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McQuade D.,Guys and St Thomas NHS Foundation Trust | Hudson S.,HFL Sport Science | Dargan P.I.,Guys and St Thomas NHS Foundation Trust and Kings Health Partners | Dargan P.I.,Kings College London | And 2 more authors.
European Journal of Clinical Pharmacology | Year: 2013

Purpose: There is increasing reported use of synthetic cannabinoid receptor agonists (SCRA) across Europe. To date, there is limited information on the acute toxicity (harm) related to the use of these products. We describe here a case in which an individual developed convulsions related to the use of the SCRA AM-2201. Case report: A 20 year old male smoked a "Spice" (SCRA-containing) product called "Black Mamba," and rapidly after smoking, he had a generalised self-terminating tonic-clonic convulsion. After a 2 h observation period in the Emergency Department (ED), he self-discharged against medical advice. Subsequent analysis of urine collected at the time of presentation to the ED detected metabolites of AM-2201; no other drugs were detected on extensive analytic screening. Discussion: This is the first case of convulsions related to the use of SCRA described in Europe, and the first case of convulsions related to the use the SCRA AM-2201 confirmed by analysis of biological samples. It is important for emergency physicians, clinical toxicologists and clinical pharmacologists managing those presenting with acute toxicity related to the use of SCRA to analytically confirm the exact compound(s) involved, to enable accurate description of the acute toxicity associated with individual SCRA. © 2012 Springer-Verlag. Source

Chan W.L.,Guys and St Thomas NHS Foundation Trust and Kings Health Partners | Wood D.M.,Guys and St Thomas NHS Foundation Trust and Kings Health Partners | Wood D.M.,Kings College London | Hudson S.,HFL Sport Science | And 2 more authors.
Journal of Medical Toxicology | Year: 2013

Introduction: There is evidence from around Europe of the availability and use of 6-(2-aminopropyl)benzofuran (6-APB) as a recreational drug. However, there is currently limited information on the acute toxicity of this compound. We describe here a case of acute toxicity associated with recreational use of legal high (6-APB) and cannabis, in which the comprehensive toxicological analysis confirmed the presence of a significant amount of 6-APB together with metabolites of both tetrahydrocannabinol and the synthetic cannabinoid receptor agonist (JWH-122). Case Report: A 21-year-old gentleman with no previous medical and psychiatric history was brought to the emergency department (ED) after he had developed agitation and paranoid behaviour following the use of 6-APB purchased over the Internet. There was no obvious medical cause for his acute psychosis. He required diazepam to control his agitation and was subsequently transferred to a psychiatric hospital for ongoing management of his psychosis. Toxicological screening of a urine sample collected after presentation to the ED detected 6-APB, with an estimated urinary concentration of 2,000 ng/ml; other drugs were also detected, but at lower concentrations including metabolites of the synthetic cannabinoid receptor agonist JWH-122 and tetrahydrocannabinol. Conclusion: This is the first case of analytically confirmed acute toxicity associated with the detection of 6-APB which will provide some information on acute toxicity of this drug to help clinicians with the management of such patients and legislative authorities in their consideration for the need of its control. © 2013 American College of Medical Toxicology. Source

Schep L.J.,University of Otago | Slaughter R.J.,University of Otago | Hudson S.,HFL Sport Science | Place R.,Southland Hospital | Watts M.,Southland Hospital
Human and Experimental Toxicology | Year: 2015

Synthetic cannabinoid use has become widespread, leading to increased burdens on health care providers. Symptoms range from agitation and psychosis to seizures and acute kidney injury. We report a case where a patient was assessed and treated twice within 12 h for seizures following synthetic cannabinoid intoxication. Blood sample determinations showed low concentrations of analogues not previously reported, some of which are legal. Clinicians should be aware that synthetic cannabinoids may cause an array of severe health consequences. Given the ever evolving structure of available analogues, clinicians must also be prepared for other unexpected adverse effects. © The Author(s) 2014. Source

Archer J.R.H.,Guys and St Thomas NHS Foundation Trust and Kings Health Partners | Hudson S.,HFL Sport Science | Wood D.M.,Guys and St Thomas NHS Foundation Trust and Kings Health Partners | Dargan P.I.,Guys and St Thomas NHS Foundation Trust and Kings Health Partners
Current Drug Abuse Reviews | Year: 2013

Current data on the epidemiology of recreational drug use is largely based on population and self-population surveys of drug use. In addition, increasingly, particularly for novel psychoactive substances, data collected from web monitoring systems is used to collect information on early trends in the use of NPS and the drugs available to users. All of these indicators rely on users self-report of the drug(s) that they are using, or more accurately the drugs that they perceive they are using. Numerous recent studies have demonstrated significant variation in the content of both classical recreational drugs and novel psychoactive substances. The technique of waste-water analysis has allowed estimation of population level use of a number of established recreational drugs such as cocaine and MDMA. However this technique is limited for novel psychoactive substances because of limitations in the knowledge of the stability and metabolism of these compounds. Our group has developed a technique that involves the collection and analysis of pooled-urine from standalone portable urinals and demonstrated that this technique can be used to detect the use of both classical, established recreational drugs and novel psychoactive substances. We discuss this technique in this paper and the ways in which this can be further developed to allow detection of use of new NPS and trends in use of these substances over time and across geographical regions. © 2013 Bentham Science Publishers. Source

Teale P.,HFL Sport Science | Houghton E.,HFL Sport Science
Bioanalysis | Year: 2010

The fight against doping in sport using analytical chemistry is a mature area with a history of approximately 100 years in horseracing. In common with human sport, anabolic/androgenic steroids (AASs) are an important group of potential doping agents. Particular issues with their detection are extensive metabolism including both phase I and phase II. A number of the common AASs are also endogenous to the equine. A further issue is the large number of synthetic steroids produced as pharmaceutical products or as 'designer' drugs intended to avoid detection or for the human supplement market. An understanding of the metabolism of AASs is vital to the development of effective detection methods for equine sport. The aim of this paper is to review current knowledge of the metabolism of appropriate steroids, the current approaches to their detection in equine sport and future trends that may affect equine dope testing. © 2010 Future Science Ltd. Source

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