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Al-Asmari AI. A critical review of workplace drug testing methods for old and new psychoactive substances: Gaps, advances, and perspectives. Saudi Pharm J 2024; 32:102065. [PMID: 38645754 PMCID: PMC11031841 DOI: 10.1016/j.jsps.2024.102065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024] Open
Abstract
Workplace drug testing (WDT) is essential to prevent drug abuse disorders among the workforce because it can impair work performance and safety. However, WDT is limited by many challenges, such as urine adulteration, specimen selection, and new psychoactive substances (NPS). This review examined the issues related to WDT. Various scientific databases were searched for articles on WDT for drug detection published between 1986 (when WDT started) and January 2024. The review discussed the history, importance, and challenges of WDT, such as time of specimen collection/testing, specimen adulteration, interference in drug testing, and detection of NPS. It evaluated the best methods to detect NPS in forensic laboratories. Moreover, it compared different techniques that can enhance WDT, such as immunoassays, targeted mass spectrometry, and nontargeted mass spectrometry. These techniques can be used to screen for known and unknown drugs and metabolites in biological samples. This review assessed the strengths and weaknesses of such techniques, such as their validation, identification, library search, and reference standards. Furthermore, this review contrasted the benefits and drawbacks of different specimens for WDT and discussed studies that have applied these techniques for WDT. WDT remains the best approach for preventing drug abuse in the workplace, despite the challenges posed by NPS and limitations of the screening methods. Nontargeted techniques using high-resolution liquid chromatography-mass spectrometry (MS)/gas chromatography-tandem MS can improve the detection and identification of drugs during WDT and provide useful information regarding the prevalence, trends, and toxicity of both traditional and NPS drugs. Finally, this review suggested that WDT can be improved by using a combination of techniques, multiple specimens, and online library searches in case of new NPS as well as by updating the methods and databases to include new NPS and metabolites as they emerge. To the best of the author's knowledge, this is the first review to address NPS as an issue in WDT and its application and propose the best methods to detect these substances in the workplace environment.
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Affiliation(s)
- Ahmed Ibrahim Al-Asmari
- Special Toxicological Analysis Section, Pathology and Laboratory Medicine Department, King Faisal Special Hospital and Research Center, P.O. Box 3354, Riyadh 11211, Saudi Arabia
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2
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Calvetti C, Salomone A, Verzeletti A, Di Nardo F, Begni PMG, Vezzoli S. Are the NPS commonly used? An extensive investigation in Northern Italy based on hair analysis. J Anal Toxicol 2023; 47:574-579. [PMID: 37506041 DOI: 10.1093/jat/bkad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/07/2023] [Accepted: 07/26/2023] [Indexed: 07/30/2023] Open
Abstract
New psychoactive substances (NPS) are present on the Italian illicit markets, but data from the analysis of biological samples to evaluate their real consumption are rare. For this reason, an epidemiological study was carried out by means of a ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS-MS) method for the determination of 115 NPS on the keratin matrix. A total of 847 hair samples were collected in 2020 and 2021 and analyzed. The sample donors were in the age range of 18-40 years, from both genders, and were tested either for driving relicensing or for drug withdrawal monitoring. The UPLC-MS-MS system consisted of a Waters ACQUITY UPLC® I-Class, coupled with a Waters XEVO TQ-XS triple quadrupole mass spectrometer. The method was developed and fully validated according to international guidelines. Limits of detection were set as the minimum criterion to identify positive samples. Overall, 56 samples resulted positive for ketamine, 35 for norketamine, 6 for fentanyl, 3 for norfentanyl, 3 for 4-ANPP, 3 for MDMB-4en-PINACA, 2 for N,N-DMT, 2 for 5-chloro AB-PINACA, 1 for α-PHP and 1 for methcathinone. NPS were detected in a small part of samples (8.4%), which seems in contrast with their apparent wide diffusion in Italy, yet it is congruent with similar investigations based on hair analysis. Future studies will be performed to expand the investigated population, especially in terms of age and origin.
