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Impact of novel psychoactive substances on clinical and forensic toxicology and global public health

Huestis, MA and Brandt, SD and Rana, S and Auwärter, V and Baumann, MH (2017) Impact of novel psychoactive substances on clinical and forensic toxicology and global public health. Clinical Chemistry. ISSN 0009-9147

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Abstract

Novel psychoactive substances (NPS) have been a part of the landscape of clinical and forensic toxicology for over a century, beginning with the introduction of a few new drugs like heroin, lysergic acid diethylamide (LSD), 3,4-methylenedioxymethamphetamine (MDMA) and gammahydroxybutyric acid (GHB). However, after the appearance of synthetic cannabinoids in the early 2000’s there was a rapid emergence of hundreds of synthetic cathinones, benzodiazepines and opioids. Toxicology laboratories previously focused on a rather narrow range of compounds including amphetamines, cannabinoids, cocaine, opioids, antidepressants, salicylate and acetaminophen. Now potent fentanyl derivatives are mixed with heroin or substituted entirely, killing unsuspecting drug users at an alarming rate. Toxicology laboratories are challenged with detecting potent drug analogs that are only present in blood for a short period of time, urinary metabolites whose chemical formula and structures are initially unknown, and no available reference standards. Here four international experts discuss what fueled the global NPS market, how toxicology laboratories can best address this challenge, and how public health and law enforcement agencies can help reduce the morbidity and mortality associated with NPS.

Item Type: Article
Additional Information: This is the accepted version of the following article: Huestis, M.A et al. Impact of novel psychoactive substances on clinical and forensic toxicology and global public health. Clinical Chemistry. http://dx.doi.org/10.1373/clinchem.2017.274662
Uncontrolled Keywords: 1004 Medical Biotechnology, 1101 Medical Biochemistry And Metabolomics, 1103 Clinical Sciences
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RA Public aspects of medicine > RA1001 Forensic Medicine. Medical jurisprudence. Legal medicine
Divisions: Pharmacy & Biomolecular Sciences
Publisher: American Association for Clinical Chemistry
Date Deposited: 05 May 2017 10:20
Last Modified: 09 Aug 2017 11:02
DOI or Identification number: 10.1373/clinchem.2017.274662
URI: http://researchonline.ljmu.ac.uk/id/eprint/6363

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