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The illegal drug market is constantly evolving, with new drugs being created and existing ones being modified. Adulterants are often added to the mix, and the primary substance may be secretly replaced by a new one. Once-known tablets can now be vastly different from what they are sold as, all due to the pursuit of profit and evasion of current drug regulations. These alterations in drug composition pose a threat to society, as their effects are still not well understood. Therefore, it is crucial for police intelligence and public health development to obtain the chemical profiles of illicit drugs. This study presents the chemical fingerprinting of ecstasy tablets seized in the state of Rio de Janeiro (Brazil) between 2012 and 2021. The tablet samples were weighed, extracted, diluted with methanol, and acidified before analysis using gas chromatography high-resolution mass spectrometry and attenuated total reflection Fourier transform infrared spectroscopy. The major constituents found were MDMA and clobenzorex, with fewer occurrences of MDA, MDEA, and 2C-B. The results also indicate that the occurrence of mega-events in the study location impacted the chemical fingerprints of ecstasy. A total of 27 combinations of cutting agents, including caffeine, ephedrine, and anesthetics, were identified. Samples composed of clobenzorex were observed throughout the evaluated period in areas near highways, suggesting that this product is mainly used by truck drivers. These findings can help police intelligence units anticipate the behavior of the illicit market during major events, identify traffic routes, and support public health initiatives.

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Resumen Introducción: La mortalidad por intoxicaciones agudas de sustancias psicoactivas representa un problema de salud pública, especialmente en personas jóvenes. El objetivo del estudio fue crear un perfil de las víctimas mortales por intoxicación aguda en Costa Rica entre los años 2012 y 2021 asociado al consumo de sustancias psicoactivas y drogas de abuso. Materiales y métodos: Se recopilaron datos de Sección de Patología Forense del Departamento de Medicina Legal en Costa Rica, con los cuales se realizó una revisión de las víctimas mortales por intoxicaciones agudas a partir del 1 de enero de 2012 hasta el 31 de diciembre de 2021. La revisión incluyó las siguientes variables: variables epidemiológicas: sexo, edad, nacionalidad, ocupación, estado civil, provincia, consumo frecuente asociado, manera de muerte, tipo de sustancia y lugar de intoxicación. Resultados: De los 456 casos de muertes asociados a intoxicaciones agudas por etanol, metanol, benzodiacepinas, anfetaminas, heroína, cocaína y mixtas; reportados entre el 1 de enero de 2012 y el 31 de diciembre de 2021: el año que más casos reportó fue 2020; 82% de las víctimas fueron hombres y 18% mujeres; las principales edades de las personas reportadas abarcan entre 41 y 60 años. 80% de las personas eran costarricenses; San José fue la provincia con mayor número de casos de intoxicación letal, siendo el domicilio el sitio más frecuente. 14% de las víctimas eran desempleadas; 77% de las personas presentaban algún trastorno de la adicción o consumo frecuente de alguna de las sustancias estudiadas. La mayoría de muertes fueron de manera accidental. Conclusiones: El perfil predominante de las víctimas fue: masculino, entre 41 y 60 años, costarricense, de estado civil indeterminado o soltero, desempleado, que muere de manera accidental, en su domicilio, por intoxicación aguda con alcohol o mixta (alcohol y cocaína).

Abstract Introduction. Mortality from acute poisoning of psychoactive substances represents a public health problem, especially in young adults. The purpose of the study was to create a profile of fatalities due to acute poisoning in Costa Rica between 2012 and 2021 associated with the consumption of psychoactive substances and drugs of abuse. Materials and methods. Data were collected from the Forensic Pathology Section of the Legal Medicine Department in Costa Rica, then a review of fatalities due to acute poisoning was carried out from January 1, 2012 to December 31, 2021. The review included the following epidemiological variables: sex, age, nationality, occupation, marital status, province, consumption associated, manner of death, type of substance, and place of intoxication. Results. Out of the 456 reported cases of deaths associated with acute intoxication with ethanol, methanol, benzodiazepines, amphetamines, heroin, cocaine, and mixed substances between January 1, 2012, and December 31, 2021: the year with the highest number of cases reported was 2020; 82% of the victims were male, and 18% were female; the main age group of reported victims ranged from 41 to 60 years old. 80% of the victims were Costa Rican, and San Jose was the province with the highest number of lethal intoxication cases, with the home being the most frequent site. 14% of the victims were unemployed, and 77% of the individuals had some addiction disorder or frequent consumption of one of the studied substances. The majority of deaths were accidental. Conclusion. The main profile of the victims was male, between 41 and 60 years old, Costa Rican, of indeterminate or single marital status, unemployed, who died accidentally, at home, due to acute intoxication with alcohol or a mixture of substances (alcohol and cocaine).

