Alessandro E Vento MD PhD

Psichiatra DSM ASL Roma C

Professore Straordinario Metodologia Clinica Universitagrave G Marconi

Responsabile ldquoOsservatorio sulle Dipendenzerdquo (ODDPSS)

Lrsquouso ricreazionale di NPS un fenomeno sommerso difficile da quantificare percheacute

1 Molecole e composti non rilevabili nelle urine con i Test rapidi

2 In caso di morte accidentale o suicidio lesame tossicologico post-mortem non egrave obbligatorio ma discrezionale

3 Gli operatori presso i servizi clinici sono spesso disinformati sul fenomeno NPS

4 Gli indicatori utilizzati non sono sensibili rispetto allrsquouso di NPS (sequestri decessi e richieste di trattamento)

I consumatori di NPS solitamente non si rivolgono ai servizi clinici se non per motivi di emergenzaurgenza non considerando lrsquoassunzione di queste sostanze come un fatto di rilevanza clinica

Si sentono normalizzati in quanto il fenomeno costituisce una tendenza della popolazione giovanile ed inoltre esiste la convinzione che molte NPS essendo legali siano sicure e non dannose per la salute

179 PIAphenethylaminesMDMA-like drugs amphet-type substances (fluoroamphetamine PMA 2C-T 2C-B etc) + 14 PIA derivatives lsquoflyrsquo NBOMe indanes benzofurans (5 6-APBAPDB) lsquoBenzoFuryrsquo

220 synthetic cannabimimetics

30 synthetic cathinones

A few synthetic opiateopioids such as 4-fluorbutyrfentanyl

3 synthetic cocaine substitutes RTI 111 RTI 121 RTI 126

64 tryptamine classical derivatives and 5 tryptamine derivatives such as 5-Meo-DALT AMT etc

126 psychedelic phenethylamines from the Shulgin Index (2011) some of them may be included in the remaining categories About 1300 molecules are anyway reportedly covered including DMAA related deaths reported in the UK

3 GHB-like drugs GHB GBL 14-BD

7 PCP-like drugs PCP ketamine methoxetamine PCE 3-MeO-PCP ethylketamine 3-HO-PCP etc

2 piperazines BZP TFMPP

12 Herbsplantsfungianimals Salvia divinorum Mytragina speciosakratom Tabernantheibogaibogaine Kava Kava Psychotria viridisAyahuasca hydrangea Rhodiola rosea Daturastramonium psychedelic mushrooms bufo sponges flies etc

11 medicinal products tramadol oxycodone and remaining opiatesopiods anticonvulsants (gabapentin and pregabalin) antiseptics (benzydamine) DXM benzodiazepinessedatives (phenazepam lsquoZinniersquo methaqualone) stimulants (ethylphenidate camfetamine) antiparkinsoniananticholinergics selegiline tropicamide) chloroquine anitretroviralsrsquowhoongarsquo xylazine

6 PIEDs minikikkesuper strength caffeine tablets DNP testosterone booster concoctions such as Tribulus terrestris-containing products cognitive enhancers (aniracetam piracetam)

Sostanze eo nicotina eo alcool 98(n 267) Sostanze illecite nellrsquoultimo anno 56(n153) Sostanze illecite lifetime 78(n 213) Sostanze illecite al test 39(n 106) Cocaina cloridratocrack 89(n 94) Cannabis 20(n 21) KetaminaMetossietamina 11(n 12) Ecstasy (MDMA) 10(n 11) Metamfetamina 5(n 6) Poliabusatori inclusi alcool e nicotina 100 (n 106)

Cannabis OGM e Cannabinoidi sintetici (Spices)

GHBGBL ndash Gamma Idrossibutirrato

Mefedrone ndash 4 metil met catinone Salvia divinorum (salvinorina A) Popper ndash Nitrito di amile LSD ndash Dietilamide di acido lisergico Psilocibina (Magic Mushrooms) BDZ ed altri psicofarmaci

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

MDMA (Ecstasy) MDA MDEA MDAA

Oltre 300 molecole

Tossicitagrave fibre serotoninergiche con conseguenze su Umore Appetito Sonno Funz sessuale Aggressivitagrave Autostima Salienza

