Chiron / nal von minden - London NPS 2018

Meeting Programme

The two day symposium aims to bring together experts working in different fields, but with a common interest; tackling drug problems.

Main themes:

Fentanyls | Synthetic Cannabinoids | Designer Benzodiazepines | Drugs in Prisons | Drug Policy | Drug Consumption Rooms | Vaping | Drug Testing | Metabolism | HCV prevalence and much more...

Who should attend:

Those working in or going through rehabilitation, those with special interest in harm minimisation, primary care workers, law enforcement, drug policy makers, scientists and researchers.


  Download the meeting programme in .pdf


Meeting Schedule

Day 1 - 29 Nov 2018

0900 – 0950 Registration and Refreshments
0950 – 1000 Thomas Zander,
CEO – nal von minden
Welcome Address
1000 - 1030 Dr. Claude Guillou,
Senior expert - European Commission - Directorate General Joint Research Centre
Collaboration of the Joint Research Centre and the European Customs laboratories for Identification of New Psychoactive Substances
read abstract
1030 - 1100 Rudi Fortson Q.C.,
Independent practicing Barrister & Visiting Professor of Law at Queen Mary, University of London
A Tale of Two Pities: Nox and Drug Consumption Rooms
read abstract

A Tale of Two Pities: Nox and Drug Consumption Rooms

Rudi Fortson Q.C.

It was foreseen that psycho-activity under the Psychoactive Substances Act 2016 would be problematic - and so it has proved to be. In this talk we will hear the reasons why.

Many agencies in the UK are discussing medically supervised drug consumption facilities, but the UK Government has thus far rejected calls for them to be even piloted there. Is it time for the Government to heed the call?

1100 - 1130 Dr. Jochen Gartz,
Chemist in the field of organic, pharmaceutical and natural chemistry -MITZ, Merseburg
Psychedelic mushrooms and hallucinogenic substances
read abstract

Psychedelic mushrooms and hallucinogenic substances

Over 60 years ago, the new alkaloids psilocybin and psilocin were isolated from six mushroom species of the genus Psilocybe. Since 1983, the author had the good fortune to be part of a research team that studied these alkaloids in species of the genera Psilocybe, Panaeolus, Inocybe, Pluteus, Conocybe, Gymnopilus and Galerina. In these investigations, the new alkaloid Aeruginascin was discovered and its chemotaxonomical value is important in the world of higher mushrooms. Additionally, 3 new Psilocybe species were found and determinate in South Africa, in the U.S.A. and Germany since 1994.

1130 - 1200 Refreshment Break
1200 - 1230 Dr. Paolo Deluca,
Reader in Addiction Research - National Addiction Centre, King’s College London
The Dynamic Environment of Crypto Markets: The Lifespan of New Psychoactive Substances (NPS) and Vendors Selling NPS
read abstract
1230 - 1300 Dr. Daan van der Gouwe,
Sociologist & drugs researcher - Trimbos Institute, Dept Drug Monitoring & Policy
Purity, adulteration and price of drugs bought on-line versus off-line in the Netherlands
read abstract
1300 - 1400 Lunch Break
1400 - 1430 Prof. Fiona Measham,
Professor of Criminology – Durham University / Director – The Loop
Multi Agency Safety Testing (MAST) - From music festivals to city centres
1430 - 1500 Associate Prof. Henrik Green,
Research Strategist - National Board of Forensic Medicine & Linköping University
Prevalence of NPS and clusters of deaths in Sweden
1500 - 1530 Refreshment Break
1530 - 1600 Prof. Christoph Stove,
Toxicologist - Ghent University
Activity-Based Detection of Consumption of Synthetic Cannabinoids
read abstract
1600 - 1630 Dr. Robert Ralphs,
Criminologist - Manchester Metropolitan University
Harm reduction or a catalyst for new harms: The consequences of substance use legislation on substance use and markets in an English prison
read abstract

Harm reduction or a catalyst for new harms: The consequences of substance use legislation on substance use and markets in an English prison

Paul Gray1, Rob Ralphs2 and Lisa Williams3

1,2 Manchester Metropolitan University, UK
3 University of Manchester, UK

Introduction
Building on the work of Ralphs et al. (2017), this paper presents the findings from a research project that investigated the impact of two significant pieces of legislation - the Psychoactive Substances Act introduced in May 2016 and the smoking ban that was introduced in prisons in September 2017 - on substance use and markets in an English prison. The paper moves beyond the focus on New Psychoactive Substances (NPS) addressed by Ralphs et al. (2017), to incorporate traditional illicit substances, diverted medications and tobacco. In addition to identifying new and emerging substance use trends, the research also explored the consequences of these trends for prison inmates, prison staff, and the prison regime.

