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Davies, D. Wood, G. Smith, J. Button, J. Ramsey, R. Archer, D. Holt, P. Use of these is common and there is a potential for ificant toxicity associated with their use. Aim: To determine the content of legal highs available for purchase in the UK and whether the content of these remains consistent. Methods: Twenty-six legal highs were purchased monthly from five different Internet sites over 6 months.
These were analysed to determine the drugs in the products and whether there were any changes in their content over this time period. : All products were supplied initially, but there was a decline in supply of products month by month. In three products there was a change in the piperazine detected, with 1-benzylpiperazine being substituted for 1-methylbenzylpiperazine or vice versa. In two other products there was a cathinone [4-fluorophenylpiperazine pFPP or 3-fluromethcathinone 3FMC ] detected in products purchased in Month 1 that was not present in the products purchased in subsequent months.
Conclusions: Whilst there was no variation in the composition of most legal highs supplied over 6 month, there was ificant variation in the piperazine or cathinone content of one quarter of the products. This variation could be of clinical ificance as the cathinone and piperazine products can be associated with ificant toxicity. However, there are numerous case reports of toxicity similar to that seen with classical recreational drugs in individuals using these legal highs.
The packaging of these drugs bought on the high street or through the Internet often does not provide any information to the user on the active constituents, and where this is provided it is usually very limited and often inaccurate. We attempted to purchase these legal highs once a month, on the same date each month, using a company debit card for delivery to a UK postal address. Upon delivery, information on the exact product s received, along with details of any missing purchases, was recorded.
Samples were retained within their original packaging for future reference, and stored within a Home Office approved and d drug analysis laboratory. Samples were subsequently qualitatively analysed in chronological order of receipt by a ly described gas chromatographic assay with mass spectrometric detection GC-MS. The analytical data were collated to determine i the initial constituents of the legal highs purchased; ii whether there was any association between the cost of an individual product and the likely constituents of that product; and iii whether the constituents of individual purchases changed over time.
All 26 legal highs selected from the five different Internet supplier sites were delivered in the first month January The names of the legal highs and the constituents detected on analysis are summarized in Table 1. The of products that were purchased and supplied each month is shown in Figure 2which demonstrates that there was a steady decline in the of products supplied over the 6-month period. Each supplier had one or more legal high in which there was a variation in content.
In three of these, there was variation in the piperazines detected on analysis, with 1-benzylpiperazine being substituted for 1-methylbenzylpiperazine and vice-versa.
In addition, there was one product, which in Months 1, 2, 4, 5 and 6 contained both caffeine and 4-fluorophenylpiperazine pFPPbut contained only caffeine in Month 3. The final product in which there was a variation in content contained 3-fluromethcathinone 3FMC and caffeine in Months 1—4, was not supplied in Month 5 and contained only caffeine in Month 6.
Legal highs such as those purchased in this study are widely used in the UK and elsewhere in Europe. We have shown that although there was no variation in the content of most legal highs supplied over the 6-month period, there was ificant variation in one quarter of the products. There is the potential for ificant toxicity associated with piperazine and cathinone drugs 145 and so the variation in the active drug in these compounds is important enough to be of clinical relevance.
For individuals purchasing these drugs, the name of the product is insufficient information for buyers to be confident as to their exact content. During this study it was relatively easy to purchase a of legal highs from different Internet suppliers. However, there were months when not all the products were available for purchase. They may decide to either purchase alternative products recommended on the same site or attempt to purchase the product from a different Internet site.
There is then the risk that individuals will be exposed to different active drugs than those that they may be used to. Potentially, this could increase the risk of unwanted effects or lead to acute toxicity due to a difference in the relative amounts of active drug ingredient s. This study was a qualitative study and therefore we did not assess the relative concentration s of the active ingredients; therefore, there is the potential that changes in the concentration s of constituents could put individuals at risk of increased acute toxicity.
At the time this study was undertaken, all of the active drug classes detected were not controlled by the UK Misuse of Drugs Act However, subsequently, the piperazines were controlled in the UK on the 23 December under this legislation. The suppliers may either withdraw these products from sale or change the active ingredients so that they remain legal for sale in the UK. Conflict of interest : D. W and P. Google Scholar. Google Preview. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.
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