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Clinical Aspects Related to Methylphenidate-Based NPS
Published in Ornella Corazza, Andres Roman-Urrestarazu, Handbook of Novel Psychoactive Substances, 2018
Dino Lüthi, Matthias E. Liechti
Methylphenidate-based NPSs are designer drugs with structural and pharmacological similarities to the prescription drug MPH. Methylphenidate itself has a history of being abused, either in recreational settings or as a cognitive enhancer. Information about MPH-based NPSs derives mainly from case reports and early in vitro studies; clinical studies are lacking. The psychoactive effects of MPH and related NPSs are predominantly mediated by potent inhibition of the NET and DAT. The pharmacological profile of MPH-based NPSs and effects that are described by users indicate similarities to cocaine and abuse potential. Nasal insufflation, oral ingestion, and intravenous injection are common routes of administration. Intravenous injection poses an especially severe health risk to users. Symptoms of intoxication are similar to amphetamine-type stimulants and are mild in most cases. The treatment of intoxication is mainly supportive, but benzodiazepines may be prescribed to treat sympathomimetic symptoms. Ethylphenidate was the first MPH-based NPS to appear on the illicit drug market, and it has been associated with several fatalities. Most of the deceased, however, were heavy drug users with combined drug intoxication.
Recent Use of Synthetic Cannabinoids, Synthetic Opioids, and Other Psychoactive Drug Groups among High-risk Drug Users
Published in Journal of Psychoactive Drugs, 2020
Barak Shapira, Ronny Berkovitz, Paola Rosca, Yehuda Neumark
Recent use of PO/TF is associated with a higher propensity for simultaneous polydrug use, including stimulants, gabapentinoids, and heroin, which may indicate a higher severity of SUD among PO/TF users. Conversely, recent use of SCRA was less prevalent, but strongly associated with the use of cannabis and synthetic cathinones. Gabapentinoid use was found to be highly prevalent among PO/TF users. The abuse of gabapentinoids may increase the risk of opioid overdose and combined drug intoxication (Gomes et al. 2017; Sason et al. 2018).