Current Ten Clinical Studies on New Psychoactive Substances in Taiwan

 

Year	Journal	University, Hospital.	Finding, Conclusion	Reference
2016	Subst Abuse Treat Prev Policy	Kaohsiung Medical University	Controlled NPS items in Taiwan were far less than those in Korea, but the quantity of total NPS seizures, especially with ketamine, was much larger in Taiwan than in Korea.	1
2017	Forensic Sci Int	Kaohsiung Medical University	Japan is the most proactive country in terms of the NPS regulation with 41% of the total number of controlled NPS in Northeast Asia, followed by South Korea (21%), China (28%), Taiwan (10%)	2
2020	J Formos Med Assoc	National Taiwan University Hospital	The most common NPS was ketamine (21.7%), followed by synthetic cathinones (14.8%). Polysubstance use was more common in the NPS group than in the traditional group. Most patients were men (78.3%)	3
2022	Clin Toxicol (Phila) .	Linkou Chang Gung Memorial Hospital	The most frequently detected drug was methamphetamine/amphetamine, followed by synthetic cathinones, ketamine and its two analogs, and opioids. Younger patients and women were more likely to have NPS detected in their urine samples. NPS-positive cases frequently experienced chest pain  tachycardia and suicide attempt/non-suicidal self-harm  whereas depressed consciousness was less frequent among NPS-positive cases than among other illicit drug-positive cases.	4
2022	J Formos Med Assoc	National Taiwan University College of Medicine	546 (73.7%) men and 195 (26.3%) women were enrolled. Compared to men, women were younger (32.03 ± 10.86 vs. 36.51 ± 10.84 years, p < 0.001) and more likely to use new psychoactive substances (NPS). Men were more likely to have HIV infection, whereas women were more likely to report psychiatric comorbidities. Women were less likely to have aggressive behaviors. The likelihood of rhabdomyolysis and intensive care unit admission was higher in men (p < 0.001).	5
2022	Clin Toxicol (Phila)	National Taiwan University College of Medicine	Tachycardia, hyperthermia, and rhabdomyolysis were more common among cathinone users than among meth/amphetamine users presented to EDs.	6
2022	J Formos Med Assoc	Taipei City Hospital	High suicidality and high psychiatric comorbidities in multiple illicit drug users call for special need for suicide screening and a more integrated care incorporating psychiatric and substance treatment.	7
2022	Toxics	Linkou Chang Gung Memorial Hospital	The mortality NPS users were older, with deep coma, faster heart rate and respiratory rate, lower blood pressures and O2 room air saturation, more seizures, abnormal breath sounds, and had urine incontinence compared to the survivor patients. The mortality patients also had acute kidney injury, higher potassium, blood sugar, liver function test, and lactate level.	8
2023	J Forensic Leg Med	Mackay Memorial Hospital	NPS users are relatively younger, are more likely to experience facial flush and palpitation and engage in more self-harm, violence, and suicide than non-NPS drug users.	9
2023	Medicine (Baltimore)	MacKay Memorial Hospital	The NPS users were significantly younger than those with negative results on toxic testing (26.4 vs 37.5, P = .005). The heart rate of NPS users was significantly faster than that of the group with negative results of toxic testing (111.1 vs 93.5 beats per minute, P = .046). The heartbeats of INPS group were also significantly faster than those with a negative result in toxicology screen (119.6 vs 93.5 beats per minute, P = .024). Those who used classical illicit drugs combined with NPS had significantly higher palpitation than those with negative results of toxic testing (27.3% vs 3.1%, P = .017).	10

1.      https://pubmed.ncbi.nlm.nih.gov/27663984/

2.      https://pubmed.ncbi.nlm.nih.gov/28088088/

3.      https://pubmed.ncbi.nlm.nih.gov/32037264/

4.      https://pubmed.ncbi.nlm.nih.gov/35315299/

5.      https://pubmed.ncbi.nlm.nih.gov/35365378/

6.      https://pubmed.ncbi.nlm.nih.gov/35438590/

7.      https://pubmed.ncbi.nlm.nih.gov/35484001/

8.      https://pubmed.ncbi.nlm.nih.gov/35878292/

9.      https://pubmed.ncbi.nlm.nih.gov/36571928/

10.  https://pubmed.ncbi.nlm.nih.gov/37352073/

 

Edited by Yu-Jang Su July, 9, 2023 

Current 10 articles related to New Psychoactive Substance

 

