Projects / Programmes
New psychoactive substances monitoring system in Slovenia
(acronym SONDA)
| Code |
Science |
Field |
Subfield |
| 3.03.00 |
Medical sciences |
Neurobiology |
|
| Code |
Science |
Field |
| B740 |
Biomedical sciences |
Pharmacological sciences, pharmacognosy, pharmacy, toxicology |
| Code |
Science |
Field |
| 3.01 |
Medical and Health Sciences |
Basic medicine |
new psychoactive substances, phenethylamines, cathinones, piperazines, piperidines, tryptamines, synthetic cannabinoids, poisoning, analysis
Researchers (9)
Organisations (3)
Abstract
During the last 10 years, the number of new psychoactive substances (NPS) has increased almost exponentially to the present situation with more than one new substance being detected and reported every week. Most of these NPS are synthetic. NPS are divided into five major groups: phenethylamines (including cathinones), piperazines, piperidines, tryptamines and synthetic cannabinoids. The consumption of new psychoactive substances (NPS) has been rapidly increasing for over a year in Europe, especially among teenagers and young adults, as NPS cause euphoria, create a sense of energy and relaxation, and stimulate the need to socialize. Poisonings following NPS abuse are unpredictable and may occur even upon consuming the recommended dosage, since NPS are produced in illegal laboratories and their exact chemical composition is not known. The information regarding their toxicity and chronic adverse health effects is still very scarce or even unknown. Therefore, some national projects for monitoring the consumption of NPS and the occurrence of poisonings with NPS are already being carried out in EU. In addition, the European Commission has presented a project called Euro-DEN, wish is to link up all national projects on NPS.
Within the proposed project we are planning to develop a national system for continuous monitoring of NPS poisonings where by collecting biological samples in all suspected cases of acute NPS intoxications and performing qualitative toxicological analyses.
In the first part of the project we are planning to link a 24/7 clinical toxicology consulting service at the Centre for Clinical Toxicology and Pharmacology (CCTP) with the network of all emergency departments and intensive care units in Slovenian hospitals with the aim of gathering biological samples (blood and urine) of all patients poisoned with NPS in one place (the laboratory of CCTP). When emergency department or hospital staff is going to consult with the Centre for Clinical Toxicology and Pharmacology (which serves health care providers) on suspected cases of acute NPS intoxication, they will be asked to collect blood and urine samples as soon as possible after admission for free-of-charge toxicological analysis within the proposed project. In Slovenia, physicians are supposed to take blood and urine samples for toxicological analysis together with other blood samples for laboratory analysis (electrolytes, enzymes) as soon as possible in all cases of acute intoxications, since some toxins could be detected in blood and urine only a short time after exposure. However, in most such cases subsequent toxicological analysis is not needed for the treatment of intoxicated patients and the biological samples are often discharged after a few days without any analysis. As a result of this project, blood and urine samples of all NPS poisoned patients will be sent to CCTP, where they will be stored at - 50C. We are planning to collect only blood samples that would be otherwise be discharged, and the treatment of poisoned patients will not depend on their participation in the project.
Afterwards, we are planning to analyze collected and frozen biological samples using liquid chromatography-mass spectrometry multicomponent methods in the Toxicological laboratory of the Institute for Forensic Medicine. If necessary, we are going to improve or develop detection techniques for new substances.
The advantage of the proposed project is also the collection of medical records along with basic clinical and laboratory biochemical parameters at discharge. This will enable us to link clinical presentation and treatment to the identified NPS by liquid chromatography-mass spectrometry.
In the second part of the project we are planning to organize the training of physicians and registered nurses about clinical presentation, diagnostic and treatment of NPS poisoning using results of the first part of the proposed project. In addition we are going to prepare some publications and
Significance for science
We believe that the presented project will bring many benefits for the profession regarding treatments of poisoned patients by NPS. Project will also allow better performance in the field of prevention concerning illicit NPS in Slovenia.
With the data collected during the project, it will be possible to achieve faster and more reliable diagnostic of poisonings by NPS and the optimization and rationalization of the treatment protocols for poisonings by NPS. At the same time we would also publish clinical guidelines for the treatment of complications associated with the use of NPS. With this project, the Centre for Clinical Toxicology and Pharmacology and the Institute of Forensic Medicine will strengthen the leading position in the field of clinical and forensic toxicology in Slovenia, with the possibility of laboratory certification and treatment of poisonings by NPS, as well as offering continuous consultation and help to other professionals in the country. During the project, the Institute of Forensic Medicine will introduce new laboratory methods and improve methods that are already developed. IFM will also gain additional experience in NPS analysis, so we will be able to present the advantages and benefits of routine laboratory proofing of NPS to the relevant authorities of the Ministry of Health and the Health Insurance Institute of Slovenia, who will consequently be able to implement them in routine treatment of patients poisoned with NPS.
With the publication of the results of the project in foreign professional and scientific journals as well as during conferences-lectures at international meetings of the project, the Centre for Clinical Toxicology and Pharmacology and the Institute of Forensic Medicine will become better established in the international arena and thereby also allow for the international recognition of the participating researchers in the field of NPS.
The data gathered regarding NPS will also be used in the already running "Early Warning System of the Emergence of New NPS", which is a part of the European project "Early Warning System (EWS)" in the context of the organization of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).
Significance for the country
We believe that this research will bring many benefits in the treatment of future poisoned patients with NPS. At the same time it will also contribute to better preventive action in the field of drug prevention, because it is impossible to a fight battle against drug consumption, if we do not really know which drugs young people in Slovenia are actually consuming.
The improvement of the recognition and treatment of poisonings by NPS would reduce the incidence of complications and prolonged hospital stays, as well as reduce the cost of subsequent treatment and rehabilitation of poisoned patients.
All gathered knowledge about the poisonings with NPS will contribute to a more rational treatment and thus to a reduction of the costs related to treatment of poisoning by NPS. A decision of physicians regarding medical treatment would become even simpler and more objective. What is more, by reducing poisonings by NPS also the number of sick leaves and accidents caused by NPS will be reduced.
In the future, the Institute of Forensic Medicine will be able to offer a service regarding the analysis of biological samples of patients poisoned by NPS also to other institutions in Slovenia and in neighbouring countries.
Most important scientific results
Annual report
2016,
final report
Most important socioeconomically and culturally relevant results
Annual report
2016,
final report