Rischio di morte per ipertermia

Disturbi associati Alcune varietagrave di SPICES

Impoverimento delle funzioni cognitive superiori

Alterazioni dello stato di coscienza

Psicosi Disturbi dellrsquoUmore e

dellrsquoAffettivitagrave Suicidio Alterazioni della

Personalitagrave Disturbi della Sfera

Sessuale

AIMS

To evaluate the proportion of patients hospitalised in an acute psychiatric ward associated

with use of the synthetic cannabinoid K2 along with their clinical features

METHODS

Retrospective audit K2 use was based on self-report

RESULTS

Seventeen patients had a total of 21 admissions during between January and April 2013 this represented 13 of all admissions to the ward during this time This was a first hospitalisation for 4 patients Of the 13 patients with previous psychiatric hospitalisation 9 patients had recurrences of pre-existing disorders and 4 patients presented new psychotic symptoms Presenting symptoms were variable and included

psychotic (paranoia thought disorder disorganised behaviour) affective (anxious depressed) disturbances andor intense suicidal thinkingbehaviour Mean duration of admission was 85 days with significantly

longer durations for those presenting with psychotic symptoms (131 vs 44 days)

CONCLUSIONS

In this case series use of K2 was associated with significant psychotoxicity requiring hospitalisation and indicates substantial risk associated with use of synthetic cannabinoids

Lrsquouso ricreazionale di NPS un fenomeno sommerso difficile da quantificare percheacute

1 Molecole e composti non rilevabili nelle urine con i Test rapidi

2 In caso di morte accidentale o suicidio lesame tossicologico post-mortem non egrave obbligatorio ma discrezionale

3 Gli operatori presso i servizi clinici sono spesso disinformati sul fenomeno NPS

4 Gli indicatori utilizzati non sono sensibili rispetto allrsquouso di NPS (sequestri decessi e richieste di trattamento)

I consumatori di NPS solitamente non si rivolgono ai servizi clinici se non per motivi di emergenzaurgenza non considerando lrsquoassunzione di queste sostanze come un fatto di rilevanza clinica

Si sentono normalizzati in quanto il fenomeno costituisce una tendenza della popolazione giovanile ed inoltre esiste la convinzione che molte NPS essendo legali siano sicure e non dannose per la salute

179 PIAphenethylaminesMDMA-like drugs amphet-type substances (fluoroamphetamine PMA 2C-T 2C-B etc) + 14 PIA derivatives lsquoflyrsquo NBOMe indanes benzofurans (5 6-APBAPDB) lsquoBenzoFuryrsquo

220 synthetic cannabimimetics

30 synthetic cathinones

A few synthetic opiateopioids such as 4-fluorbutyrfentanyl

3 synthetic cocaine substitutes RTI 111 RTI 121 RTI 126

64 tryptamine classical derivatives and 5 tryptamine derivatives such as 5-Meo-DALT AMT etc

126 psychedelic phenethylamines from the Shulgin Index (2011) some of them may be included in the remaining categories About 1300 molecules are anyway reportedly covered including DMAA related deaths reported in the UK

3 GHB-like drugs GHB GBL 14-BD

7 PCP-like drugs PCP ketamine methoxetamine PCE 3-MeO-PCP ethylketamine 3-HO-PCP etc

2 piperazines BZP TFMPP

12 Herbsplantsfungianimals Salvia divinorum Mytragina speciosakratom Tabernantheibogaibogaine Kava Kava Psychotria viridisAyahuasca hydrangea Rhodiola rosea Daturastramonium psychedelic mushrooms bufo sponges flies etc

11 medicinal products tramadol oxycodone and remaining opiatesopiods anticonvulsants (gabapentin and pregabalin) antiseptics (benzydamine) DXM benzodiazepinessedatives (phenazepam lsquoZinniersquo methaqualone) stimulants (ethylphenidate camfetamine) antiparkinsoniananticholinergics selegiline tropicamide) chloroquine anitretroviralsrsquowhoongarsquo xylazine

6 PIEDs minikikkesuper strength caffeine tablets DNP testosterone booster concoctions such as Tribulus terrestris-containing products cognitive enhancers (aniracetam piracetam)

