Surveillance of emerging drugs of abuse in Hong Kong: validation of an analytical tool

• Published in: Hong Kong medical journal = Xianggang yi xue za zhi Vol. 21; no. 2; p. 114
• Main Authors: Tang, Magdalene H Y, Ching, C K, Tse, M L, Ng, Carol, Lee, Caroline, Chong, Y K, Wong, Watson, Mak, Tony W L
• Format: Journal Article
• Language: English; Chinese
• Published: China Hong Kong Academy of Medicine 01.04.2015
• Subjects: Adolescent; Adult; Aged; Amphetamines; Analgesics, Opioid - analysis; Chromatography; Clinics; Cocaine; Crime prevention; Cross-Sectional Studies; Donations; Drug abuse; Fatalities; Female; Hair; Hair - chemistry; Health Surveys; Heroin; Hong Kong - epidemiology; Humans; Incidence; Ketamine; Male; Methadone; Methamphetamine; Methamphetamine - analogs & derivatives; Methamphetamine - analysis; Middle Aged; Piperazines - analysis; Rehabilitation; Statistical analysis; Street Drugs - analysis; Substance Abuse Detection - methods; Substance-Related Disorders - diagnosis; Substance-Related Disorders - epidemiology; Tandem Mass Spectrometry - methods; Toxicology; Urine; Urine - chemistry; Young Adult; Hong Kong; Hong Kong China; China; Hong Kong; Designer drugs
• ISSN: 1024-2708; 2226-8707
• DOI: 10.12809/hkmj144398

To validate a locally developed chromatography-based method to monitor emerging drugs of abuse whilst performing regular drug testing in abusers. Cross-sectional study. Eleven regional hospitals, seven social service units, and a tertiary level clinical toxicology laboratory in Hong Kong. A total of 972 drug abusers and high-risk individuals were recruited from acute, rehabilitation, and high-risk settings between 1 November 2011 and 31 July 2013. A subset of the participants was of South Asian ethnicity. In total, 2000 urine or hair specimens were collected. Proof of concept that surveillance of emerging drugs of abuse can be performed whilst conducting routine drug of abuse testing in patients. The method was successfully applied to 2000 samples with three emerging drugs of abuse detected in five samples: PMMA (paramethoxymethamphetamine), TFMPP [1-(3-trifluoromethylphenyl)piperazine], and methcathinone. The method also detected conventional drugs of abuse, with codeine, methadone, heroin, methamphetamine, and ketamine being the most frequently detected drugs. Other findings included the observation that South Asians had significantly higher rates of using opiates such as heroin, methadone, and codeine; and that ketamine and cocaine had significantly higher detection rates in acute subjects compared with the rehabilitation population. This locally developed analytical method is a valid tool for simultaneous surveillance of emerging drugs of abuse and routine drug monitoring of patients at minimal additional cost and effort. Continued, proactive surveillance and early identification of emerging drugs will facilitate prompt clinical, social, and legislative management.