Methods
The research adopted a qualitative approach. During March 2018, a total of 21 semi-structured interviews were undertaken with eight prisoners (four of whom were peer mentors) and 13 prison staff.

Results
The study found evidence of a marked change in both substance use and markets since our previous research in this prison in 2015. The legislative changes have led to increases in the availability and use of other drugs, such as cannabis and Subutex. Furthermore, the price of tobacco has escalated to up to as much as £500 for a 30g packet. In terms of the impact of recent substance use legislation on prison drug markets, the main impact has been the shift from synthetic cannabinoid receptor agonists (SCRAs) arriving on inert plant matter to SCRAs entering the prison sprayed or soaked on to paper; something interviewees attributed directly to the smoking ban. While SCRAs are still been used at similar prevalence levels, they are now being consumed in different ways, from being smoked in makeshift pipes and bongs to being consumed in vape pens. Discussion We argue that legislation aimed at reducing the consumption of substances in prison has resulted in transformations in both substance use and markets, thereby continuing to facilitate drug use in prisons. Furthermore, the ways in which SCRAs are consumed has changed in direct response to the implementation of the smoking ban in prisons. Consequently, prisoners are consuming them in ways that are contrary to clinical advice and considered to be more harmful to users. The continued investment by the British government on detecting and preventing substance use in prisons would be better spent on providing prisoners with more meaningful activities to reduce the boredom they experience which is a primary motivation for substance use in this context.

1630-1700 Dr. David Wood,
Consultant Physician and Clinical Toxicologist - Guy’s and St Thomas’ NHS Foundation Trust
A cloud on the horizon-a survey into the use of electronic vaping devices for recreational drug and NPS administration
read abstract
1700 Day 1 Close – Depart for the Alchemist
1800 Seated for dinner

Day 2 - 30 Nov 2018

Morning Session

Parallel Session 1: nal von minden

0900 – 0930 Registration and Refreshments
0930 - 1000 Dr. Anna Tarjan,
Scientific analyst (sociologist) - Hungarian Reitox National Focal Point to the EMCDDA
HCV prevalence and risk behaviours among injectors of new psychoactive substances in a risk environment in Hungary-An expanding public health burden
read abstract
1000 - 1030 Tim Murphy,
Manager - Community Drug and Alcohol Support Trust CLG
New Psychoactive Substances: The Irish Experience
read abstract

New Psychoactive Substances: The Irish Experience

In 2010 the Irish Government introduced the Psychoactive Substances Act which effectively closed the headshops. The apparent success of this act led other governments, including the UK, enacting similar legislation. However almost a decade later a growing body of international research suggests that Ireland has one of the highest levels of NPS use across the EU, creating a range of challenges for treatment, support and law enforcement services, particularly across the border region. So what went wrong?

Short bio: Tim Murphy manages drug and alcohol support services across counties Cavan and Monaghan (Republic of Ireland). He has worked within the addiction treatment services for fifteen years, both in the UK and ROI. He is a graduate in psychology and has a master’s degree in Drug and Alcohol Policy from Trinity College Dublin. He has advised the Irish Government on the growing issue of NPS.

1030 - 1100 Dr. Amira Guirguis,
Senior Lecturer in Pharmaceutical Chemistry - University of Hertfordshire
The development of an Early Warning System for the in-field detection of psychoactive substances
read abstract

The development of an Early Warning System for the in-field detection of psychoactive substances

A. Guirguis, R. Gittins, J. Calvo-Castro, E. Samaras, M. Zloh, F. Schifano, S.B. Kirton and J.L. Stair

Introduction:
New Psychoactive Substances (NPS) pose a burden on health services and numerous challenges that hinder their detection. In the UK, recently emerging NPS have shown a significant increase in emergency visits and inadvertent overdoses. Enhanced identification of NPS may be employed as an early warning system to accelerate alerts to stakeholders and save lives. The aim of this work is to explore the use of NPS by individuals in treatment for substance misuse and showcase our research on enhancing the in-field detection of NPS.

Methods: Individuals in treatment for substance misuse were purposely selected based on pre-designed and approved inclusion criteria. Semi-structured interviews were carried out and data was analysed using a thematic analysis. Raman spectroscopy coupled with chemometric and in-silico models were explored for their ability to enhance the detection of NPS.