Sostanze eo nicotina eo alcool 98(n 267) Sostanze illecite nellrsquoultimo anno 56(n153) Sostanze illecite lifetime 78(n 213) Sostanze illecite al test 39(n 106) Cocaina cloridratocrack 89(n 94) Cannabis 20(n 21) KetaminaMetossietamina 11(n 12) Ecstasy (MDMA) 10(n 11) Metamfetamina 5(n 6) Poliabusatori inclusi alcool e nicotina 100 (n 106)

Cannabis OGM e Cannabinoidi sintetici (Spices)

GHBGBL ndash Gamma Idrossibutirrato

Mefedrone ndash 4 metil met catinone Salvia divinorum (salvinorina A) Popper ndash Nitrito di amile LSD ndash Dietilamide di acido lisergico Psilocibina (Magic Mushrooms) BDZ ed altri psicofarmaci

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

MDMA (Ecstasy) MDA MDEA MDAA

Oltre 300 molecole

Tossicitagrave fibre serotoninergiche con conseguenze su Umore Appetito Sonno Funz sessuale Aggressivitagrave Autostima Salienza

Rischio di morte per ipertermia

Disturbi associati Alcune varietagrave di SPICES

Impoverimento delle funzioni cognitive superiori

Alterazioni dello stato di coscienza

Psicosi Disturbi dellrsquoUmore e

dellrsquoAffettivitagrave Suicidio Alterazioni della

Personalitagrave Disturbi della Sfera

Sessuale

AIMS

To evaluate the proportion of patients hospitalised in an acute psychiatric ward associated

with use of the synthetic cannabinoid K2 along with their clinical features

METHODS

Retrospective audit K2 use was based on self-report

RESULTS

Seventeen patients had a total of 21 admissions during between January and April 2013 this represented 13 of all admissions to the ward during this time This was a first hospitalisation for 4 patients Of the 13 patients with previous psychiatric hospitalisation 9 patients had recurrences of pre-existing disorders and 4 patients presented new psychotic symptoms Presenting symptoms were variable and included

psychotic (paranoia thought disorder disorganised behaviour) affective (anxious depressed) disturbances andor intense suicidal thinkingbehaviour Mean duration of admission was 85 days with significantly

longer durations for those presenting with psychotic symptoms (131 vs 44 days)

CONCLUSIONS

In this case series use of K2 was associated with significant psychotoxicity requiring hospitalisation and indicates substantial risk associated with use of synthetic cannabinoids

I consumatori di NPS solitamente non si rivolgono ai servizi clinici se non per motivi di emergenzaurgenza non considerando lrsquoassunzione di queste sostanze come un fatto di rilevanza clinica

Si sentono normalizzati in quanto il fenomeno costituisce una tendenza della popolazione giovanile ed inoltre esiste la convinzione che molte NPS essendo legali siano sicure e non dannose per la salute

179 PIAphenethylaminesMDMA-like drugs amphet-type substances (fluoroamphetamine PMA 2C-T 2C-B etc) + 14 PIA derivatives lsquoflyrsquo NBOMe indanes benzofurans (5 6-APBAPDB) lsquoBenzoFuryrsquo

220 synthetic cannabimimetics

30 synthetic cathinones

A few synthetic opiateopioids such as 4-fluorbutyrfentanyl

3 synthetic cocaine substitutes RTI 111 RTI 121 RTI 126

64 tryptamine classical derivatives and 5 tryptamine derivatives such as 5-Meo-DALT AMT etc

126 psychedelic phenethylamines from the Shulgin Index (2011) some of them may be included in the remaining categories About 1300 molecules are anyway reportedly covered including DMAA related deaths reported in the UK

3 GHB-like drugs GHB GBL 14-BD

7 PCP-like drugs PCP ketamine methoxetamine PCE 3-MeO-PCP ethylketamine 3-HO-PCP etc

2 piperazines BZP TFMPP

12 Herbsplantsfungianimals Salvia divinorum Mytragina speciosakratom Tabernantheibogaibogaine Kava Kava Psychotria viridisAyahuasca hydrangea Rhodiola rosea Daturastramonium psychedelic mushrooms bufo sponges flies etc

