Collisions and traffic violations of alcohol, cannabis and cocaine abuse clients before and after treatment

Prior research has shown that those with alcohol problems have significantly elevated rates of traffic events (i.e. traffic violations and collisions) than licensed drivers from the general population and that treatment is associated with reductions in alcohol-related collisions. However, very little research exists on traffic events and the impact of treatment for cannabis or cocaine clients. The objectives of this research are: (1) to determine whether clients in treatment for a primary problem of alcohol, cannabis or cocaine have significantly elevated rates of traffic events than a matched control group of licensed drivers; and (2) to assess whether a significant reduction in traffic events occurs after treatment for each client group compared to a control group. Driver records of patients admitted to substance abuse treatment in 1994 for a primary problem of alcohol (n = 117), cannabis (n = 80) or cocaine (n = 169) were accessed from the Ministry of Transportation for Ontario, Canada. A comparison group of 504 licensed drivers frequency matched by age, sex and place of residence, was also randomly selected. Data was collapsed into two 6-year time periods: 1988-1993 (i.e. before treatment) and 1995-2000 (i.e. after treatment). Six repeated measures analysis of variance tests were conducted where traffic violations and collisions of three treatment groups (i.e. alcohol, cannabis or cocaine) and a control group were compared before and after treatment. All three treatment groups had significantly more traffic violations than the control group and no significant interactions between time period and group membership were found. For collisions, there was a significant interaction between the alcohol and control groups and between the cocaine and control groups. The average number of collisions for the alcohol and cocaine groups decreased after completing treatment, whereas the number for the control group was stable over the same time periods. Neither the interaction term nor the between group effect was significant in the comparison of the cannabis and control groups. When rates of collisions were calculated based on the period that each driver had a valid license, the interaction term was still significant for the comparison of the alcohol and control groups but not for the cocaine and control groups. The results contribute to existing literature by demonstrating that cocaine and cannabis clients have a higher risk of traffic violations than matched controls and that reductions in collision risk was found after treatment for the alcohol and cocaine groups. More research is needed to better understand the reasons for the higher risk of traffic events and to determine reasons for declines.     

Occurrence of cocaine in the air of the World’s cities: An emerging problem? A new tool to investigate the social incidence of drugs?

The occurrence of illicit substances in the air was investigated in various world locations and ambient conditions. The analytical procedure optimized for cocaine, methadone and cocaethylene, based upon soxhlet extraction with organic solvent, clean-up through column chromatography, gas chromatographic separation and mass spectrometric detection, allowed the detection of the three compounds at levels as low as ~ 1 pg m^− 3 in air samples of ~ 500 m³. Apart from Algiers, Algeria, and Pan?evo, Serbia, cocaine was found in all cities investigated and its concentration ranged from picograms to nanograms/cubic meter (e.g., Rome, Italy, 22 ÷ 97 pg m^− 3; Santiago, Chile, 2.2 ÷ 3.3 ng m^− 3). By contrast, the concentrations of methadone and cocaethylene in the air were always lower than the limit-of-detection allowed by the method. The procedure adopted was unsuitable for measuring cannabinoids and allowed only the identification of cannabinol. It was also poor in limit-of-detection with regards to heroin (35 pg m^− 3), however this compound could be identified in airborne particulates in Oporto, Portugal. Atmospheric concentrations of cocaine appeared to correlate to drug prevalence in the Italian regions investigated.     

Synthesis of stereoisomers of 6β- and 7β-(benzylthio)-3-(p-tolyl) tropane-2-carboxylic acid methyl ester

To develop new ^99mTc-labelled agents to evaluate dopamine transporters (DAT) involved in Parkinson's disease, by in vivo SPECT imaging, we have synthesized six new sulfur-containing ligands with the tropane skeleton. We have introduced the complexing sulfur atom far from the three sites of recognition by DAT of these tropane derivatives. The 6β-substituted tropinone has been obtained by a double Mannich condensation followed by the introduction of the moieties for molecular interactions at the binding site on C2 and C3, leading to the six stereoisomers.     