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New Psychoactive Substances (NPSs) are defined as a group of substances produced from molecular modifications of traditional drugs. These molecules represent a public health problem since information about their metabolites and toxicity is poorly understood. N-ethyl pentedrone (NEP) is an NPS that was identified in the illicit market for the first time in the mid-2010s, with four intoxication cases later described in the literature. This study aims to evaluate the metabolic stability of NEP as well as to identify its metabolites using three liver microsomes models. To investigate metabolic stability, NEP was incubated with rat (RLM), mouse (MLM) and human (HLM) liver microsomes and its concentration over time evaluated by liquid chromatography-mass spectrometry. For metabolite identification, the same procedure was employed, but the samples were analyzed by liquid chromatography-high resolution mass spectrometry. Different metabolism profiles were observed depending on the model employed and kinetic parameters were determined. The in vitro NEP elimination half-lives (t1/2) were 12.1, 187 and 770 min for the rat, mouse and human models, respectively. Additionally, in vitro intrinsic clearances (Cl int, in vitro) were 229 for rat, 14.8 for mouse, and 3.6 µL/min/mg in the human model, and in vivo intrinsic clearances (Cl int, in vivo) 128, 58.3, and 3.7 mL/min/kg, respectively. The HLM model had the lowest rate of metabolism when compared to RLM and MLM. Also, twelve NEP metabolites were identified from all models, but at different rates of production.

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Psychoactive substances act on the central nervous system producing changes in mental processes, such as perception, consciousness, cognition or mood and emotions. The present study aims to identify: (i) the most used psychoactive substances, (ii) how psychoactive substances are acquired, (iii) and possible reasons for the use of psychoactive substances amongst university students. A literature search was carried out without language restrictions and included articles published between 2019 and 2020 in journals indexed in the electronic databases of Pubmed and Scielo. The inclusion criteria considered were: (i) original articles, (ii) studies carried out with university students, (iii) providing data on the use of psychoactive substances. 15 studies were included in this review, of which: 4 studies addressed possible reasons that lead to use of psychoactive substances, 10 studies reported usage profile and demographic data, and 1 study addressed how students acquire psychoactive substances. Reasons that led to the consumption of psychoactive substances include: feelings of loneliness after moving away from family; difficulty making new friends; poor academic performance and susceptible environment to acquisition of these substances. In the selected studies, alcohol was identified as the main drug used. In light of the findings reported in this review, new prevention and harm reduction measures can be formulated, based mainly on the reasons that lead to the use of psychoactive drugs, consumption patterns and how the drugs were acquired by university students.

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3',4'-Methylenedioxy-N-tert-butylcathinone (MDPT), also known as tBuONE or D-Tertylone, is a synthetic cathinone (SC) frequently abused for recreational purposes due to its potent stimulant effects and similarity to illegal substances like methamphetamine and ecstasy. The structural diversity and rapid introduction of new SC analogs to the market poses significant challenges for law enforcement and analytical methods for preliminary screening of illicit drugs. In this work, we present, for the first time, the electrochemical detection of MDPT using screen-printed electrodes modified with carbon nanofibers (SPE-CNF). MDPT exhibited three electrochemical processes (two oxidations and one reduction) on SPE-CNF. The proposed method for MDPT detection was optimized in 0.2 mol L-1 Britton-Robinson buffer solution at pH 10.0 using differential pulse voltammetry (DPV). The SPE-CNF showed a high stability for electrochemical responses of all redox processes of MDPT using the same or different electrodes, with relative standard deviations less than 4.7% and 1.5% (N = 3) for peak currents and peak potentials, respectively. Moreover, the proposed method provided a wide linear range for MDPT determination (0.90-112 µmol L-1) with low LOD (0.26 µmol L-1). Interference studies for two common adulterants, caffeine and paracetamol, and ten other illicit drugs, including amphetamine-like compounds and different SCs, showed that the proposed sensor is highly selective for the preliminarily identification of MDPT in seized forensic samples. Therefore, SPE-CNF with DPV can be successfully applied as a fast and simple screening method for MDPT identification in forensic analysis, addressing the significant challenges posed by the structural diversity of SCs.