11 medicinal products tramadol oxycodone and remaining opiatesopiods anticonvulsants (gabapentin and pregabalin) antiseptics (benzydamine) DXM benzodiazepinessedatives (phenazepam lsquoZinniersquo methaqualone) stimulants (ethylphenidate camfetamine) antiparkinsoniananticholinergics selegiline tropicamide) chloroquine anitretroviralsrsquowhoongarsquo xylazine

6 PIEDs minikikkesuper strength caffeine tablets DNP testosterone booster concoctions such as Tribulus terrestris-containing products cognitive enhancers (aniracetam piracetam)

Sostanze eo nicotina eo alcool 98(n 267) Sostanze illecite nellrsquoultimo anno 56(n153) Sostanze illecite lifetime 78(n 213) Sostanze illecite al test 39(n 106) Cocaina cloridratocrack 89(n 94) Cannabis 20(n 21) KetaminaMetossietamina 11(n 12) Ecstasy (MDMA) 10(n 11) Metamfetamina 5(n 6) Poliabusatori inclusi alcool e nicotina 100 (n 106)

Cannabis OGM e Cannabinoidi sintetici (Spices)

GHBGBL ndash Gamma Idrossibutirrato

Mefedrone ndash 4 metil met catinone Salvia divinorum (salvinorina A) Popper ndash Nitrito di amile LSD ndash Dietilamide di acido lisergico Psilocibina (Magic Mushrooms) BDZ ed altri psicofarmaci

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

MDMA (Ecstasy) MDA MDEA MDAA

Oltre 300 molecole

Tossicitagrave fibre serotoninergiche con conseguenze su Umore Appetito Sonno Funz sessuale Aggressivitagrave Autostima Salienza

Rischio di morte per ipertermia

Disturbi associati Alcune varietagrave di SPICES

Impoverimento delle funzioni cognitive superiori

Alterazioni dello stato di coscienza

Psicosi Disturbi dellrsquoUmore e

dellrsquoAffettivitagrave Suicidio Alterazioni della

Personalitagrave Disturbi della Sfera

Sessuale

AIMS

To evaluate the proportion of patients hospitalised in an acute psychiatric ward associated

with use of the synthetic cannabinoid K2 along with their clinical features

METHODS

Retrospective audit K2 use was based on self-report

RESULTS

Seventeen patients had a total of 21 admissions during between January and April 2013 this represented 13 of all admissions to the ward during this time This was a first hospitalisation for 4 patients Of the 13 patients with previous psychiatric hospitalisation 9 patients had recurrences of pre-existing disorders and 4 patients presented new psychotic symptoms Presenting symptoms were variable and included

psychotic (paranoia thought disorder disorganised behaviour) affective (anxious depressed) disturbances andor intense suicidal thinkingbehaviour Mean duration of admission was 85 days with significantly

longer durations for those presenting with psychotic symptoms (131 vs 44 days)

CONCLUSIONS

In this case series use of K2 was associated with significant psychotoxicity requiring hospitalisation and indicates substantial risk associated with use of synthetic cannabinoids

179 PIAphenethylaminesMDMA-like drugs amphet-type substances (fluoroamphetamine PMA 2C-T 2C-B etc) + 14 PIA derivatives lsquoflyrsquo NBOMe indanes benzofurans (5 6-APBAPDB) lsquoBenzoFuryrsquo

220 synthetic cannabimimetics

30 synthetic cathinones

A few synthetic opiateopioids such as 4-fluorbutyrfentanyl

3 synthetic cocaine substitutes RTI 111 RTI 121 RTI 126

64 tryptamine classical derivatives and 5 tryptamine derivatives such as 5-Meo-DALT AMT etc

126 psychedelic phenethylamines from the Shulgin Index (2011) some of them may be included in the remaining categories About 1300 molecules are anyway reportedly covered including DMAA related deaths reported in the UK

3 GHB-like drugs GHB GBL 14-BD

7 PCP-like drugs PCP ketamine methoxetamine PCE 3-MeO-PCP ethylketamine 3-HO-PCP etc

2 piperazines BZP TFMPP

12 Herbsplantsfungianimals Salvia divinorum Mytragina speciosakratom Tabernantheibogaibogaine Kava Kava Psychotria viridisAyahuasca hydrangea Rhodiola rosea Daturastramonium psychedelic mushrooms bufo sponges flies etc

