Lianping Ti1,2, Samuel Tobias1, Nazlee Maghsoudi3,4, M-J Milloy1,2, Karen McDonald3, Aaron Shapiro5,6, Daniel Beriault7, Cristiana Stefan8, Mark Lysyshyn9,10, Daniel Werb3,11. 1. British Columbia Centre on Substance Use, Vancouver, Canada. 2. Department of Medicine, University of British Columbia, Vancouver, Canada. 3. Centre on Drug Policy Evaluation, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada. 4. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. 5. British Columbia Provincial Toxicology Centre, Vancouver, Canada. 6. Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada. 7. Department of Laboratory Medicine and Pathobiology, University of Toronto, St Michael's Hospital, Toronto, Canada. 8. Centre for Addiction and Mental Health, Clinical Laboratory and Diagnostic Services, Toronto, Canada. 9. Vancouver Coastal Health Authority, Vancouver, Canada. 10. School of Population and Public Health, University of British Columbia, Vancouver, Canada. 11. Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, USA.
Abstract
INTRODUCTION: Novel psychoactive substances (NPS) are increasingly being consumed worldwide, with synthetic cannabinoids and synthetic opioids being the second and third most commonly used NPS, respectively. Certain synthetic cannabinoids can produce significant harms, particularly when used with opioids. The objective of this study was to characterise the presence of synthetic cannabinoids in the unregulated drug supply in three Canadian settings METHODS: In the British Columbia setting, all samples were first analysed at point-of-care using combination Fourier-transform infrared (FTIR) spectroscopy and fentanyl immunoassay strips prior to confirmatory testing using quantitative nuclear magnetic resonance spectroscopy, gas chromatography/mass spectrometry (GC/MS) and/or liquid chromatography/mass spectrometry (LC/MS). In the Toronto, Ontario setting, the samples were analysed directly by GC/MS, LC/MS liquid chromatography-high resolution/mass spectrometry. RESULTS: Between January 2018 and December 2019, 38 (2.8%) synthetic cannabinoid samples were detected in the unregulated drug supply (25/909 in British Columbia and 13/440 in Ontario). In British Columbia and Ontario, 76% and 85% of samples, respectively, were expected by individuals to be an opioid. Synthetic cannabinoids detected included AMB-FUBINACA, AB-FUBINACA, 5-fluoro-MDMB-PINACA, and 5-fluoro-MDMB-PICA, and largely co-occurred with fentanyl. In the British Columbia context, Fourier-transform infrared spectroscopy failed to detect synthetic cannabinoid compounds in almost half (48%) of the samples at point-of-care. DISCUSSION AND CONCLUSIONS: As point-of-care technologies failed to detect these compounds in many occasions, our findings demonstrate the importance of laboratory confirmatory analysis to identify NPS. Given the high risk of harm associated with the consumption of synthetic cannabinoids, further research should investigate the reasons for adulteration.
INTRODUCTION: Novel psychoactive substances (NPS) are increasingly being consumed worldwide, with synthetic cannabinoids and synthetic opioids being the second and third most commonly used NPS, respectively. Certain synthetic cannabinoids can produce significant harms, particularly when used with opioids. The objective of this study was to characterise the presence of synthetic cannabinoids in the unregulated drug supply in three Canadian settings METHODS: In the British Columbia setting, all samples were first analysed at point-of-care using combination Fourier-transform infrared (FTIR) spectroscopy and fentanyl immunoassay strips prior to confirmatory testing using quantitative nuclear magnetic resonance spectroscopy, gas chromatography/mass spectrometry (GC/MS) and/or liquid chromatography/mass spectrometry (LC/MS). In the Toronto, Ontario setting, the samples were analysed directly by GC/MS, LC/MS liquid chromatography-high resolution/mass spectrometry. RESULTS: Between January 2018 and December 2019, 38 (2.8%) synthetic cannabinoid samples were detected in the unregulated drug supply (25/909 in British Columbia and 13/440 in Ontario). In British Columbia and Ontario, 76% and 85% of samples, respectively, were expected by individuals to be an opioid. Synthetic cannabinoids detected included AMB-FUBINACA, AB-FUBINACA, 5-fluoro-MDMB-PINACA, and 5-fluoro-MDMB-PICA, and largely co-occurred with fentanyl. In the British Columbia context, Fourier-transform infrared spectroscopy failed to detect synthetic cannabinoid compounds in almost half (48%) of the samples at point-of-care. DISCUSSION AND CONCLUSIONS: As point-of-care technologies failed to detect these compounds in many occasions, our findings demonstrate the importance of laboratory confirmatory analysis to identify NPS. Given the high risk of harm associated with the consumption of synthetic cannabinoids, further research should investigate the reasons for adulteration.
Authors: Ryan McNeil; Taylor Fleming; Samara Mayer; Allison Barker; Manal Mansoor; Alex Betsos; Tamar Austin; Sylvia Parusel; Andrew Ivsins; Jade Boyd Journal: Am J Public Health Date: 2022-03-09 Impact factor: 9.308
Authors: Wendy Masterton; Danilo Falzon; Gillian Burton; Hannah Carver; Bruce Wallace; Elizabeth V Aston; Harry Sumnall; Fiona Measham; Rosalind Gittins; Vicki Craik; Joe Schofield; Simon Little; Tessa Parkes Journal: Int J Environ Res Public Health Date: 2022-09-22 Impact factor: 4.614