Dr. Salah E. Breidi, Head of Toxicology at DNA Legal, is a global expert in this field. This means that you will have access to a variety of expertise if you choose to use DNA Legal for your legal highs and synthetic drug testing services. While male overdoses dominate epidemiological statistics, there is an increase in drug-related deaths among women and a narrowing of the gap in mortality rates by sex (1), which is not yet clear. In Scotland, which currently has the highest rate of drug-related deaths per capita in Europe (3), the gender gap in DRDs has narrowed since 2016/8, with a 212% increase in reported DRDs among women compared to a 75% increase among men (4). The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) points out that the gap between girls and boys aged 15-16 has narrowed in Europe (5) and that drug-related deaths among women aged 30-64 have increased by 260 % in the United States (6). Synthetic drugs, legal highs, herbal highs, party pills, synthetic cocaine, synthetic cannabis, herbal ecstasy, NBOM, bath salts, plant fertilizers, herbal incense, room fresheners, aphrodisiac tea, social tonics, new and emerging drugs (NEDs), drug analogues and research chemicals. These products can sometimes be labelled “not intended for human consumption”.1 Worryingly, the colourful packaging of NPS targets the younger population.6 In the UK, DrugScope suggests that the typical NPS user is a vulnerable young person living in socioeconomic distress, too young to engage in club drug use, with limited disposable income.
and now having easy access to intoxicating substances that are still legal.6 The Royal College of Psychiatrists disagrees. There is evidence that NPS users are more likely to be engaged and have built social networks.7 The main effects of almost all psychoactive drugs, including legal highs, can be described using the following four main categories. Although drugs in each of these categories have similar effects in their products, they will have very different strengths and effects on different people. NPS have gained popularity in recent years due to low prices and widespread use through headshops on the main street and online. Previously, the NPS was able to circumvent the law by labeling substances as “plant foods” and “not intended for human consumption.” This has misled the public about the real danger of these substances. The Law on Psychoactive Substances came into force in May 2016, making it illegal to supply and manufacture these drugs. While we feel confident enough to treat a patient who has injected heroin, treating a patient who has smoked “Blast Off,” sniffed “Charly Sheen,” or injected “Magic Dragon” may not be as easy. Toxbase`s guidelines for synthetic stimulants, hallucinogens and pathogens are, if at all, rare,4 and the fact that there is no way to know what chemicals these products contain is the problem, as treating physicians cannot know which chemicals to refer to on Toxbase.
In addition, data show that products labelled with the same name may contain different compounds, sometimes with multiple compounds in the same product.5 The lack of manufacturing instructions and quality assurance5 also means that there is a high probability of contamination. Some studies show the presence of illicit drugs in these so-called legal substances, most of which users are unaware, resulting in unimaginable biological and psychological effects.5 Therefore, it is very unlikely that NPS users can be sure of what they have taken.6 Recent deaths of NPS during this period seem to show more naïve use. drug use less versatile and more likely to be used with friends and at leisure. A large proportion of NPS deaths have been linked to mephedrone, a cathinone that has proven particularly dangerous but particularly popular as a club drug (25). Deaths related to methadone and/or diazepam were also more often associated with deaths of older women who also had social problems such as unstable living conditions and health problems. These deaths may reflect the spread of NPS from recreational use to established populations of drug users and more disadvantaged locations [i.e., (26)], as well as populations where polydrug use and self-medication are more common behaviours (27). Analysis of gender differences within the cohort showed significantly higher proportions of women of antidepressants, hypnotics/tranquilizers, implicit and prescribed hypnotics/tranquilizers, methadone and diazepam (see Table 3). This reflects current and recent data on substances associated with female DRDs. However, a case study of NPS by sex showed no significant difference in proportions by sex, with the exception of methadone (females = 20.0%, males 9.0%, OR = 1.218, (95% CI = 1.02-1.45) (Kendall tau-b p < 0.025). There is also a small significant difference in the implicit ratio of methadone for females for the entire cohort (females = 24%, males = 22%) (Kendall tau-b p < 0.047), but this difference is more significant in NPS-related deaths (p < 0.025), showing that methadone is also more likely to be used by females than men when using NPS. Of the women`s deaths involving methadone, nearly two-thirds had also involved diazepam, but only two cases of NPS were prescribed diazepam, and only one case was prescribed methadone.
It also suggests that many women who use NPS are also more likely than men to get illegal tranquilizers/sedatives. New psychoactive substances (NPS) are a term coined to describe a wide range of substances designed to simulate the effects of illicit drugs. NPS are often referred to in the media as “legal highs” or “synthetic drugs”; However, these terms can minimize the hazardousness of these substances. Factors associated with this increase include increased access to opioids, polydrug use and polypharmacy (prescription drugs) (7), as well as the effects of psychosocial and socio-economic pressures, which disproportionately affect women (8). The increase in fentanyl prescribing in the United States is likely to skew global rates of opioid use and mortality among women (9), but other national data suggests that this may be symptomatic of specific trends in other women and that the availability of opioid prescriptions only underscores this problem. Tweed et al. (4) suggest that the ageing cohort of drug users, accompanied by increasing physical and mental health problems, may influence women`s susceptibility to antiretroviral diseases more than men, as they may also change drug use patterns, with methadone deaths being slightly higher among women than men in Scotland. The NPSAD surveillance program found gender differences in the types of drugs involved in deaths in England and Northern Ireland, showing that deaths among males are most strongly associated with heroin and female deaths are more strongly associated with other opioid opioids and painkillers (10).
Compared to male DRDs, DRDs in women included proportionately more antidepressants, hypnotics and tranquilizers, methadone, and antiepileptics (i.e., , gabapentin) and were more likely to be classified as “suicide” or “indeterminate” than deaths in males (10). The record was extracted from the NPSAD database. We were particularly interested in constructing parameters to capture all drug-related cases during the period when NPS were legal and therefore highly available in the UK for regular and `recreational` or occasional drug users. Therefore, the date parameters were set to cover all NPS deaths over a 10-year period until the implementation of the Psychoactive Substances Act (2016) (2007-2016) and all cases registered during this period, regardless of the status of the NPS.