11 medicinal products tramadol oxycodone and remaining opiatesopiods anticonvulsants (gabapentin and pregabalin) antiseptics (benzydamine) DXM benzodiazepinessedatives (phenazepam lsquoZinniersquo methaqualone) stimulants (ethylphenidate camfetamine) antiparkinsoniananticholinergics selegiline tropicamide) chloroquine anitretroviralsrsquowhoongarsquo xylazine

6 PIEDs minikikkesuper strength caffeine tablets DNP testosterone booster concoctions such as Tribulus terrestris-containing products cognitive enhancers (aniracetam piracetam)

Sostanze eo nicotina eo alcool 98(n 267) Sostanze illecite nellrsquoultimo anno 56(n153) Sostanze illecite lifetime 78(n 213) Sostanze illecite al test 39(n 106) Cocaina cloridratocrack 89(n 94) Cannabis 20(n 21) KetaminaMetossietamina 11(n 12) Ecstasy (MDMA) 10(n 11) Metamfetamina 5(n 6) Poliabusatori inclusi alcool e nicotina 100 (n 106)

Cannabis OGM e Cannabinoidi sintetici (Spices)

GHBGBL ndash Gamma Idrossibutirrato

Mefedrone ndash 4 metil met catinone Salvia divinorum (salvinorina A) Popper ndash Nitrito di amile LSD ndash Dietilamide di acido lisergico Psilocibina (Magic Mushrooms) BDZ ed altri psicofarmaci

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

MDMA (Ecstasy) MDA MDEA MDAA

Oltre 300 molecole

Tossicitagrave fibre serotoninergiche con conseguenze su Umore Appetito Sonno Funz sessuale Aggressivitagrave Autostima Salienza

Rischio di morte per ipertermia

Disturbi associati Alcune varietagrave di SPICES

Impoverimento delle funzioni cognitive superiori

Alterazioni dello stato di coscienza

Psicosi Disturbi dellrsquoUmore e

dellrsquoAffettivitagrave Suicidio Alterazioni della

Personalitagrave Disturbi della Sfera

Sessuale

AIMS

To evaluate the proportion of patients hospitalised in an acute psychiatric ward associated

with use of the synthetic cannabinoid K2 along with their clinical features

METHODS

Retrospective audit K2 use was based on self-report

RESULTS

Seventeen patients had a total of 21 admissions during between January and April 2013 this represented 13 of all admissions to the ward during this time This was a first hospitalisation for 4 patients Of the 13 patients with previous psychiatric hospitalisation 9 patients had recurrences of pre-existing disorders and 4 patients presented new psychotic symptoms Presenting symptoms were variable and included

psychotic (paranoia thought disorder disorganised behaviour) affective (anxious depressed) disturbances andor intense suicidal thinkingbehaviour Mean duration of admission was 85 days with significantly

longer durations for those presenting with psychotic symptoms (131 vs 44 days)

CONCLUSIONS

In this case series use of K2 was associated with significant psychotoxicity requiring hospitalisation and indicates substantial risk associated with use of synthetic cannabinoids

Sostanze eo nicotina eo alcool 98(n 267) Sostanze illecite nellrsquoultimo anno 56(n153) Sostanze illecite lifetime 78(n 213) Sostanze illecite al test 39(n 106) Cocaina cloridratocrack 89(n 94) Cannabis 20(n 21) KetaminaMetossietamina 11(n 12) Ecstasy (MDMA) 10(n 11) Metamfetamina 5(n 6) Poliabusatori inclusi alcool e nicotina 100 (n 106)

Cannabis OGM e Cannabinoidi sintetici (Spices)

GHBGBL ndash Gamma Idrossibutirrato

Mefedrone ndash 4 metil met catinone Salvia divinorum (salvinorina A) Popper ndash Nitrito di amile LSD ndash Dietilamide di acido lisergico Psilocibina (Magic Mushrooms) BDZ ed altri psicofarmaci

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

MDMA (Ecstasy) MDA MDEA MDAA

Oltre 300 molecole

Tossicitagrave fibre serotoninergiche con conseguenze su Umore Appetito Sonno Funz sessuale Aggressivitagrave Autostima Salienza