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Affiliation(s)
- Cristina Calvetti
- Institute of Legal Medicine, University of Brescia, Piazzale Spedali Civili, 1, Brescia 25123, Italy
| | - Alberto Salomone
- Department of Chemistry, University of Turin, via P. Giuria 5, Torino 10125, Italy
| | - Andrea Verzeletti
- Institute of Legal Medicine, University of Brescia, Piazzale Spedali Civili, 1, Brescia 25123, Italy
| | - Fabio Di Nardo
- Department of Chemistry, University of Turin, via P. Giuria 5, Torino 10125, Italy
| | - Paola Maria Giulia Begni
- Institute of Legal Medicine, University of Brescia, Piazzale Spedali Civili, 1, Brescia 25123, Italy
| | - Sara Vezzoli
- Institute of Legal Medicine, University of Brescia, Piazzale Spedali Civili, 1, Brescia 25123, Italy
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Vincenti F, Montesano C, Pirau S, Gregori A, Di Rosa F, Curini R, Sergi M. Simultaneous Quantification of 25 Fentanyl Derivatives and Metabolites in Oral Fluid by Means of Microextraction on Packed Sorbent and LC-HRMS/MS Analysis. Molecules 2021; 26:molecules26195870. [PMID: 34641416 PMCID: PMC8512571 DOI: 10.3390/molecules26195870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
Fentanyl and fentalogs’ intake as drugs of abuse is experiencing a great increase in recent years. For this reason, there are more and more cases in which it is important to recognize and quantify these molecules and related metabolites in biological matrices. Oral fluid (OF) is often used to find out if a subject has recently used a psychoactive substance and if, therefore, the person is still under the effect of psychotropics. Given its difficulty in handling, good sample preparation and the development of instrumental methods for analysis are essential. In this work, an analytical method is proposed for the simultaneous determination of 25 analytes, including fentanyl, several derivatives and metabolites. OF was collected by means of passive drool; sample pretreatment was developed in order to be fast, simple and possibly semi-automated by exploiting microextraction on packed sorbent (MEPS). The analysis was performed by means of LC–HRMS/MS obtaining good identification and quantification of all the analytes in less than 10 min. The proposed method was fully validated according to the Scientific Working Group for Forensic Toxicology (SWGTOX) international guidelines. Good results were obtained in terms of recoveries, matrix effect and sensitivity, showing that this method could represent a useful tool in forensic toxicology. The presented method was successfully applied to the analysis of proficiency test samples.
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Affiliation(s)
- Flaminia Vincenti
- Department of Chemistry, Sapienza University of Rome, 00185 Rome, Italy; (F.V.); (S.P.); (R.C.)
- Department of Public Health and Infectious Disease, Sapienza University of Rome, 00185 Rome, Italy
| | - Camilla Montesano
- Department of Chemistry, Sapienza University of Rome, 00185 Rome, Italy; (F.V.); (S.P.); (R.C.)
- Correspondence: (C.M.); (M.S.); Tel.: +39-064-9913-559 (C.M.); +39-086-1266-949 (M.S.)
| | - Svetlana Pirau
- Department of Chemistry, Sapienza University of Rome, 00185 Rome, Italy; (F.V.); (S.P.); (R.C.)
| | - Adolfo Gregori
- Department of Scientific Investigation (RIS), Carabinieri, 00191 Rome, Italy; (A.G.); (F.D.R.)
| | - Fabiana Di Rosa
- Department of Scientific Investigation (RIS), Carabinieri, 00191 Rome, Italy; (A.G.); (F.D.R.)
| | - Roberta Curini
- Department of Chemistry, Sapienza University of Rome, 00185 Rome, Italy; (F.V.); (S.P.); (R.C.)
| | - Manuel Sergi
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, 64100 Teramo, Italy
- Correspondence: (C.M.); (M.S.); Tel.: +39-064-9913-559 (C.M.); +39-086-1266-949 (M.S.)
