A liquid chromatography-tandem mass spectrometry (LC-MS-MS) method was developed to screen and confirm mescaline in human urine, with a detection limit of 3-5 micrograms per liter and an upper quantification limit of 10,000 micrograms per liter. The method proved sensitive and specific for routine testing. Among 462 urine samples from young people with alcohol or drug problems, 32% were positive for illicit drugs, but none for mescaline.
Diphenidine and methoxphenidine (MXP) are new dissociative recreational drugs sold online. In a Swedish case series of 750 suspected new psychoactive substance (NPS) intoxications over 12 months in 2014, 17 patients tested positive for diphenidine (14 cases) or MXP (3 cases). Most patients were men (76%), aged 20–48 (median 32). Common symptoms included hypertension (76%), anxiety (65%), and altered mental status (65%) such as confusion, dissociation, or hallucinations. Eight patients (47%) had severe intoxication. Polysubstance use occurred in 87% of cases. The adverse effects resembled those of ketamine and methoxetamine, though co-use of other drugs may have contributed.