Rischio di morte per ipertermia

Disturbi associati Alcune varietagrave di SPICES

Impoverimento delle funzioni cognitive superiori

Alterazioni dello stato di coscienza

Psicosi Disturbi dellrsquoUmore e

dellrsquoAffettivitagrave Suicidio Alterazioni della

Personalitagrave Disturbi della Sfera

Sessuale

AIMS

To evaluate the proportion of patients hospitalised in an acute psychiatric ward associated

with use of the synthetic cannabinoid K2 along with their clinical features

METHODS

Retrospective audit K2 use was based on self-report

RESULTS

Seventeen patients had a total of 21 admissions during between January and April 2013 this represented 13 of all admissions to the ward during this time This was a first hospitalisation for 4 patients Of the 13 patients with previous psychiatric hospitalisation 9 patients had recurrences of pre-existing disorders and 4 patients presented new psychotic symptoms Presenting symptoms were variable and included

psychotic (paranoia thought disorder disorganised behaviour) affective (anxious depressed) disturbances andor intense suicidal thinkingbehaviour Mean duration of admission was 85 days with significantly

longer durations for those presenting with psychotic symptoms (131 vs 44 days)

CONCLUSIONS

In this case series use of K2 was associated with significant psychotoxicity requiring hospitalisation and indicates substantial risk associated with use of synthetic cannabinoids

Cannabis OGM e Cannabinoidi sintetici (Spices)

GHBGBL ndash Gamma Idrossibutirrato

Mefedrone ndash 4 metil met catinone Salvia divinorum (salvinorina A) Popper ndash Nitrito di amile LSD ndash Dietilamide di acido lisergico Psilocibina (Magic Mushrooms) BDZ ed altri psicofarmaci

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

MDMA (Ecstasy) MDA MDEA MDAA

Oltre 300 molecole

Tossicitagrave fibre serotoninergiche con conseguenze su Umore Appetito Sonno Funz sessuale Aggressivitagrave Autostima Salienza

Rischio di morte per ipertermia

Disturbi associati Alcune varietagrave di SPICES

Impoverimento delle funzioni cognitive superiori

Alterazioni dello stato di coscienza

Psicosi Disturbi dellrsquoUmore e

dellrsquoAffettivitagrave Suicidio Alterazioni della

Personalitagrave Disturbi della Sfera

Sessuale

AIMS

To evaluate the proportion of patients hospitalised in an acute psychiatric ward associated

with use of the synthetic cannabinoid K2 along with their clinical features

METHODS

Retrospective audit K2 use was based on self-report

RESULTS

Seventeen patients had a total of 21 admissions during between January and April 2013 this represented 13 of all admissions to the ward during this time This was a first hospitalisation for 4 patients Of the 13 patients with previous psychiatric hospitalisation 9 patients had recurrences of pre-existing disorders and 4 patients presented new psychotic symptoms Presenting symptoms were variable and included

psychotic (paranoia thought disorder disorganised behaviour) affective (anxious depressed) disturbances andor intense suicidal thinkingbehaviour Mean duration of admission was 85 days with significantly

longer durations for those presenting with psychotic symptoms (131 vs 44 days)

CONCLUSIONS

In this case series use of K2 was associated with significant psychotoxicity requiring hospitalisation and indicates substantial risk associated with use of synthetic cannabinoids

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

MDMA (Ecstasy) MDA MDEA MDAA

Oltre 300 molecole

Tossicitagrave fibre serotoninergiche con conseguenze su Umore Appetito Sonno Funz sessuale Aggressivitagrave Autostima Salienza

Rischio di morte per ipertermia

Disturbi associati Alcune varietagrave di SPICES

Impoverimento delle funzioni cognitive superiori

Alterazioni dello stato di coscienza

Psicosi Disturbi dellrsquoUmore e

dellrsquoAffettivitagrave Suicidio Alterazioni della

Personalitagrave Disturbi della Sfera

Sessuale

AIMS

To evaluate the proportion of patients hospitalised in an acute psychiatric ward associated

with use of the synthetic cannabinoid K2 along with their clinical features

METHODS

Retrospective audit K2 use was based on self-report

RESULTS

Seventeen patients had a total of 21 admissions during between January and April 2013 this represented 13 of all admissions to the ward during this time This was a first hospitalisation for 4 patients Of the 13 patients with previous psychiatric hospitalisation 9 patients had recurrences of pre-existing disorders and 4 patients presented new psychotic symptoms Presenting symptoms were variable and included

psychotic (paranoia thought disorder disorganised behaviour) affective (anxious depressed) disturbances andor intense suicidal thinkingbehaviour Mean duration of admission was 85 days with significantly

longer durations for those presenting with psychotic symptoms (131 vs 44 days)