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Amante E, Alladio E, Rizzo R, Di Corcia D, Negri P, Visintin L, Guglielmotto M, Tamagno E, Vincenti M, Salomone A. Untargeted Metabolomics in Forensic Toxicology: A New Approach for the Detection of Fentanyl Intake in Urine Samples. Molecules 2021; 26:4990. [PMID: 34443578 PMCID: PMC8398448 DOI: 10.3390/molecules26164990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/29/2022] Open
Abstract
The misuse of fentanyl, and novel synthetic opioids (NSO) in general, has become a public health emergency, especially in the United States. The detection of NSO is often challenged by the limited diagnostic time frame allowed by urine sampling and the wide range of chemically modified analogues, continuously introduced to the recreational drug market. In this study, an untargeted metabolomics approach was developed to obtain a comprehensive "fingerprint" of any anomalous and specific metabolic pattern potentially related to fentanyl exposure. In recent years, in vitro models of drug metabolism have emerged as important tools to overcome the limited access to positive urine samples and uncertainties related to the substances actually taken, the possible combined drug intake, and the ingested dose. In this study, an in vivo experiment was designed by incubating HepG2 cell lines with either fentanyl or common drugs of abuse, creating a cohort of 96 samples. These samples, together with 81 urine samples including negative controls and positive samples obtained from recent users of either fentanyl or "traditional" drugs, were subjected to untargeted analysis using both UHPLC reverse phase and HILIC chromatography combined with QTOF mass spectrometry. Data independent acquisition was performed by SWATH in order to obtain a comprehensive profile of the urinary metabolome. After extensive processing, the resulting datasets were initially subjected to unsupervised exploration by principal component analysis (PCA), yielding clear separation of the fentanyl positive samples with respect to both controls and samples positive to other drugs. The urine datasets were then systematically investigated by supervised classification models based on soft independent modeling by class analogy (SIMCA) algorithms, with the end goal of identifying fentanyl users. A final single-class SIMCA model based on an RP dataset and five PCs yielded 96% sensitivity and 74% specificity. The distinguishable metabolic patterns produced by fentanyl in comparison to other opioids opens up new perspectives in the interpretation of the biological activity of fentanyl.
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Affiliation(s)
- Eleonora Amante
- Dipartimento di Chimica, Università di Torino, 10125 Torino, Italy; (E.A.); (E.A.); (R.R.); (L.V.); (A.S.)
| | - Eugenio Alladio
- Dipartimento di Chimica, Università di Torino, 10125 Torino, Italy; (E.A.); (E.A.); (R.R.); (L.V.); (A.S.)
- Centro Regionale Antidoping e di Tossicologia, 10043 Orbassano, Italy;
| | - Rebecca Rizzo
- Dipartimento di Chimica, Università di Torino, 10125 Torino, Italy; (E.A.); (E.A.); (R.R.); (L.V.); (A.S.)
| | - Daniele Di Corcia
- Centro Regionale Antidoping e di Tossicologia, 10043 Orbassano, Italy;
| | | | - Lia Visintin
- Dipartimento di Chimica, Università di Torino, 10125 Torino, Italy; (E.A.); (E.A.); (R.R.); (L.V.); (A.S.)
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, B-9000 Ghent, Belgium
| | - Michela Guglielmotto
- Dipartimento di Neuroscienze Rita Levi Montalcini, Università di Torino, 10126 Torino, Italy; (M.G.); (E.T.)
- Neuroscience Institute Cavalieri-Ottolenghi (NICO), 10043 Orbassano, Italy
| | - Elena Tamagno
- Dipartimento di Neuroscienze Rita Levi Montalcini, Università di Torino, 10126 Torino, Italy; (M.G.); (E.T.)
- Neuroscience Institute Cavalieri-Ottolenghi (NICO), 10043 Orbassano, Italy
| | - Marco Vincenti
- Dipartimento di Chimica, Università di Torino, 10125 Torino, Italy; (E.A.); (E.A.); (R.R.); (L.V.); (A.S.)
- Centro Regionale Antidoping e di Tossicologia, 10043 Orbassano, Italy;
| | - Alberto Salomone
- Dipartimento di Chimica, Università di Torino, 10125 Torino, Italy; (E.A.); (E.A.); (R.R.); (L.V.); (A.S.)