Spatial and temporal variations in the occurrence of cocaine and benzoylecgonine in waste- and surface water from Belgium and removal during wastewater treatment

Estimates of cocaine consumption are currently resulting from population surveys, consumer interviews and crime statistics. A new approach (“sewage epidemiology”) based on the analysis of cocaine (COC) and its metabolite, benzoylecgonine (BE), in water samples was applied to 10 river sites and 30 wastewater treatment plants (WWTPs) in Belgium. Each river site was sampled twice, during the summer of 2007 and the winter of 2007-2008, while each WWTP was sampled on a Sunday and a Wednesday, during the summer-autumn of 2007 and the winter of 2007-2008. This sampling strategy allowed for the evaluation of spatial and seasonal variations in the occurrence of COC and BE in waste- and surface water. WWTP Brussel-Noord was sampled for 19 consecutive days to evaluate daily and weekly variations in the presence of COC and BE in wastewater. For 7 WWTPs, influent and effluent water samples were collected to investigate the removal of COC and BE during the wastewater treatment process. Analysis of water samples was performed using solid-phase extraction and liquid chromatography coupled to tandem mass spectrometry. Measured concentrations were further converted into an amount of used cocaine, called cocaine equivalents, as previously described in the literature. Results showed no significant difference in cocaine use between the investigated seasons. A constant cocaine consumption was observed during the week (Monday-Friday) with peaks during the weekend for WWTP Brussel-Noord. The COC/BE ratio in water samples was significantly higher during winter, most probably due to a slower hydrolysis of cocaine in low-temperature water. COC and BE were removed in the investigated WWTPs with a removal efficiency of >93%.     

Alcohol- or drug-use disorders and motor vehicle accident mortality: A retrospective cohort study

A large body of research has linked alcohol consumption and motor vehicle accidents (MVAs), but far fewer studies have estimated the risk of MVA fatality among drug users. Our study addresses this gap. We identified cohorts of individuals hospitalized in California from 1990 to 2005 with ICD-9 diagnoses of methamphetamine- (n = 74,170), alcohol- (n = 592,406), opioids- (n = 68,066), cannabis- (n = 47,048), cocaine- (n = 48,949), or polydrug-related disorders (n = 411,175), and these groups were followed for up to 16 years. Age-, sex-, and race-adjusted standardized mortality rates (SMRs) for deaths due to MVAs were generated in relation to the California general population. Standardized MVA mortality ratios were elevated across all drug cohorts: alcohol (4.5, 95% CI, 4.1–4.9), cocaine (3.8, 95% CI, 2.3–5.3), opioids (2.8, 95% CI, 2.1–3.5), methamphetamine (2.6, 95% CI, 2–3.1), cannabis (2.3, 95% CI, 1.5–3.2) and polydrug (2.6, 95% CI, 2.4–2.9). Males and females had similar MVA SMRs. Our large, population-based study found elevated risk of MVA mortality across all cohorts of individuals with alcohol- or drug-use disorders. Given that illicit drug users are often unaware of or misperceive the impacts of drug use on safe driving, it may be important for health-service or public-health interventions to address such biases and improve road safety.     

液液萃取-气相色谱法测定尿液中的可卡因

目的:建立人体尿液中可卡因的快速提取及气相色谱-氢火焰离子化(GC-FID)检测方法。方法:用0.05 mol/L碳酸钠-碳酸氢钠缓冲溶液调节尿液pH9.5,提取溶剂:氯仿∶异丙醇=9∶1(体积比),液-液萃取10 min,气相色谱分析。结果:方法的平均回收率为84%,检出限50ng/mL,线性范围0.1～15μg/mL,精密度小于5.47%。结论:该方法可快速、准确进行可卡因滥用者的尿液分析。     

The rate ratio of injury and aggressive incident for alcohol alone,cocaine alone and simultaneous use before the event: A case–crossover study

Objectives

(i) To estimate the rate ratio (RR) of use of alcohol alone, cocaine alone, and both substances simultaneously on acute injury or an aggressive incident, (ii) to compare the RRs for simultaneous use within 3 or 6 h of the event; and (iii) to compare the RRs of two measures of exposure, “hours of feeling effects” vs estimates based on self-reported quantity and frequency of use.

Methods

The study employed a case–crossover design with the frequency approach. Clients (N = 616) in substance abuse treatment for alcohol or cocaine issues from 2009 to 2012 completed a self-administered questionnaire on their substance use within 3 and 6 h before a recent injury or physically aggressive incident. Clients also reported detailed quantity and frequency information in relation to their typical substance use, as well as information on “feeling effects”. The RR of acute harms due to substance use was estimated using the Mantel–Haenszel estimator.

