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‘In and Out of the Hole’
Published in Ornella Corazza, Andres Roman-Urrestarazu, Handbook of Novel Psychoactive Substances, 2018
The heterogeneous panorama of novel psychoactive substances includes various classes of compounds, among which phencyclidine derivatives stand out because of their peculiar mechanism of action involving NMDA, AMPA, and opioid receptors, among others. Their diverse features from traditional stimulants or hallucinogenic substances allow dose-dependent effects, ranging from analgesia and anaesthesia to dissociation, NDE, and OBE-like experiences. Furthermore, one of the main PCP derivatives, ketamine, has shown clinical relevance in various medical settings, and it is currently viewed as a promising resource in new therapeutic applications. A further effort in research is needed to define reliable guidelines to limit known toxic effects as shown in chronic users for recreational purposes. The development of knowledge on NMDA-based therapeutics could lead also to a significant boost in strategies of harm reduction for users. Meanwhile, a great variety of PCP-type substances and PCP derivatives have been released in drug markets, each one differing from the others in terms of chemical structure and toxicology profile. Online and traditional drug markets have been invaded by such products since the early years of this decade, when several EU members reported the appearance of MXE and 3-methoxyeticyclidine (3-MeO-PCE) to the European Early Warning System (UNODC, 2014). The recent ban on such compounds in the United Kingdom was followed by the marketing of new dissociative drugs with almost unexplored pharmacological properties, such as ephenidine and diphenidine. Although similar to ketamine in terms of effects experienced by users, MXE and other novel dissociative substances may pose a threat to users’ health. As for other psychoactive substances which have also drawn significant interest as therapeutics, an effort is needed by researchers and policy makers to better understand the mechanism of action of these compounds and define both their adverse effects and their potential in clinical settings.
Prevalence of Stimulant, Hallucinogen, and Dissociative Substances Detected in Biological Samples of NPS-Intoxicated Patients in Italy
Published in Journal of Psychoactive Drugs, 2021
Pietro Papa, Antonella Valli, Marcello Di Tuccio, Eleonora Buscaglia, Elena Brambilla, Giulia Scaravaggi, Mariapina Gallo, Carlo Alessandro Locatelli
Eleven different dissociative substances (Table 4) were identified in 115 patients (7.9% of total cases, 46.7% of positives). The 73% of users were male and the age of the patients ranged from 14 to 62 years (mean = 24.6). Intoxication by the illegal use of ketamine was diagnosed in 105 patients throughout the considered period. Forty-one times ketamine was the only detected NPS, while in 7 cases methoxetamine, an analogue of ketamine, was present. During the period 2012–2014 methoxetamine was identified in 13 other cases. Methoxyphencyclidine (MeO-PCP) and ethylketamine, analogues of ketamine, were detected in 2 cases, one positive for both substances, the other for MeO-PCP and methoxetamine. From 2013, diphenidine (2 cases) and methoxyphenidine (2 cases) appeared in our casuistry. Indeed, data literature (Wallach et al. 2016) report the presence of these substances as chemical research has been available on the internet since 2013 as a legal replacement for the ketamine analogues banned in some European countries. In 2019, 2 cases of phencyclidine and fluoroketamine, respectively, were observed. With regard to the association with different NPS, ketamine was associate with cathinones, atropine, PMMA, and DOC. The designer benzodiazepine flubromazepam was identified in an intoxication involving methoxphenidine (Valli et al. 2017). GHB was involved in an intoxication case with ketamine. Conventional drugs of abuse were detected in 53 of the ketamine-positive cases (50.1%), distributed as follow: 25.5% phytocannabinoids, 17.3% cocaine, 11.2% amphetamines, and 18.4% ecstasy.
Underreporting of drug use among electronic dance music party attendees
Published in Clinical Toxicology, 2021
Joseph J. Palamar, Alberto Salomone, Katherine M. Keyes
Specimens were tested via published methods using ultra-high performance liquid chromatography–tandem mass spectrometry [41–43]. We tested for common drugs including cannabis (THC), amphetamine, methamphetamine, cocaine, MDMA, ketamine, PCP, heroin (6-MAM), and prescription opioids including morphine, codeine, oxycodone, hydrocodone, hydromorphine, and oxymorphone. We also tested for a variety of uncommon drugs and NPS including 19 synthetic cathinones (i.e. mephedrone, 4-MEC, methylone, 3,4-MDPV, pentedrone, 3-MMC, ethylcathinone, alpha-PVP, butylone, buphedrone, mexedrone, amfepramone, pentylone, methedrone, ethylone, naphyrone, 4-F-methylcathinone, 3,4-DMMC, alpha-PHiP) and 7 psychedelic phenethylamines (i.e. 2 C-B, 2 C-P, 25B-NBOMe, 25 C-NBOMe, 25H-NBOMe, 25I-NBOMe, 4-EA-NBOMe). We also tested for 5 other euphoric stimulants (i.e. 4-FA, 5/6-APB, 5-MAPB, PMA, PMMA) and 3 dissociative NPS (i.e. MXE, 4-MeO-PCP, diphenidine). In addition, we tested for fentanyl, 8 fentanyl analogs (i.e. carfentanyl, acetylfentanyl, furanylfentanyl, butyrfentanyl, acryloylfentanil, 4-fluorofentanyl, 3-methylfentanyl, ocfentanyl), and for 5 other opioid NPS (i.e. U-47,700, U-49900, AH-7921, MT-45, U-51,754).
Drugs of abuse and ocular effects
Published in Clinical and Experimental Optometry, 2021
Valérie Proulx, Benoit Tousignant
Another group of new psychoactive substances includes the derivatives of ketamine and phencyclidine, which include 3-methoxyphencyclidine (3-MeO-PCP), 4-methoxy-phencyclidine (4-MeO-PCP), methoxphenidine (MXP) or 2-MeO-diphenidine (1-1(2-methoxyphenyl)-2-phenylethylpiperidine), N-ethyl ketamine derivative 2-(3-methoxyphenyl)-2(ethylamine)cyclo-hexanone.170 Occasionally reported ocular effects include pupillary disturbances, mydriasis, anisocoria, sluggish or absent pupillary responses and nystagmus.110,111,168,170