- Centro Regionale Antidoping e di Tossicologia, 10043 Orbassano, Italy;
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5
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Vincenti F, Gregori A, Flammini M, Di Rosa F, Salomone A. Seizures of New Psychoactive Substances on the Italian territory during the COVID-19 pandemic. Forensic Sci Int 2021; 326:110904. [PMID: 34371393 PMCID: PMC8411784 DOI: 10.1016/j.forsciint.2021.110904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 12/23/2022]
Abstract
In recent years, the availability and the consequent consumption of New Psychoactive Substances (NPS) have proliferated at an unprecedented rate, posing a significant risk to the public health and challenging the law enforcement efforts to tackle the black market. In particular, large availability on Internet and unmonitored shipping have facilitated the diffusion of NPS on national territories. In this scenario, the forensic activity based on the process of drug detection, including investigation, seizure, recognition and analytical identification is crucial to get insights into the drug black market transformation. In this study, we describe the results obtained from the analysis of hundreds of packages seized during the months of year 2020, and suspected to contain NPS because not reacting with standard field test kits. We focused on the analysis by GC-MS and HPLC-HRMS, and NPS in particular, trying to underline the most common molecules present on the Italian territory during the COVID-19 pandemic. NPS were identified in 92.6% of the samples. The most prevalent compounds were synthetic cathinones, and 3-MMC in particular, which alone accounted for 18.6% of the total cases. Other prevalent molecules were 5F-MDMB-PICA, 2-FDCK, 1cp-LSD and 1P-LSD. Fentanyl was never detected. The information obtained from drug seizures is crucial to publish national alerts, which are in turn important to assist the legislative effort to ban new compounds and the update of toxicological and analytical methods.
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Affiliation(s)
- Flaminia Vincenti
- Sapienza University of Rome, Department of Chemistry, 00185 Rome, Italy; Sapienza University of Rome, Department of Public Health and Infectious Diseases, 00185 Rome, Italy
| | - Adolfo Gregori
- Carabinieri, Department of Scientific Investigation (RIS), 00191 Rome, Italy
| | - Martina Flammini
- Dipartimento di Chimica, Università di Torino, 10125 Torino, Italy
| | - Fabiana Di Rosa
- Carabinieri, Department of Scientific Investigation (RIS), 00191 Rome, Italy
| | - Alberto Salomone
- Dipartimento di Chimica, Università di Torino, 10125 Torino, Italy; Centro Regionale Antidoping e di Tossicologia, 10043 Orbassano (TO), Italy.
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Salomone A, Palamar JJ. Toxicosurveillance of novel opioids: just screening tests may not be enough. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:271-272. [PMID: 34010587 DOI: 10.1080/00952990.2021.1917588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- A Salomone
- Dipartimento di Chimica, Università di Torino, Torino, Italy
| | - J J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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7
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Salomone A, Di Corcia D, Negri P, Kolia M, Amante E, Gerace E, Vincenti M. Targeted and untargeted detection of fentanyl analogues and their metabolites in hair by means of UHPLC-QTOF-HRMS. Anal Bioanal Chem 2020; 413:225-233. [PMID: 33063167 PMCID: PMC7801321 DOI: 10.1007/s00216-020-02994-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/25/2020] [Accepted: 10/06/2020] [Indexed: 12/25/2022]
Abstract
Detection of new psychoactive substances and synthetic opioids is generally performed by means of targeted methods in mass spectrometry, as they generally provide adequate sensitivity and specificity. Unfortunately, new and unexpected compounds are continuously introduced in the illegal market of abused drugs, preventing timely updating of the analytical procedures. Moreover, the investigation of biological matrices is influenced by metabolism and excretion, in turn affecting the chance of past intake detectability. In this scenario, new opportunities are offered by both the non-targeted approaches allowed by modern UHPLC-HRMS instrumentation and the investigation of hair as the matrix of choice to detect long-term exposure to toxicologically relevant substances. In this study, we present a comprehensive and validated workflow that combines the use of UHPLC-QTOF-HRMS instrumentation with a simple hair sample extraction procedure for the detection of a variety of fentanyl analogues and metabolites. A simultaneous targeted and untargeted analysis was applied to 100 real samples taken from opiates users. MS and MS/MS data were collected for each sample. Data acquisition included a TOF-MS high-resolution scan combined with TOF-MS/MS acquisition demonstrating considerable capability to detect expected and unexpected substances even at low concentration levels. The predominant diffusion of fentanyl was confirmed by its detection in 68 hair samples. Other prevalent analogues were furanylfentanyl (28 positive samples) and acetylfentanyl (14 positive samples). Carfentanil, methylfentanyl, and ocfentanil were not found in any of the analyzed samples. Furthermore, the retrospective data analysis based on untargeted acquisition allowed the identification of two fentanyl analogues, namely β-hydroxyfentanyl and methoxyacetylfentanyl, which were not originally included in the panel of targeted analytes.
