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Wastewater-based Epidemiology to Track Down the Actual Use of New Psychoactive Substances : Challenges and Recommendations

机译:基于废水的流行病学以追踪新型精神活性物质的实际使用:挑战和建议

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Background New Psychoactive Substances (NPS) are substances that mimic psychoactive effects of illicit drugs like cocaine, cannabis and amphetamine and are produced to evade national and international drug control legislations by introducing slight modifications to chemical structures of controlled substances. NPS are easily acquired legally through online vendors and smart shops where they are sold under false labels with misleading information about their effects and safety. They are considered a growing problem in many communities and are responsible for numerous fatal intoxications. Detection of NPS is a challenge due to their rapid appearance in and out of the drug scene and due to the constantly increasing amount of new substances that appears on the drug market. Objectives In order to perform an evidence-based risk assessement of NPS, it is necessary to gather detaled information on the types and amounts of NPS that are used in the general population. Wastewater-based epidemiology, which analyses wastewater samples for the presence of biomarkers of NPS, is a promising approach to gain knowledge on the actual use of NPS. However, there exist several challenges that hampers the routine application of wastewater-based epidemiology for detection of NPS use: 1) Very little scientific information on the metabolic fate of NPS is available. Therefore, it is not always clear which biomarker (parent compound or metabolite) needs to be targeted in wastewater-based epidemiology studies. 2) If the use of NPS is limited to only a few individuals within a community, concentrations of the biomarker in wastewater will be too low to detect with the existing analytical methods. This presentation gives an overview on the work that has been carried out so far regarding the detection of the actual use of NPS in the general population based on wastewater analysis, discusses the challenges and issues that still exist in this research field, and will provide some recommendations for future research directions.
机译:背景技术新的精神活性物质(NPS)是模仿可卡因,大麻和苯丙胺等非法药物的精神活性的物质,其生产是通过对受控物质的化学结构稍加修改来规避国家和国际药物管制法规。 NPS很容易通过在线供应商和智能商店合法地获得,在这些商店中,它们以虚假标签出售,带有关于其影响和安全的误导性信息。在许多社区中,它们被认为是一个日益严重的问题,并导致许多致命的陶醉。 NPS的检测是一项挑战,这是由于NPS在药物现场内外快速出现以及在药物市场上不断增加的新物质数量。目的为了进行基于证据的NPS风险评估,有必要收集有关一般人群中NPS的类型和数量的详细信息。基于废水的流行病学分析废水样本中是否存在NPS的生物标志物,是一种获得有关NPS实际使用知识的有前途的方法。但是,存在一些挑战,阻碍了基于废水的流行病学在检测NPS使用中的常规应用:1)关于NPS代谢命运的科学信息很少。因此,在基于废水的流行病学研究中并不总是需要确定针对哪些生物标志物(母体化合物或代谢产物)。 2)如果NPS仅限社区中的少数几个人使用,则废水中生物标志物的浓度将太低而无法使用现有的分析方法进行检测。本演讲概述了迄今为止在基于废水分析的普通人群中检测NPS实际使用方面已经开展的工作,讨论了该研究领域中仍然存在的挑战和问题,并将提供一些建议。有关未来研究方向的建议。

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