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ABSTRACT BACKGROUND: Medical students demonstrate higher rates of substance use than other university students and the general population. The challenges imposed by the coronavirus disease 2019 (COVID-19) pandemic raised significant concerns about mental health and substance use. OBJECTIVES: Assess the current prevalence of substance use among medical students at the University of São Paulo and evaluate the impact of the COVID-19 pandemic on drug consumption. DESIGN AND SETTING: A cross-sectional study was conducted on 275 medical students from the University of São Paulo Medical School (São Paulo, Brazil) in August 2020. METHODS: Substance use (lifetime, previous 12 months, and frequency of use before and during the COVID-19 pandemic) and socioeconomic data were assessed using an online self-administered questionnaire. Symptoms of depression were assessed using the Patient Health Questionnaire-9. RESULTS: Alcohol was the most consumed substance in their lifetime (95.6%), followed by illicit drugs (61.1%), marijuana (60%), and tobacco (57.5%). The most commonly consumed substances in the previous year were alcohol (82.9%), illicit drugs (44.7%), marijuana (42.5%), and tobacco (36%). Students in the first two academic years consumed fewer substances than those from higher years. There was a decreasing trend in the prevalence of most substances used after the COVID-19 pandemic among sporadic users. However, frequent users maintained their drug use patterns. CONCLUSION: The prevalence of substance use was high in this population and increased from the basic to the clinical cycle. The COVID-19 pandemic may have affected the frequency of drug use and prevalence estimates.

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No início dos anos 2000, as Novas Substâncias Psicoativas (NPS) emergiram de forma sem precedentes causando uma drástica mudança no mercado de drogas sintéticas mundial. Estas substâncias são sintetizadas para fins ilícitos e mimetizam o efeito psicoativo das drogas tradicionais. Até o momento, mais de 1000 substâncias foram reportadas mundialmente, representando um grande problema de saúde pública principalmente associado ao desconhecimento das suas propriedades toxicológicas. Por este motivo, métodos analíticos para detectar e quantificar estas substâncias em materiais biológicos são importantes nos casos de toxicologia analítica e forense. Contudo, a tendência de reduzir o impacto ambiental destas metodologias tem ganhado popularidade com a Toxicologia Analítica Verde (GAT). Portanto, o objetivo do presente trabalho foi desenvolver novas técnicas analíticas para analisar as principais classes de NPS em amostras biológicas enquanto aplicando os princípios sustentáveis estabelecidos pela GAT. Os resultados obtidos no presente trabalho são apresentados como coletânea de artigos científicos publicados em revistas. Estes estão descritos nos capítulos 4 a 8. No capítulo 4, uma revisão sobre os desafios no desenvolvimento de técnicas de preparo de amostra para fins forenses é abordada com foco no uso das matrizes secas. No Capítulo 5, está descrito a aplicação da microextração líquido-líquido dispersiva para catinonas sintéticas em amostras de sangue total e urina. No capítulo 6, o artigo descreve o desenvolvimento da técnica microextração líquido-líquido homogênea com solventes de hidrofilicidade comutável para canabinoides sintéticos em amostras de plasma. No capítulo 7, a microextração em fase líquida em placas de 96 poços, cunhada extração paralela em membranas artificiais líquidas, foi desenvolvida para diferentes classes de drogas de abuso, incluindo NPS. O capítulo 8 mostra o desenvolvimento de uma extração por eletromembrana também no formato de placa de 96 poços para catinonas sintéticas em amostras de sangue total. Em todos os trabalhos, as técnicas de extração foram desenvolvidas, otimizadas e validadas. Os princípios da GAT foram aplicados de diferentes formas, como reduzindo o volume de amostra, simplificando os procedimentos, evitando o uso de solventes orgânicos, dentre outros. Assim, alternativas mais sustentáveis para a análise de drogas de abuso em amostras biológicas foram apresentadas e estas ajudam a consolidar e difundir o conceito do desenvolvimento de métodos analíticos com consciência ambiental além de fornecer ferramentas para auxiliar o controle das NPS no país