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Affiliation(s)
- Alberto Salomone
- Centro Regionale Antidoping e di Tossicologia, Regione Gonzole 10/1, 10043, Orbassano, TO, Italy. .,Department of Chemistry, University of Turin, Via Pietro Giuria 5, 10125, Torino, Italy.
| | - Daniele Di Corcia
- Centro Regionale Antidoping e di Tossicologia, Regione Gonzole 10/1, 10043, Orbassano, TO, Italy
| | | | - Maria Kolia
- Department of Chemistry, University of Ioannina, Ioannina Campus, 1186, Ioannina, 45500, Greece
| | - Eleonora Amante
- Department of Chemistry, University of Turin, Via Pietro Giuria 5, 10125, Torino, Italy
| | - Enrico Gerace
- Centro Regionale Antidoping e di Tossicologia, Regione Gonzole 10/1, 10043, Orbassano, TO, Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia, Regione Gonzole 10/1, 10043, Orbassano, TO, Italy.,Department of Chemistry, University of Turin, Via Pietro Giuria 5, 10125, Torino, Italy
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De-Giorgio F, Bilel S, Tirri M, Arfè R, Trapella C, Camuto C, Foti F, Frisoni P, Neri M, Botrè F, Marti M. Methiopropamine and its acute behavioral effects in mice: is there a gray zone in new psychoactive substances users? Int J Legal Med 2020; 134:1695-1711. [DOI: 10.1007/s00414-020-02302-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 04/14/2020] [Indexed: 12/18/2022]
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Abuse of Licit and Illicit Psychoactive Substances in the Workplace: Medical, Toxicological, and Forensic Aspects. J Clin Med 2020; 9:jcm9030770. [PMID: 32178358 PMCID: PMC7141377 DOI: 10.3390/jcm9030770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/01/2020] [Accepted: 03/10/2020] [Indexed: 01/23/2023] Open
Abstract
About one-third of adult life is spent in the workplace. The use of psychoactive substances is a major preventable cause of morbidity and mortality. The consumption of psychoactive substances during or outside working hours greatly increases the frequency and severity of labor accidents, as well as the workers’ poor general state of health and productivity, implying higher costs for enterprises. It is the responsibility of organizations to ensure the safety and health of their workers. These cannot be limited to traditional routine clinical exams, as other aspects also have an impact on health. Thus, prevention and intervention in the consumption of psychoactive substances (e.g., ethanol, opioids, central nervous system stimulants or depressants, hallucinogens, Cannabis derivatives, dissociative substances, and inhalants) in labor activity should be considered as an investment of organizations and not as a cost, in view of the professional, personal, and family advantages for workers and employers, with a potential impact on productivity, security, health, and quality of life at work. Despite the extensive literature on the subject, each article generally focuses on one or another aspect of a very specific nature, not tackling the problem in a holistic way by confronting clinical, safety, and legal issues. This article presents a reflection on the legal, laboratorial, clinical, ethical, forensic, and safety concerns related to the consumption of psychoactive substances in the workplace, and can be a cross-cutting contribution to occupational medicine, forensic medicine, and insurance medicine, as well as for entrepreneurs, lawyers, judges, workers, and technicians from the public and private sectors that develop projects in this area. This discussion is based on general principles established internationally and highlights the role of the occupational healthcare system and other decision-making actors in the prevention and supervision of workplace psychoactive consumption.
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