月）、苯丙胺（4 个月）、5-(2-氨基丙基)苯并呋喃（3 个月）和 4-甲基乙基卡西酮（3 个月）。值得注意的是，在任何样本中均未检测到甲氧麻黄酮和合成大麻素受体激动剂。
使用相同方法的先前研究在夜总会和小便池环境中分别在一个晚上检测到三种和五种 NPS。6 个月的更长采样时间允许检测到 13 种 NPS。值得注意的是，在 6 个月的采样期间，4-甲基乙卡西酮的检测显示出最小的月度变化。关于 Classical Recreational Drugs，所检测到的与英国人群调查中的使用数据一致。唯一的例外是安非他命，自 1996 年以来，这些调查显示其使用量一直在稳步下降，但我们的研究显示其检测频率存在一些变化。然而，采样时间太短，需要进行更长时间的研究才能检测到使用量下降的趋势。
本研究表明，对独立小便池的 pooled 匿名尿液样本进行分析，可以用于在大城市中心随着时间的推移检测和监测 Classical Recreational Drugs 和 NPS 的使用趋势。这项技术有可能成为其他现有指标之外的一种新的关键指标，为包括 NPS 在内的娱乐性药物使用情况提供更全面的情况。