In the early 2000s, New Psychoactive Substances (NPS) emerged and unprecedentedly changed the illicit drug market. These substances are synthesized for illicit purposes and mimic the psychoactive effect of traditional drugs of abuse. To date, more than 1000 substances have been reported worldwide, representing a major public health problem mainly associated with their mostly unknown toxicological properties. In this context, analytical methods able to detect and quantitate these new drugs in biological specimens are important in cases of analytical and forensic toxicology. However, reducing the environmental impact of these methodologies has recently gained popularity with Green Analytical Toxicology (GAT). Therefore, the aim of this work was to develop new analytical techniques to analyze the main classes of NPS in biological samples while applying the environmentally friendly principles established by GAT. The results obtained throughout the development of the present work were split into four papers (chapters 4-8). In chapter 4, a review of common challenges faced during the development of new sample preparation techniques for forensic applications is described focusing on the use of dried matrices. In chapter 5, the application of dispersive liquid-liquid microextraction for synthetic cathinones in whole blood and urine samples is described. In chapter 6, the application of the somewhat recent switchable hydrophilicity solvent-based homogenous liquidliquid microextraction to synthetic cannabinoids in plasma samples is reported. In chapter 7, liquid-phase microextraction in the 96-well plate format, termed parallel artificial liquid membrane extraction, for different classes of drugs of abuse, including NPS, in plasma samples is presented. In chapter 8, an electromembrane extraction in the 96-well plate format for synthetic cathinones in whole blood samples was developed. In this work, sample preparation techniques were developed, optimized and validated. The principles of sustainable chemistry in method development were applied in different ways, such as reducing the sample volume, simplifying procedures, avoiding the use of organic solvents, among others. Thus, greener alternatives were presented for the analysis of drugs of abuse in biological samples and contribute to consolidate and spread this trend of environmental consciousness during method development. Additionally, valuable techniques that can be used in the combat against NPS were provided

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The lack of data regarding infant exposure to drugs of abuse consumed by lactating mothers has become a major health concern. Investigating psychoactive substances and their metabolites in breastmilk is an analytical approach to estimate the rate at which drugs of abuse are excreted and how much infants are exposed to them. In this study, we have developed and validated a GC-MS method using disposable pipette tips for simultaneously extracting ten analytes from breastmilk samples obtained from a milk bank in the city of Ribeirão Preto, Brazil. All the 67 analyzed samples tested negative for all the analytes. This is the first study that has applied disposable pipette extraction to analyze drugs of abuse in breastmilk samples.

Breastfeeding, the most effective single strategy to reduce child mortality, provides numerous benefits for both the mother and the infant. The mother's consumption habits during breastfeeding strongly influence breastmilk quality and the newborn's nutrition. Given that drugs of abuse negatively affect both the mother's and the infant's health, analyzing breastmilk samples helps to estimate infant exposure to these drugs and to evaluate how severe this public health issue is. We have developed a new method to monitor ten substances in breastmilk, to improve our understanding of this issue in Brazil. None of the substances were detected in the few samples obtained from a milk bank, which showed that this organization successfully analyzes the donor's profile and conducts effective anamnesis. Future analysis of a larger number of samples and hence more data could help to describe the current scenario in more detail.

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Introducción: el consumo de sustancias psicoactivas (SPA) en escolares es un fenómeno complejo con múltiples efectos negativos. Desde la perspectiva de los determinantes sociales y la promoción de la salud, la institución educativa (IE) es un agente decisivo para acciones participativas. El objetivo fue identificar factores individuales e institucionales asociados con la participación de estudiantes en una IE pública de Cali (Colombia) para prevenir el consumo de SPA. Materiales y métodos: estudio de caso con enfoque mixto. La aproximación cualitativa implicó un análisis documental para explorar la respuesta y factores institucionales de la IE seleccionada como caso crítico; mientras que para identificar los factores individuales relevantes se desarrolló un componente cuantitativo mediante encuesta a 156 estudiantes (secundaria-media) de esa IE. Resultados: los estudiantes identifican como factor relevante para el consumo de SPA la presión de amigos o compañeros; se evidencia que los espacios y procesos de prevención de mayor aporte son la comunicación con pares. También se reconoce como factor institucional el trabajo curricular desde las áreas para fortalecer la toma de decisiones. Conclusión: en la estrategia de escuelas saludables, es crucial la alianza entre el sector educativo y el sector salud, para dinamizar espacios y procesos de participación dirigidos a prevenir el consumo de SPA. Los estudios de análisis del desarrollo de la estrategia de escuelas saludables son requeridos para generar elementos de reflexión dirigidos al ajuste de las acciones de empoderamiento de los estudiantes y que los procesos de participación juvenil logren la continuidad requerida

Introduction: The consumption of psychoactive substances (PAS) among schoolchildren suggests a complex phenomenon with multiple negative effects. From the perspective of social determinants and health promotion, the educational institution (EI) acts as a decisive agent for participatory actions. The present study aimed to identify individuals and institutional factors associated with the participation of students in an IE public of Cali (Colombia) toward the prevention of the consumption of PAS. Materials and methods: This is a case study with a qualitative and quantitative approach. The former involved a documentary analysis for the exploration of the response and the institutional factors of EI, which were selected as a critical case. Meanwhile, to identify the relevant individual factors, a quantitative component was developed through a survey of 156 students (Secondary­Middle School) of that EI. Results: Students identified pressure from friends or classmates as a relevant factor for PAS consumption, indicating that the spaces and prevention processes with the most significant contribution are communication with peers. The curricular work from the areas to strengthen decision-making is also recognized as an institutional factor. Conclusion: Within the healthy schools' strategy, the alliance between the education and health sectors is of crucial relevance for the promotion of the revitalization of spaces and participation processes aimed at preventing the consumption of PAS. The analysis of studies on the development of healthy schools strategy is thus required to generate elements of reflection directed toward the adjustment of the actions facilitating the empowerment of the students and those referring to youth participation to achieve the required continuity.

