Axelsson Magnus A B, Lövgren Hanna, Kronstrand Robert, Green Henrik, Bergström Moa Andresen
Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Sahlgrenska University Hospital, Laboratory of Clinical Chemistry, Region Västra Götaland, Gothenburg, Sweden.
Basic Clin Pharmacol Toxicol. 2025 Feb;136(2):e14117. doi: 10.1111/bcpt.14117.
New psychoactive substances (NPS) are health-hazardous through unpredictable toxicity and effects and largely unknown epidemiology, motivating studies of the latter. Up to 138 NPS were retrospectively identified using liquid chromatography-high resolution mass spectrometry data from all 34 183 oral fluid drug samples collected in one Swedish health care region 2019-2020 representing 9468 psychiatric and addiction care patients. In total, 618 findings representing 58 NPS were detected in 481 samples from 201 patients. Male gender and age ≥25 years correlated positively with NPS use. Ketamine correlated positively with all NPS classes except cannabinoids; additionally, fentanyl, methadone, tapentadol and clonazepam correlated with multiple NPS classes. More numerous traditional drugs of abuse (DoA) correlated positively with sedative/hypnotic NPS, indicating that these are used in broader patient groups than other NPS. Mitragynine correlated negatively with other NPS in general and with several traditional DoA, but positively with the potential opioid abstinence remedies buprenorphine, loperamide and tapentadol aside from ketamine. In conclusion, NPS use is infrequent but occur also at higher ages, certain traditional DoA and particularly ketamine could have clinical value as NPS use signals, and mitragynine exhibited an atypical NPS consumption pattern indicating significant use as an opioid abstinence remedy.
新型精神活性物质（NPS）因其不可预测的毒性和影响以及很大程度上未知的流行病学情况而对健康有害，这促使人们对后者展开研究。利用液相色谱-高分辨率质谱数据，对2019年至2020年在瑞典一个医疗保健地区收集的所有34183份口腔液药物样本进行回顾性分析，共识别出多达138种NPS，这些样本代表了9468名精神科和成瘾护理患者。在来自201名患者的481份样本中，总共检测到618次NPS检出结果，涉及58种NPS。男性和年龄≥25岁与NPS使用呈正相关。氯胺酮与除大麻素类以外的所有NPS类别呈正相关；此外，芬太尼、美沙酮、曲马多和氯硝西泮与多种NPS类别相关。更多的传统滥用药物（DoA）与镇静/催眠NPS呈正相关，表明这些药物的使用患者群体比其他NPS更广泛。一般来说，帽柱木碱与其他NPS呈负相关，与几种传统DoA也呈负相关，但除氯胺酮外，与潜在的阿片类戒断药物丁丙诺啡、洛哌丁胺和曲马多呈正相关。总之，NPS的使用并不常见，但在较高年龄段也有发生，某些传统DoA尤其是氯胺酮可能具有作为NPS使用信号的临床价值，而帽柱木碱表现出非典型的NPS消费模式，表明其作为阿片类戒断药物有大量使用。