Results: A thematic analysis of interview transcripts identified a variety of substance use histories; 50% of participants were prescribed opiate substitutes and 25% used NPS as a primary substance. All predominantly smoked synthetic cannabinoid receptor agonists and snorted/injected stimulant NPS. NPS are not detected in routine tests undertaken in drug misuse services and lack of detection is a significant factor encouraging NPS use by these individuals. Handheld Raman spectroscopy coupled with both chemometric and in-silico models were explored and have shown promise for enhancing the detection of a wide range of NPS. Chemometric models underpinned by in-Silico studies were undertaken. A set of representative NPS was selected and added to known cutting and adulterants, and together formed the “calibration” sample set. A Principal Component Analysis (PCA) model was generated and validated using reference “validation” and unknown “test” NPS. The model was challenged by NPS internet products with variable purity using both projection PCA and Soft-Independent-Modelling-of-Class-Analogy (SIMCA) and then transferred on a handheld system to test its transferability in the field. The model successfully identified the NPS content in the presence of adulterants and discriminated between NPS products based on their purity profile. SIMCA promoted a pattern recognition system to confirm the proximity of the “test” to the “calibration” set. Owing to the complexity of some mixtures, the model has shown some limitations with respect to samples, which produced limited or no Raman signal. Conclusions: NPS use and associated experiences vary widely among people receiving substance use treatment. Development of effective recovery pathways should be tailored to individuals. The proposed method showed the potential to accelerate the screening of emerging NPS and act as an early warning system for emerging psychoactive substances.

1100 - 1130 Refreshment Break
1130 - 1200 Dr. Lorna Nisbet,
Senior Lecturer - Anglia Ruskin University
Saliva sampling of volunteers at London nightclubs
1200 - 1215 Dr. Nicola Barabas,
R&D Director – nal von minden
RSS III and RSS Flash for objective POCT interpretation
1215 - 1230 Jenny Button,
Country Manager for UK & Ireland – nal von minden
Expanding the Scope without Stretching the Budget: Detection of New Designer Benzodiazepines with nal von minden Benzodiazepine Drug-Screen® Rapid Tests
read abstract

Expanding the Scope without Stretching the Budget: Detection of New Designer Benzodiazepines with nal von minden Benzodiazepine Drug-Screen® Rapid Tests

Button, Jennifer, nal von minden Ltd, Ticehurst, UK, Johansen, Jon, Chiron AS, Trondheim, Norway, Beer, Dani, nal von minden GmbH, Regensburg, Germany, Zander, Thomas, nal von minden GmbH, Regensburg, Germany

The rapid evolution of New Psychoactive Substances (NPS) poses significant challenges for drug detection. The time frame required for development, regulatory approval and market launch of new rapid tests struggles to keep pace with the emergence and disappearance of new compounds. As a consequence, investments are unlikely to be recouped before trends move on and tests fail to meet the current market need. Furthermore, even if specific and timely tests should become available, it is unlikely that customers’ budgets and testing protocols could easily expand to accommodate them all. Instead we investigated exploiting the cross reactivity of immunoassays as a means of expanding the scope of testing without stretching the customers budget.

Through collaboration with analytical standards manufacturer, Chiron, nal von minden have been able to test the cross reactivity of their current benzodiazepine rapid test against 14 new designer benzodiazepines and metabolites; Clonazolam, Deschloroetizolam, Diclazepam, Etizolam, Flubromazepam, 3OH Flubromazepam, Flunitrazolam, Meclonazepam, Metizolam (Desmethyletizolam), Nifoxipam, Nimetazepam, Nitrazolam, 3OH Phenazepam, Pivoxipam. Each compound was spiked into pooled, blank urine and evaluated on nal von minden Benzodiazepine Drug-Screen® test strips with a 300 ng/mL (Oxazepam) cut off. Results were determined objectively using the nal von minden Rapid Slide Scanner (RSS) II. The concentrations were adjusted to determine the positive and negative thresholds.

Clonazolam, Diclazepam, Flubromazepam, Flunitrazolam, Meclonazepam, Nifoxipam, Nimetazepam, Nitrazolam all gave a positive result at 300 ng/mL, whilst 3OH Flubromazepam and 3OH Phenazepam gave a borderline result. Nimetazepam and Nitrazolam demonstrated the greatest cross reactivity and were still detectable at 25 ng/mL. Metizolam and Etizolam showed no cross reactivity up to 10,000 ng/mL. The results from Deschloroetizolam were inconclusive, delivering borderline results across a wide concentration range.

