Chicora F Oliver1, Joseph J Palamar2, Alberto Salomone3, Steven J Simmons4,5, Helene L Philogene-Khalid4,6, Nick Stokes-McCloskey4, Scott M Rawls4. 1. Center for Substance Abuse Research, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, 882A, Philadelphia, PA, 19140, USA. chicoraoliver@temple.edu. 2. Department of Population Health, 180 Madison Avenue Room 1752, New York, NY, 10016, USA. 3. Centro Regionale Antidoping "A. Bertinaria", Regione Gonzole 10/1, 10043, Orbassano, Torino, Italy. 4. Center for Substance Abuse Research, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, 882A, Philadelphia, PA, 19140, USA. 5. Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia Research Institute, Philadelphia, PA, 19104, USA. 6. Department of Psychiatry, 100 E. Lehigh Ave, Philadelphia, PA, 19125, USA.
Abstract
RATIONALE: Current prevalence estimates of synthetic cathinone ("bath salt") use may be underestimates given that traditional metrics (e.g., surveys, urinalysis) often fail to capture the emergent issue of synthetic cathinone adulteration of more common illegal drugs, such as ecstasy (3,4-methylenedioxymethamphetamine). OBJECTIVES: This review examines the evolution of synthetic cathinones and prevalence of use over the past decade in the United States. We also review methods of self-report and biological testing of these compounds as well as adverse outcomes associated with adulterated drug use. RESULTS: Synthetic cathinone use emerged in the United States by 2009 with use associated with tens of thousands of poisonings. Reported poisonings and self-reported use have substantially decreased over the past five years. However, our review suggests that current estimates of use are underestimates due to underreporting stemming primarily from unknown or unintentional use of adulterated formulations of relatively popular illegal drugs, such as ecstasy. CONCLUSIONS: While intentional synthetic cathinone use has decreased in recent years, evidence suggests that prevalence of use is underestimated. Testing of drugs and/or biological specimens can improve the accuracy of synthetic cathinone use estimates. Furthermore, we advocate that researchers and clinicians should become better aware that exposure to these potent compounds (e.g., as adulterants) often occurs unknowingly or unintentionally. To improve our understanding of synthetic cathinone adulteration, research utilizing a combinatorial approach (survey and biological testing) will help more accurately estimate the prevalence and impact of this public health issue.
RATIONALE: Current prevalence estimates of synthetic cathinone ("bath salt") use may be underestimates given that traditional metrics (e.g., surveys, urinalysis) often fail to capture the emergent issue of synthetic cathinone adulteration of more common illegal drugs, such as ecstasy (3,4-methylenedioxymethamphetamine). OBJECTIVES: This review examines the evolution of synthetic cathinones and prevalence of use over the past decade in the United States. We also review methods of self-report and biological testing of these compounds as well as adverse outcomes associated with adulterated drug use. RESULTS: Synthetic cathinone use emerged in the United States by 2009 with use associated with tens of thousands of poisonings. Reported poisonings and self-reported use have substantially decreased over the past five years. However, our review suggests that current estimates of use are underestimates due to underreporting stemming primarily from unknown or unintentional use of adulterated formulations of relatively popular illegal drugs, such as ecstasy. CONCLUSIONS: While intentional synthetic cathinone use has decreased in recent years, evidence suggests that prevalence of use is underestimated. Testing of drugs and/or biological specimens can improve the accuracy of synthetic cathinone use estimates. Furthermore, we advocate that researchers and clinicians should become better aware that exposure to these potent compounds (e.g., as adulterants) often occurs unknowingly or unintentionally. To improve our understanding of synthetic cathinone adulteration, research utilizing a combinatorial approach (survey and biological testing) will help more accurately estimate the prevalence and impact of this public health issue.
Authors: David M Wood; Susannah Davies; Malgorzata Puchnarewicz; Jenny Button; Roland Archer; Hanna Ovaska; John Ramsey; Terry Lee; David W Holt; Paul I Dargan Journal: J Med Toxicol Date: 2010-09
Authors: Tom P Freeman; Celia J A Morgan; James Vaughn-Jones; Nahida Hussain; Kash Karimi; H Valerie Curran Journal: Addiction Date: 2012-01-18 Impact factor: 6.526