Introdução: o consumo de substâncias psicoativas (SPA) em estudantes é um fenômeno complexo com múl- tiplos efeitos negativos. Na perspectiva dos determinantes sociais e da promoção da saúde, a instituição de ensino (IE) é um agente decisivo para ações participativas. O objetivo foi identificar fatores individuais e institucionais associados à participação de alunos em uma IE pública de Cali (Colômbia) para prevenir o consumo de SPA. Materiais e métodos: estudo de caso com abordagem mista. A abordagem qualitativa envolveu uma análise documental para explorar a resposta e os fatores institucionais da IE selecionada como caso crítico; enquanto para identificar os fatores individuais relevantes, desenvolveu-se um com- ponente quantitativo através de um questionário a 156 alunos (ensino médio) daquela IE. Resultados: os alunos identificam a pressão de amigos ou colegas como fator relevante para o consumo de SPA; é evidente que os espaços e processos de prevenção com maior contribuição são a comunicação com os pares. O trabalho curricular das áreas para fortalecer a tomada de decisão também é reconhecido como um fator institucional. Conclusão: na estratégia das escolas saudáveis, a aliança entre o setor da educação e o setor da saúde, assume uma relevância crucial para promover a revitalização de espaços e processos participativos direcionados à prevenção do consumo de SPA. Os estudos de análise do desenvolvimento da estratégia de escolas saudáveis são necessários para gerar elementos de reflexão direcionados ao ajuste das ações de empoderamento dos alunos e que os processos de participação juvenil alcancem a necessária continuidade

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Este estudo busca identificar e analisar os estudos que associam a Psicologia Positiva e seus construtos com os transtornos relacionados ao uso de substâncias psicoativas. Foi feita uma revisão integrativa sobre o tema. De 64 resultados encontrados, 13 artigos foram selecionados para descrição e análise. Identificou-se baixa produção científica sobre o tema, ainda que esteja em expansão. Apenas sete estudos tinham como objetivo principal a relação entre a Psicologia Positiva e o uso de substâncias psicoativas, sendo apenas dois experimentais. Evidenciou-se também a concentração de publicações nos EUA e a falta de estudos brasileiros. Os construtos da Psicologia Positiva mais abordados são a felicidade e a espiritualidade, estando associados a um menor uso de substâncias psicoativas. Fica demonstrado o potencial desse campo de estudo para a prevenção e tratamento desses transtornos, sugerindo-se o aumento da produção cientifica. (AU)

This study aims to identify and analyze studies that associate Positive Psychology and its constructs with disorders related to the use of psychoactive substances. Method: An integrative review on the subject was conducted. Of the 64 results found, 13 articles were selected for description and analysis. Results: Although expanding, a low scientific production on the subject was identified. There were only seven studies focused on the relationship between Positive Psychology and the use of psychoactive substances, and only two were experimental. The concentration of publications in the USA and the lack of Brazilian studies were also evident. The most discussed constructs of Positive Psychology are happiness and spirituality, which are associated with a reduced use of psychoactive substances. Conclusions: This field of study has demonstrated potential for the prevention and treatment of these disorders, suggesting an increase in scientific production. (AU)

Este estudio busca identificar y analizar estudios que asocien la Psicología Positiva y sus constructos con trastornos relacionados con el uso de sustancias psicoactivas. Método: Se realizó una revisión integrativa sobre el tema. De 64 resultados encontrados, 13 artículos fueron seleccionados para su descripción y análisis. Resultados: Se identificó una baja producción científica sobre el tema, aunque se encuentra en expansión. Solo siete estudios tuvieron como objetivo principal la relación entre la Psicología Positiva y el uso de sustancias psicoactivas, de los cuales, solo dos fueron experimentales. También fue evidente la concentración de publicaciones en los EE. UU. y la falta de estudios brasileños. Los constructos más discutidos de la Psicología Positiva son la felicidad y la espiritualidad, asociándose a un menor consumo de sustancias psicoactivas. Conclusiones: Se demuestra el potencial de este campo de estudio para la prevención y tratamiento de estos trastornos, sugiriendo un incremento en la producción científica. (AU)

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