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- Novel synthetic opioids – toxicological aspects and analysisPublication . Tabarra, Inês; Soares, Sofia; Rosado, Tiago; Gonçalves, Joana; Luís, Ângelo; Malaca, Sara; Barroso, Mário; Keller, Thomas; Restolho, José; Gallardo, EugeniaOver the past few years, there has been an emerging number of new psychoactive drugs. These drugs are frequently mentioned as “legal highs”, “herbal highs”, “bath salts” and “research chemicals”. They are mostly sold and advertised on online forums and on the dark web. The emerging new psychoactive substances are designed to mimic the effects of psy- choactive groups, which are often abused drugs. Novel synthetic opioids are a new trend in this context and represent an alarming threat to public health. Given the wide number of fatalities related to these compounds reported within the last few years, it is an important task to accurately identify these compounds in biologic matrices in order to administer an effective treatment and reverse the respiratory depression caused by opioid related substan- ces. Clinicians dealing with fentanyl intoxication cases should consider that it could, in fact, be a fentanyl analogue. For this reason, it is a helpful recommendation to include synthetic opioids in the routine toxicological screening procedures, including analysis in alternative matrices, if available, to investigate poly-drug use and possible tolerance to opioids. To address this public health problem, better international collaboration, effective legislation, effective investigation, control of suspicious “research chemicals” online forums and continu- ous community alertness are required. This article aims to review diverse reported fatalities associated with new synthetic opioids describing them in terms of pharmacology, metabol- ism, posology, available forms, as well as their toxic effects, highlighting the sample proce- dures and analytical techniques available for their detection and quantification in biological matrices
- Toxicological analysis of cocaine adulterants in blood samplesPublication . Gameiro, Rui; Costa, Suzel; Barroso, Mário; Franco, João; Fonseca, SuzanaBackground & Objectives According to the European Drug Report of 2017, cocaine was the second most widely used drug in 2016, with 3.5 million consumers between 15 and 64 years old. This pattern of consumption also occurs in Portugal (2012). Adulterants are pharmacologically active substances developed for medical purposes (analgesics, local anesthetics, antihistamines, anthelmintics and others). However, there is little knowledge about their influence in the human body when there is concomitant use with cocaine, such as an increase of cocaine toxicity even in non-toxic concentrations. The objective of this work was to validate a method that allows the identification, confirmation and quantification of cocaine adulterants in blood samples collected in vivo or post-mortem. The studied substances (atropine, phenacetin, hydroxyzine, ketamine, lidocaine and tetramisole) were selected taking into account the literature review, the analytical standards and the technical conditions. It is also intended to make a retrospective study of the prevalence of these substances in cases with a positive result for cocaine or its metabolites, as well as their relative concentrations.
- Fatal poisoning by Hemlock water dropwort roots (Oenanthe Crocata )Publication . Costa, Suzel; Franco, João; Barroso, Mário; Carvalho, S.; Fonseca, SuzanaIntrodution : This report describes the history and investigation of a suspected plant poisoning event in Portugal, involving the death of two adult males, who have mistakenly ingested Hemlock water dropwort roots Oenanthe crocata during a 36 h resistance path in May 2017 in Santarém Portugal Six hours after beginning the path, they have called to emergency services for assistance because they suddenly become unwell reporting plants ingestion and describing that they felt nauseated, vomits, seizures and disorientation Both were found dead a few hours later in a rural area In their backpacks, in addition to food supplies, they had fennel and spearmint that were probably picked up on the route Further investigations by police authorities found that during that morning they shared several photos in social media, including screenshots of wild parsnips Pastinaca sativa.