Laboratory of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Basic Clin Pharmacol Toxicol. 2022 Nov;131(5):420-434. doi: 10.1111/bcpt.13786. Epub 2022 Sep 5.
New psychoactive substances (NPS) are life threatening through unpredictable toxicity and limited analytical options for clinicians. We present the retrospective identification of NPS in raw data from a liquid chromatography-high resolution mass spectrometry (LC-HRMS)-based multidrug panel analysis on 14 367 clinical oral fluid samples requested during 2019 mainly by psychiatric and addiction care clinics. Retrospectively analysed NPS included 48 notified originally in 2019 by the European Union Early Warning System (EU EWS) and 28 frequently reported in Sweden. Of 88 included NPS, 34 (mitragynine, flualprazolam, 3F/4F-α-P(i)HP, etizolam, 4F-MDMB-BINACA, cyproheptadine, 5F-MDMB-PICA, isotonitazene, isohexedrone, MDPEP, N-ethylpentedrone, tianeptine, flubromazolam, 4'-methylhexedrone, α-P(i)HP, eutylone, mephedrone, N-ethylhexedrone, 5F-MDMB-PINACA, ADB-BUTINACA, 3-methoxy PCP, 4F-furanylfentanyl, 4F-isobuturylfentanyl, acrylfentanyl, furanylfentanyl, clonazolam, norfludiazepam, 3F-phenmetrazine, 3-MMC, 4-methylpentedrone, BMDP, ethylphenidate, methylone and α-PVP) were identified as 219 findings in 84 patients. Eight NPS notified in 2019 were identified, five before EWS release. NPS occurred in 1.20% of all samples and 1.53% of samples containing traditional drugs, and in 1.87% of all patients and 2.88% of patients using traditional drugs. NPS use was more common in men and polydrug users. Legal (not scheduled) NPS were more used than comparable illegal ones. Retrospective identification could be useful when prioritizing NPS for clinical routine analysis and when studying NPS epidemiology.
新精神活性物质（NPS）具有毒性不可预测且临床医生分析选择有限等特点，对生命构成威胁。我们报告了对 2019 年期间主要由精神科和成瘾治疗诊所请求的基于液相色谱-高分辨质谱（LC-HRMS）的多药物检测分析的 14367 份临床口服液样本原始数据中 NPS 的回顾性鉴定。回顾性分析的 NPS 包括 48 种最初于 2019 年由欧盟早期预警系统（EU EWS）报告的和 28 种在瑞典经常报告的 NPS。88 种 NPS 中，34 种（即美沙酮、氟拉苯丙胺、3F/4F-α-P(i)HP、依替唑仑、4F-MDMB-BINACA、赛庚啶、5F-MDMB-PICA、异噁唑酮、异己酮、甲普庚嗪、N-乙基戊基酮、替奈普汀、氟拉苯丙胺、4'-甲基己酮、α-P(i)HP、依他酮、麦角酸二乙胺、甲普龙、N-乙基己基酮、5F-MDMB-PINACA、ADB-BUTINACA、3-甲氧基苯丙胺、4F-呋喃基芬太尼、4F-异丁基芬太尼、丙烯酰芬太尼、呋喃基芬太尼、氯硝西泮、去甲氟安定、3F-苯丙胺、3-MMC、4-甲基戊基酮、BMDP、乙基苯丙胺、甲基酮和 α-PVP）被鉴定为 84 名患者的 219 项检测结果。2019 年报告的 8 种 NPS 中有 5 种在 EWS 发布之前就已被鉴定。NPS 在所有样本中的检出率为 1.20%，在含有传统药物的样本中的检出率为 1.53%，在所有患者中的检出率为 1.87%，在使用传统药物的患者中的检出率为 2.88%。NPS 使用在男性和多药使用者中更为常见。合法（未列入附表）的 NPS 比类似的非法 NPS 使用更为普遍。当优先考虑将 NPS 纳入临床常规分析和研究 NPS 流行病学时，回顾性鉴定可能会很有用。
