Are the NPS commonly used? An extensive investigation in Northern Italy based on hair analysis.

An analysis of 847 hair samples from Italian adults aged 18–40, collected during 2020–2021 for driving relicensing or drug withdrawal monitoring, found that 8.4% tested positive for new psychoactive substances (NPS). Ketamine and its metabolite norketamine were the most common, appearing in 56 and 35 samples respectively. Fentanyl, norfentanyl, 4-ANPP, MDMB-4en-PINACA, N,N-DMT, 5-chloro AB-PINACA, α-PHP, and methcathinone were detected in fewer than six samples each. The low detection rate contrasts with the perceived widespread availability of NPS in Italy but aligns with similar hair analysis studies. The authors plan to expand the study population to include a broader age range and more diverse origins.

Study at a glance

Abstract

New psychoactive substances (NPS) are present on the Italian illicit markets, but data from the analysis of biological samples to evaluate their real consumption are rare. For this reason, an epidemiological study was carried out by means of a ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS-MS) method for the determination of 115 NPS on the keratin matrix. A total of 847 hair samples were collected in 2020 and 2021 and analyzed. The sample donors were in the age range of 18-40 years, from both genders, and were tested either for driving relicensing or for drug withdrawal monitoring. The UPLC-MS-MS system consisted of a Waters ACQUITY UPLC® I-Class, coupled with a Waters XEVO TQ-XS triple quadrupole mass spectrometer. The method was developed and fully validated according to international guidelines. Limits of detection were set as the minimum criterion to identify positive samples. Overall, 56 samples resulted positive for ketamine, 35 for norketamine, 6 for fentanyl, 3 for norfentanyl, 3 for 4-ANPP, 3 for MDMB-4en-PINACA, 2 for N,N-DMT, 2 for 5-chloro AB-PINACA, 1 for α-PHP and 1 for methcathinone. NPS were detected in a small part of samples (8.4%), which seems in contrast with their apparent wide diffusion in Italy, yet it is congruent with similar investigations based on hair analysis. Future studies will be performed to expand the investigated population, especially in terms of age and origin.