Country	Journal	Date	Important information	References
Spain	Anal Methods	2023 Jan 3	Using Membrane-assisted solvent extraction followed by liquid chromatography-tandem mass spectrometry for urine testing	[1]
Canada	Nicotine Tob Res.	2023 Jan 2	Compassion clubs are a model for the distribution of psychoactive substances that are focused on harm reduction and social support rather than profit.	[2]
Australia	Front Psychiatry.	2022 Dec 15	Synthetic cannabinoid receptor agonists (SCRAs) are a diverse class of new psychoactive substances that have been associated with multiple instances and types of toxicity. Some "off-targets" could possibly contribute to the SCRA toxidrome, particularly at high concentrations, CB1-mediated cellular dysfunction provides support for hypotheses concerning on-target, rather than off-target, toxicity.	[3]
UK	Drug Test Anal.	2022 Dec 29.	Higher drug levels were detected in leg hair for cannabinol, THC, methadone, and EtG and in beard hair for THC, THC-COOH, and 6-acetylmorphine. In contrast, significantly lower levels were detected in axilla hair for cannabinol, THC and for EDDP, but median levels of mephedrone and DHEA were higher.	[4]
France	Rev Epidemiol Sante Publique.	2022 Dec 24	Drug consumption rooms (DCR) are devices that target people who inject drugs (PWID) exposed to high sanitary or social risks, i.e. people living in precarious conditions, who have to inject in public spaces, in deleterious sanitary environments and with rapid gestures in order not to be seen. These analyzes highlight that the people who most want to attend a DCR are aware of the harms associated with their practices and show a desire to seek protection from street-based drug scenes.	[5]
Taiwan	J Forensic Leg Med.	2022 Dec 22	NPS users were 5.7 years younger than non-NPS drug users (37 vs. 42.7 years, p = 0.022). NPS users had a 2.6-fold higher rate of suicide and a 2.9-fold greater possibility of violence than non-NPS drug users. Moreover, NPS users experienced a 4.3-fold greater feeling of palpitation (p = 0.024) and had an 8.1-fold higher chance of presenting facial flush (p = 0.032) than non-NPS drug users.	[6]
Czech Republic	Pharmaceuticals (Basel).	2022 Nov 30	Find a synthetic pathway for a novel synthetic cathinone, namely 4-isobutylmethcathinone, and describe its spectroscopic properties and biological activity in vitro. Higher cytotoxicity in comparison with other synthetic cathinones. In the receptor binding studies, a significant difference in the agonistic effect on dopamine and adrenergic receptors of individual enantiomers was observed. The lack of binding affinity towards the serotonin receptors then relates 4-isobutylmethcathinone to the family of monoamine drugs, such as 3,4-methylenedioxymathamphetamine (ecstasy, MDMA).	[7]
Germany	Metabolites.	2022 Dec 2	In Vitro and In Vivo Toxicometabolomics of the Synthetic Cathinone PCYP Studied by Means of LC-HRMS/MS	[8]
France	Int J Mol Sci.	2022 Dec 8	Arylcyclohexylamine (ACH) compounds such as ketamine, phencyclidine and eticyclidine derivatives are rapidly increasing use and the absence of detailed toxicity data. First used mainly for their pharmacological properties in anesthesia, their recreational use is increasing. ACH derivatives have an antagonistic activity against the N-methyl-D-aspartate receptor, which leads to dissociative effects (dissociation of body and mind). Synthetic ketamine derivatives produced in Asia are now arriving in Europe, where most are not listed as narcotics and are, thus, legal. These structural derivatives have pharmacokinetic and pharmacodynamic properties that are sometimes very different from ketamine.	[9]
Sweden. Netherlands. USA. UK.	Basic Clin Pharmacol Toxicol.	2022 Dec 21	4'Cl-cumyl-PINACA (SGT-157), 4'F-cumyl-5F-PINACA (4F-cumyl-5F-PINACA, SGT-65) and 4'F-cumyl-5F-PICA (4F-cumyl-5F-PICA, SGT-64) are a series of new halogenated cumyl synthetic cannabinoid receptor agonists (SCRAs). Many metabolites retained halogen groups at the cumyl moieties which, in various combinations, may be suitable as analytical biomarkers.	[10]

 

[1] https://pubmed.ncbi.nlm.nih.gov/36594640/

[2] https://pubmed.ncbi.nlm.nih.gov/36591922/

[3] https://pubmed.ncbi.nlm.nih.gov/36590635/

[4] https://pubmed.ncbi.nlm.nih.gov/36581323/

[5] https://pubmed.ncbi.nlm.nih.gov/36571957/

[6] https://pubmed.ncbi.nlm.nih.gov/36571928/

[7] https://pubmed.ncbi.nlm.nih.gov/36558946/

[8] https://pubmed.ncbi.nlm.nih.gov/36557246/

[9] https://pubmed.ncbi.nlm.nih.gov/36555217/

[10] https://pubmed.ncbi.nlm.nih.gov/36544361/

edited by Yu-Jang Su  Jan 4, 2023

 

The Age Distribution of Illicit Agents Users.

