Medicine
January 31, 2018
Evangelia Liakoni, Chris Yates, Alison M. Dines et al.
38 citations
Self-reported substance use by patients arriving at emergency departments with acute recreational drug toxicity matches toxicological analysis best for heroin (86.1% agreement) and cocaine (74.1% agreement). Inhalants, poppers, and magic mushrooms were self-reported but never detected analytically. Immunoassays accurately identified methadone (100% agreement) and cocaine (95.5% agreement) but were less consistent for amphetamines (81.8% agreement). Mass spectrometry confirmed MDMA, amphetamine, methamphetamine, and new psychoactive substances in many cases where immunoassays were negative, and revealed multiple-substance use. Diagnosis of new psychoactive substance use relied primarily on self-report.
Metabolites
July 27, 2020
Andrea E. Steuer, Daria Kaelin, Martina I. Boxler et al.
32 citations
Three psychoactive stimulants—MDMA, amphetamine, and the new psychoactive substance mephedrone—alter blood metabolites in overlapping but distinct ways. Using plasma samples from controlled human administration studies and liquid chromatography-high resolution mass spectrometry, researchers identified changes in metabolites linked to energy metabolism, steroid biosynthesis, and amino acid pathways. Linoleic acid and pregnenolone-sulfate shifted similarly after intake of all three drugs. Mephedrone produced a metabolic profile more like amphetamine than MDMA, particularly in energy metabolism. These findings could guide future targeted studies on pharmacological actions and help identify biomarkers of drug use.
Clinical toxicology (Philadelphia, Pa.)
March 1, 2025
Joep J. J. Ouwerkerk, David M. Wood, Alison M. Dines et al.
1 citation
When 3,4-methylenedioxymetamfetamine (MDMA) is taken with alcohol, emergency department visits show higher odds of agitation, drowsiness, and vomiting compared to MDMA alone. Co-intoxication with other substances increases odds of bradycardia, psychosis, and coma. Mortality rates remain low across all groups. Female patients report less chest pain but more vomiting, headache, and hypotension than males. These variations suggest that physicians should consider both the type of co-intoxication and patient sex to optimize treatment.