Results

In the 6-h window before the event, use of cocaine alone, alcohol alone and simultaneous alcohol and cocaine use were each significantly (P < 0.05) related to a recent injury and aggressive incident. Simultaneous use was not significantly greater than use of either drug alone. Estimates of RR based on simultaneous use for a 3-h window before the event were consistently larger than those based on a 6-h window, and comparisons were significant (P < 0.05) for an aggressive incident but not an injury. With reference to the two measures of exposure, three of eight comparisons of RRs were significantly larger for feeling the effects of the substance in comparison to quantity and frequency of substance use.

Conclusion

These findings are consistent with increased likelihood of harms related to the acute effects of alcohol alone, cocaine alone or simultaneous use. The results are suggestive that the acute effects of these drugs may be better measured within a 3-h time window than a 6-h window. Finally, we found that “hours of feeling effects” yielded higher estimates of RR than the quantity–frequency approach; however both measures support the overall findings.     

Identification of cocaine and its metabolites in urban wastewater and comparison with the human excretion profile in urine

The most relevant human urinary metabolites of cocaine (nine metabolites) were measured in urban wastewater in Italy and USA. A novel analytical method based on liquid chromatography tandem mass spectrometry allowed the identification of ecgonine, ecgonine methyl ester and the pyrolytic derivatives of cocaine in untreated wastewater. The aim of this study was to verify whether the pattern of cocaine metabolites in wastewater reflected the human excretion profile in urine. The performance of the method was good, with recoveries higher than 60% and limits of quantifications in the low ng/L range. The stability in untreated wastewater was assessed for all metabolites and the best storage condition resulted freezing samples immediately after collection and keep them frozen until analysis. All the selected compounds were measured in wastewater at concentrations up to 1.5 μg/L and their weekly loads were calculated during a five weeks monitoring campaign in Milan (Italy). The profiles of cocaine metabolites in wastewater matched with those in human urine reported in the literature, suggesting that measures in wastewater reflect the real human excretion and that wastewater analysis is suitable for assessing drug consumption. Benzoylecgonine was confirmed as the best target for estimating cocaine use by wastewater analysis, while cocaine itself should not be considered because its amount in wastewater is affected by other environmental sources such as transport, handling and consumption. Results suggested that the measurement of other metabolites in combination with benzoylecgonine might reflect 60% of an administered dose of cocaine providing also information on different patterns of use.     

土豆泥中痕量可卡因的表面解吸常压化学电离质谱直接检测

采用纳升取样表而解吸常压化学电离质谱法(nanoSDAPCI-MS),无需任何样品预处理,直接对肯德幕生产的糊状土豆泥样品进行快速质谱检测.实验结果表明.nanoSDAPCI可以承受粘稠土豆泥样品中的大量基体,直接检测土豆泥中痕量的可卡因等成分.本方法操作简单,取样品量少,对含有复杂基体的粘稠样品的直接质谱检测具有借鉴意义.     

Assessment of total uncertainty in cocaine and benzoylecgonine wastewater load measurements

To check the effectiveness of campaigns preventing drug abuse or indicating local effects of efforts against drug trafficking, it is beneficial to know consumed amounts of substances in a high spatial and temporal resolution. The analysis of drugs of abuse in wastewater (WW) has the potential to provide this information. In this study, the reliability of WW drug consumption estimates is assessed and a novel method presented to calculate the total uncertainty in observed WW cocaine (COC) and benzoylecgonine (BE) loads. Specifically, uncertainties resulting from discharge measurements, chemical analysis and the applied sampling scheme were addressed and three approaches presented. These consist of (i) a generic model-based procedure to investigate the influence of the sampling scheme on the uncertainty of observed or expected drug loads, (ii) a comparative analysis of two analytical methods (high performance liquid chromatography-tandem mass spectrometry and gas chromatography-mass spectrometry), including an extended cross-validation by influent profiling over several days, and (iii) monitoring COC and BE concentrations in WW of the largest Swiss sewage treatment plants. In addition, the COC and BE loads observed in the sewage treatment plant of the city of Berne were used to back-calculate the COC consumption. The estimated mean daily consumed amount was 107 ± 21 g of pure COC, corresponding to 321 g of street-grade COC.