 

Year	Country	Age	n	Substance	Reference
2021	US	40.0 ±11.4	1362	illegal drug	https://pubmed.ncbi.nlm.nih.gov/34831700/
2022	Taiwan	36.0 ±30.0	675	illicit drugs	https://pubmed.ncbi.nlm.nih.gov/35315299/
2020	Taiwan	34.5 ± 10.0	203	illicit substance	https://pubmed.ncbi.nlm.nih.gov/32037264/
2016	Switzerland	33	210	psychoactive substances	https://pubmed.ncbi.nlm.nih.gov/27228985/
2017	Switzerland	33	503	recreational drug toxicity	https://pubmed.ncbi.nlm.nih.gov/28264690/
2021	UK	31.2 (SD 10.0)	283	ketamine	https://pubmed.ncbi.nlm.nih.gov/34092131/
2021	Spain	31	17198	acute drug toxicity	https://pubmed.ncbi.nlm.nih.gov/33724118/
2016	Japan	30	589	novel psychoactive substances	https://pubmed.ncbi.nlm.nih.gov/27314752/
2016	Germany	26.9	13	gamma hydroxybutyrate	https://pubmed.ncbi.nlm.nih.gov/26395197/
2022	Taiwan	25.5	24	Nitrous Oxide	https://pubmed.ncbi.nlm.nih.gov/35324737/

 Edited by Yu-Jang Su   June 26, 2022. 

False-Positive Urine Drug Screen

  

UDS (urine drug screen)	Causing False Positive Substance	Possible Treatment-Related	References
Amphetamine and 3,4-methylenedioxymethamphetamine (MDMA)	Amantadine Aripiprazole Bupropion chlorpromazine  Esmolol Ephedrine Labetalol Dimethylamylamine (DMAA) Methylphenidate promethazine Selegiline Phentermine Pseudoephedrine Ranitidine Selegiline  Trazadone	trazodone	[1] [2] [3] [4] [5]
Benzodiazepine	50% of Efavirenz user Oxaprozin Sertraline		[3] [4] [5]
Cannabinoid	Efavirenz 600mg lumacaftor/ivacaftor Ibuprofen Naproxen		[3] [4] [5] [6]
Ketamine	Quetiapine (Seroquel)		[7]
Methadone	quetiapine		[3]
Opiate, Opioid	Quetiapine 69.2% Levofloxacin, ofloxacin and pefloxacin users Poppy seeds Verapamil	Buprenorphine Naloxone	[3] [4] [5] [7]
Phencyclidine (Angel Dust)	Tramadol Venlafaxine Medicon (Dextromethorphan) Diphenhydramine Ketamine		[3] [4] [5]
Tricyclic Antidepressants	Carbamazepine Cyclobenzaprine Diphenhydramine Phenothiazines		[5]

 

1.      Caricasole V, Spagnolo G, Di Bernardo I, Cirnigliaro G, Piccoli E, Dell'Osso B. Aripiprazole causing false positive urine amphetamine drug screen in an adult patient with bipolar disorder. Compr Psychiatry. 2019 Oct;94:152126. doi: 10.1016/j.comppsych.2019.152126. Epub 2019 Sep 5. PMID: 31518847.

2.      Adashek JJ, Khadilkar A, Enciso J, Rane R, Wu R. A Case of Esmolol-Induced False-Positive Amphetamine Urine Drug Test. Cureus. 2021 Jan 2;13(1):e12429. doi: 10.7759/cureus.12429. PMID: 33542876; PMCID: PMC7849827.

3.      Saitman A, Park HD, Fitzgerald RL. False-positive interferences of common urine drug screen immunoassays: a review. J Anal Toxicol. 2014 Sep;38(7):387-96. doi: 10.1093/jat/bku075. Epub 2014 Jul 1. PMID: 24986836.

4.      Shafiq Q, Mutgi A. Urine opiate screening: false-positive result with levofloxacin. CMAJ. 2010 Oct 19;182(15):1644-5. doi: 10.1503/cmaj.091508. Epub 2010 Sep 27. PMID: 20876267; PMCID: PMC2952012.

5.      Algren DA, Christian MR. Buyer Beware: Pitfalls in Toxicology Laboratory Testing. Mo Med. 2015 May-Jun;112(3):206-10. PMID: 26168592; PMCID: PMC6170116.

6.      Kissner D, LeFlore Y, Narayan SB, Marigowda G, Simard C, Le Camus C. False-positive cannabinoid screens in adult cystic fibrosis patients treated with lumacaftor/ivacaftor. J Cyst Fibros. 2018 Nov;17(6):e51-e53. doi: 10.1016/j.jcf.2018.08.006. Epub 2018 Sep 12. PMID: 30217546.

7.      Liu CH, Wang HY, Shen SH, Chiu YW. False positive ketamine urine immunoassay screen result induced by quetiapine: A case report. J Formos Med Assoc. 2017 Sep;116(9):720-722. doi: 10.1016/j.jfma.2017.04.008. Epub 2017 May 8. PMID: 28495417.

edited by Yu-Jang Su   Sep 12, 2021.