The results show that the nal von minden BZD Drug-Screen® test is capable of detecting a broad range of both traditional and new designer benzodiazepines. It is important that confirmatory laboratories are aware of the expanded scope of rapid tests, and not be too quick to dismiss results as false positives. Unconfirmed positives in the laboratory should serve as a prompt to critically review the appropriateness of current targeted drug panels and/or libraries.

1230 - 1300 Tobias Scholl,
R&D scientist - ESA - Test GmbH
Chemical colour tests for NPS
1300 - 1400 Lunch Break

Parallel Session 2: Chiron

0900 – 0930 Registration and Refreshments
0930 - 0950 Dr. Huiling Liu,
R&D Manager – Chiron AS
Strategies for offering a large number of NPS CRM: The Eurostars PSYCHOMICS and QUANTUM SPICE Projects
0950 - 1010 Dr. Matthew Connolly,
Senior Research Scientist – Chiron AS
Fentanyls and fentanyls metabolite synthesis as part of the PSYCHOMICS project
1010 - 1030 Dr. Svante Vikingsson,
Toxicologist - National Board of Forensic Medicine
Investigating the metabolism of NPS
1030 - 1100 Dr. Thomas Bergh,
Scientist - Oslo University Hospital
The application of 13C Internal standards in NPS and Toxicology analysis
1100 - 1130 Refreshment Break
1130 -1200 Dr. Petur Dalsgaard,
Senior Researcher - Section of Forensic Chemistry, University of Copenhagen
How to screen for all NPS with LC-HR-MS in forensic samples
1200 - 1230 Prof. Dariusz Zuba,
Forensic toxicologist, Forensic chemist - Institute of Forensic Research, Krakow
The NPS-situation in Poland
1230 - 1250 Dr. Loretta Ford,
Consultant Clinical Scientist, Clinical Biochemistry, City Hospital Birmingham
Analytical evidence to show letters impregnated with NPS are a means of getting drugs to inmates within the UK prison service

Waters

1300 - 1400 Lunch Break

Afternoon Session

1400 - 1430 Simon Hudson,
Technical Director – LGC Standards
Fatberg autopsy – an alternative specimen
read abstract

Fatberg autopsy – an alternative specimen

Hudson, S. Hudson, J

Sport and Specialised Analytical Services, LGC, Cambridge, UK

In September 2017, a congealed mass of fat, wet wipes and nappies was found in a routine inspection of a sewer in the Whitechapel area of London. This so called fatberg was estimated to weight the same as 11 double decker buses (130 tonnes) and stretch the length of two football pitches (250m) and had it not been found it would have caused raw sewage to flood on to the streets of Whitechapel.

In January 2018, LGC were approached by the BBC to assist them in the production of a television documentary based on the analysis of the fatberg and its surrounding environment. The tentatively titled programme, Fatberg Autopsy, is to be shown on Channel 4 in the UK in the spring of 2018.

Initially LGC was asked to quantify the level of the cocaine metabolite benzoylecgonine that had been detected in the sewer wastewater surrounding the fatberg by another collaborating laboratory. This was duly completed and a level of 916ng/L reported.

Subsequent work using high resolution accurate mass (HRAM) LCMS workflows identified a further 65 drug compounds, many with multiple metabolites, with estimated concentrations ranging from 11ng/L to 8967ng/L. A wide range of drug types were detected including prescription drugs, over the counter medicines, diet related compounds, drugs only available from internet purchasing, drugs of abuse and NPS. Of particular interest were the identification of 4-chloro-N-ethylcathinone, as the ‘current’ cathinone of choice in that area of London and the Selective Androgen Receptor Modulator (SARM) Ostarine, which is an unlicensed pharmaceutical that is becoming prevalent as an alternative to anabolic steroids in nutritional supplements.

The poster outlines the analytical approach to the detection of the 65 drugs, presents the complete list of findings and demonstrates the power of the current state of the art mass spectrometry technology in analytical challenges such as this.

1430 - 1500 Dr. Jose Restolho,
Forensic Toxicologist – nal von minden
Fentanyls - A review
1500 - 1530 Dr. Martin Jübner,
Forensic Toxicologist - Institute of Legal Medicine / University Hospital Cologne
Fly high touch the sky? Cases of fatal NPS intake
1530 - 1540 Dr. Jon Eigill Johansen,
Managing Director – Chiron AS
Meeting Close
1540 - 1600 Coffee for the road