Department of Pharmacology and Toxicology, Versailles Saint-Quentin-en-Yvelines University, Inserm U-1173, Raymond Poincaré Hospital, AP-HP, 104, Raymond Poincaré Blvd., 92380 Garches, France.
Talan Solutions, 21 Dumont d'Urville Street, 75016, Paris, France.
Drug Alcohol Depend. 2019 Nov 1;204:107508. doi: 10.1016/j.drugalcdep.2019.06.011. Epub 2019 Aug 30.
The 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.
Hair 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.
480 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.
NPS screening should be assessed in routine clinical practice, especially in high-risk populations.
本研究旨在通过毛发检测方法描述六年来巴黎及其郊区的新精神活性物质（NPS）和传统药物滥用的流行情况。
2012 年至 2017 年间，在巴黎医院的不同科室入院的患者中采集毛发样本。主要考虑了两个高危人群：1）药物依赖者和 2）急性中毒者。通过经验证的 LC-MS/MS 方法进行分段毛发分析，以筛选 DOA 和 83 种 NPS。
共纳入 480 例患者（280 例男性/200 例女性，年龄 15-70 岁）。141 例患者的 NPS 检测呈阳性（99 例男性/42 例女性；中位年龄：33 岁）。NPS 的流行率为 29%，安非他命、可卡因和阿片类药物的流行率分别为 32%、38.5%和 52%。共鉴定出 27 种 NPS，4-MEC 和甲卡西酮（各有 24 例）是最常见的苯丙胺类物质。JWH-122（1 例）是唯一检测到的合成大麻素，而氯胺酮（104 例）在许多 NPS 用户中存在（67%）。3-氟芬太尼（1 例）、呋喃芬太尼（1 例）、N-乙基戊基酮（2 例）、戊酮（2 例）、麦角酸二乙酰胺（1 例）、甲卡西酮（3 例）、6-APDB（2 例）、TFMPP（2 例）、2-CE（1 例）、3,4-MD-αPHP（1 例）和右美沙芬（27 例）均首次在毛发中检出。53%的病例中发现使用者同时使用一种以上的 NPS，主要与传统药物滥用同时使用。检测到的 NPS 数量从 2012 年的 5 种增加到 2017 年的 42 种。发现的浓度范围很广（0.001-318ng/mg），但中位数浓度较低，表明偶尔暴露的可能性大于慢性使用。
应在常规临床实践中评估 NPS 筛查，特别是在高危人群中。
