Pojavnost in varnost halucinogenov v skupini novih psihoaktivnih snovi v Evropi

Malavašič, Vita (author), Peterlin Mašič, Lucija (mentor)

Nove psihoaktivne snovi ali designer drugs so spojine, ki niso nadzorovane s strani Konvencije o psihotropnih snoveh iz leta 1971. Mednje spadajo tudi novi halucinogeni, kamor štejemo predvsem fenetilamine, triptamine in arilalkilamine. V magistrski nalogi smo obravnavali pojavnost in varnost novih halucinogenov v skupini novih psihoaktivnih snovi v Evropi med letoma 2010 in 2022. Najprej smo naredili pregled novih halucinogenov in njihovih želenih učinkov. Analiza pojavnosti pa je bila narejena s pomočjo podatkov, pridobljenih iz evropskih poročil o drogah, ki jih letno izdaja Evropski center za spremljanje drog in odvisnosti od drog. Ugotovili smo, da je v opazovanem obdobju število vseh novih psihoaktivnih snovi naraščalo do leta 2014. Temu je sledil vsesplošen upad, najverjetneje zaradi poostritve nadzora trga in prodaje. Porast v številu je bil spet opažen šele leta 2020. V skupini novih halucinogenov pa so bili najbolj zastopani fenetilamini. Sledili so jim triptamini, lizergamidi ter druge snovi. Prav tako smo ugotovili, da so novi halucinogeni v primerjavi s preostalimi skupinami novih psihoaktivnih snovi (katinoni, sintetični kanabinodi in benzodiazepini) zastopani v manjšem številu. Varnost novih halucinogenov pa smo analizirali s pomočjo podatkov spletne strani Urada Združenih narodov za droge in kriminal. Toksikološko ovrednotenje novih halucinogenov smo naredili s pomočjo literature, ki opisuje akutne zastrupitve in hujše neželene učinke. Mednje štejemo serotoninski sindrom, ponovna doživetja ali flashbacks in obstojno halucinogeno motnjo zaznavanja. Druga potencialna tveganja uporabe novih halucinogenov so prenos ali okužba s HIV ali hepatitisom C in odtegnitveni sindrom. Prav tako je veliko spojin še neraziskanih, omejeni pa smo tudi pri toksikoloških analizah. Trg novih halucinogenov se konstantno in hitro širi, za kar je potreben ustrezen nadzor. Nekateri novi halucinogeni so razvrščeni v razrede, ki jih definira Konvencija o psihotropnih snoveh iz leta 1971. Od 43 spodaj opisanih spojin jih je 24 že uvrščenih v razred I. To so snovi z velikim potencialom za zlorabo in nimajo prepisane nobene medicinske uporabe. V razred III spada le spojina 2C-B, preostale pa so še vedno dovoljene in do zdaj še niso bile razvrščene. Specifičnega zdravljenja pri zastrupitvah z novejšimi halucinogeni zaenkrat še ne poznamo. Trenutno je glavni temelj simptomatsko zdravljenje. Zdravljenje serotoninskega sindroma pa je odvisno od resnosti simptomov in sega vse od ukinitve zdravila do hospitalizacije, kjer se lahko dodaja kisik, vpelje rehidracija, znižuje povišana telesna temperatura in celo intubira.

• Language: Slovenian
• Keywords: nove psihotropne snovi, novi halucinogeni, serotoninski sindrom, EMCDDA, zastrupitve
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2023
• PID: 20.500.12556/RUL-151954
• Publication date in RUL: 26.10.2023

Secondary language

• Language: English
• Title: Incidence and safety of new hallucinogens in a group of new psychoactive substances in Europe

Abstract

New psychoactive substances, or designer drugs, are compounds that are not controlled under the 1971 Convention on Psychotropic Substances. These include the new hallucinogens, which are mainly phenethylamines, tryptamines and arylalkylamines. In this master thesis, we addressed the incidence and safety of new hallucinogens in the group of new psychoactive substances in Europe between 2010 and 2022. First, we gave an overview of new hallucinogens and their desired effects. The analysis of the incidence was done using data obtained from the European Drug Reports published annually by the European Monitoring Centre for Drugs and Drug Addiction. We found that the number of all new psychoactive substances increased during the period under review until 2014, followed by a generalised decline, most likely due to the tightening of market and sales controls. The increase in numbers was only observed again in 2020. In the group of new hallucinogens, phenethylamines were the most represented. They were followed by tryptamines, lysergamides and other substances. We also found that the new hallucinogens were less represented than the other groups of new psychoactive substances (cathinones, synthetic cannabinoids and benzodiazepines). The safety of the new hallucinogens was analysed using data from the United Nations Office on Drugs and Crime website. Toxicological evaluation of the new hallucinogens was carried out using literature describing acute intoxications and serious side effects. These include serotonin syndrome, flashbacks, and persistent hallucinogenic cognitive impairment. Other potential risks of the use of new hallucinogens are transmission or infection with HIV or hepatitis C and withdrawal syndrome. Also, many compounds are still unexplored and toxicological analyses are limited. The market for new hallucinogens is constantly and rapidly expanding and needs to be properly controlled. Some of the new hallucinogens are classified in classes defined by the 1971 Convention on Psychotropic Substances. Of the 43 compounds described below, 24 are already classified in Class I. These are substances with a high potential for abuse and have no prescribed medical use. Only compound 2C-B is in Class III, the rest are still allowed and have not been classified so far. Specific treatment for poisoning with the newer hallucinogens is not yet known. Currently, symptomatic treatment is the mainstay. However, treatment of serotonin syndrome depends on the severity of the symptoms and ranges from withdrawal to hospitalisation, where oxygen may be added, rehydration introduced, fever lowered and even intubation.

• Keywords: new psychotropic substances, new hallucinogens, serotonin syndrome, EMCDDA, poisonings