Clinical value of analytical testing in patients presenting with New Psychoactive Substances intoxication.

Grafinger, Katharina Elisabeth; Liechti, Matthias E; Liakoni, Evangelia (2020). Clinical value of analytical testing in patients presenting with New Psychoactive Substances intoxication. British journal of clinical pharmacology, 86(3), pp. 429-436. Wiley-Blackwell 10.1111/bcp.14115

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New psychoactive substances (NPS) have emerged worldwide in recent years, posing a threat to public health and a challenge to drug policy. NPS are usually derivatives or analogues of"classical" recreational drugs designed to imitate their effects while circumventing regulations. This article provides an overview of benefits and limitations of analytical screening in managing patients presenting with acute NPS toxicity. NPS typically cannot be analytically identified with the usual immunoassay tests. In order to detect NPS using an immunoassay, antibodies specifically binding to the new structures would have to be developed, which is complicated by the rapid change of the NPS market. Activity-based assays could circumvent this problem since no prior knowledge on the substance structure is necessary. However,"classical" recreational drugs activating the same receptors could lead to false positive results. Liquid or gas chromatography coupled with mass spectrometry is a valuable NPS analysis tool, but its costs (e.g. equipment), run time (results usually within hours vs. minutes in case of immunoasssays) and the need for specialized personnel hinder its use in clinical setting, while factors such as lack of reference standards can pose further limitations. Although supportive measures are sufficient in most cases for adequate patient management, the detection and identification of NPS can contribute significantly to public health and safety in cases of e.g. cluster intoxications and outbreaks, and to the investigation of these novel compounds' properties. However, this requires not only availability of the necessary equipment and personnel, but also collaboration between clinicians, authorities and laboratories.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Pharmacology
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Grafinger, Katharina and Liakoni, Evangelia

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0306-5251

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Christine Baumgartner

Date Deposited:

14 Oct 2019 10:55

Last Modified:

20 Mar 2020 01:31

Publisher DOI:

10.1111/bcp.14115

PubMed ID:

31483059

Uncontrolled Keywords:

New psychoactive substances activity-based assays analytical detection chromatography clinical toxicology immunoassay mass spectometry screening tests

BORIS DOI:

10.7892/boris.133864

URI:

https://boris.unibe.ch/id/eprint/133864

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