Drug Testing and Analysis

This paper describes some of the new classes of ‘designer drugs’ being encountered today by forensic scientists and law enforcement agencies in Europe, the United States and Australia.

Gamma-hydroxybutyrate (GHB) has been used as a recreational drug since the 1990s and over the last few years there has been increasing use of its analogues gamma-butyrolactone (GBL) and to a lesser extent 1,4-butanediol (1,4BD). This review article will summarise the literature on the pharmacology of these compounds; the patterns and management of acute toxicity associated with their use; and the clinical patterns of presentation and management of chronic dependency associated with GHB and its analogues.

In 2005 the New Zealand Government created a new schedule of ‘Restricted Substances’ under the Misuse of Drugs Act (1975). Benzylpiperazine was the first drug to be classified as what became known informally as ‘Class D’. The rationale behind that decision and the subsequent reclassification of benzylpiperazine to Class C, in 2008, is discussed.

This review reports the current pharmacological and toxicological information for piperazine derivatives and also includes new ante-mortem and post-mortem blood data.

This review emphasises the current knowledge of the chemistry, pharmacology and toxicology of cathinone derivatives. Cathinone is the prototype naturally occurring substance from which a variety of derivatives have been synthesised, that have demonstrated amphetamine-like effects, with consequent concerns about their abuse potential and safety, most particularly mephedrone. Such concerns have led to cathinone derivatives becoming illegal in a number of countries.

This review summarises the available literature regarding sources, availability, and prevalence of the use of mephedrone. In addition offering a discussion in response to pharmacology, patterns of acute toxicity, reported fatalities associated with its use, and the potential formephedrone dependence.

Mephedrone is a cathinone derivative that has been used as a ‘legal high’ but was re-classified in the UK as a class B (intermediate category) drug. This report describes an 18-year-old man with type 1 diabetes who developed ketoacidosis following self-reported mephedrone use. Cathinone compounds may directly increase the risk of diabetic ketoacidosis by stimulating the central nervous system but may also indirectly impair an individual's ability to manage their diabetes through changes in cognitive function and behaviour.

The so called ‘Spice’ herbal incense products are a recent phenomenon that is getting frequent international press coverage. The synthetic cannabinoids that are the active ingredients in these products are significantly more potent than cannabis. Approaches to the detection of these synthetic cannabinoids are presented together with a comprehensive summary of GCMS and LCMS spectral data generated to date.

The aminoindanes are potent serotonin releasing agents that may have the appropriate chemical structure to become one of the new waves of drugs of abuse. A number of analogues of 2-aminoindane are being marketed as ‘legal highs’, all having substitutions around the aromatic ring. The chemistry, pharmacology and toxicological aspects of these analogues are discussed.

In recent years, numerous new psychoactive compounds have appeared on the illicit drugs market. Studies on the metabolism of such new drugs (ND) are an important task in analytical toxicology. In this paper, in vitro approaches employing subcellular fractions such as microsomes (MS) or cytosol (CS) or whole cells such as intact hepatocytes (HC) or genetically modified fission yeast cells (FY) for identification of new drug metabolites (MB) or to study the kinetics of their formation are critically reviewed.

Direct analysis of diluted urine by LC-MS/MS offers an attractive way forward for the development of a rapid routine screen for new psychoactive substances in workplace drug testing.

Historically, the appearance of new psychoactive materials (and hence the requirement for new reference standards) has been relatively slow. This position has now changed, with 101 new psychoactive substances reported to EMCDDA-Europol since 2006. The sudden appearance and sometimes brief lifetime in the market place of many of these novel legal highs or research chemicals present commercial difficulties for reference material producers. These issues are examined through a discussion of the synthesis of cathinones and a brief examination of other mechanisms for sourcing starting materials.

New psychoactive substances pose a particular challenge to those formulating drugs policy and related public health responses. This paper outlines some of the main issues arising from their use, with a particular focus on user perspectives.