CONCLUSIONS

In this case series use of K2 was associated with significant psychotoxicity requiring hospitalisation and indicates substantial risk associated with use of synthetic cannabinoids

MDMA (Ecstasy) MDA MDEA MDAA

Oltre 300 molecole

Tossicitagrave fibre serotoninergiche con conseguenze su Umore Appetito Sonno Funz sessuale Aggressivitagrave Autostima Salienza

Rischio di morte per ipertermia

Disturbi associati Alcune varietagrave di SPICES

Impoverimento delle funzioni cognitive superiori

Alterazioni dello stato di coscienza

Psicosi Disturbi dellrsquoUmore e

dellrsquoAffettivitagrave Suicidio Alterazioni della

Personalitagrave Disturbi della Sfera

Sessuale

AIMS

To evaluate the proportion of patients hospitalised in an acute psychiatric ward associated

with use of the synthetic cannabinoid K2 along with their clinical features

METHODS

Retrospective audit K2 use was based on self-report

RESULTS

Seventeen patients had a total of 21 admissions during between January and April 2013 this represented 13 of all admissions to the ward during this time This was a first hospitalisation for 4 patients Of the 13 patients with previous psychiatric hospitalisation 9 patients had recurrences of pre-existing disorders and 4 patients presented new psychotic symptoms Presenting symptoms were variable and included

psychotic (paranoia thought disorder disorganised behaviour) affective (anxious depressed) disturbances andor intense suicidal thinkingbehaviour Mean duration of admission was 85 days with significantly

longer durations for those presenting with psychotic symptoms (131 vs 44 days)

CONCLUSIONS

In this case series use of K2 was associated with significant psychotoxicity requiring hospitalisation and indicates substantial risk associated with use of synthetic cannabinoids

Disturbi associati Alcune varietagrave di SPICES

Impoverimento delle funzioni cognitive superiori

Alterazioni dello stato di coscienza

Psicosi Disturbi dellrsquoUmore e

dellrsquoAffettivitagrave Suicidio Alterazioni della

Personalitagrave Disturbi della Sfera

Sessuale

AIMS

To evaluate the proportion of patients hospitalised in an acute psychiatric ward associated

with use of the synthetic cannabinoid K2 along with their clinical features

METHODS

Retrospective audit K2 use was based on self-report

RESULTS

Seventeen patients had a total of 21 admissions during between January and April 2013 this represented 13 of all admissions to the ward during this time This was a first hospitalisation for 4 patients Of the 13 patients with previous psychiatric hospitalisation 9 patients had recurrences of pre-existing disorders and 4 patients presented new psychotic symptoms Presenting symptoms were variable and included

psychotic (paranoia thought disorder disorganised behaviour) affective (anxious depressed) disturbances andor intense suicidal thinkingbehaviour Mean duration of admission was 85 days with significantly

longer durations for those presenting with psychotic symptoms (131 vs 44 days)

CONCLUSIONS

In this case series use of K2 was associated with significant psychotoxicity requiring hospitalisation and indicates substantial risk associated with use of synthetic cannabinoids

AIMS

To evaluate the proportion of patients hospitalised in an acute psychiatric ward associated

with use of the synthetic cannabinoid K2 along with their clinical features

METHODS

Retrospective audit K2 use was based on self-report

RESULTS

Seventeen patients had a total of 21 admissions during between January and April 2013 this represented 13 of all admissions to the ward during this time This was a first hospitalisation for 4 patients Of the 13 patients with previous psychiatric hospitalisation 9 patients had recurrences of pre-existing disorders and 4 patients presented new psychotic symptoms Presenting symptoms were variable and included

psychotic (paranoia thought disorder disorganised behaviour) affective (anxious depressed) disturbances andor intense suicidal thinkingbehaviour Mean duration of admission was 85 days with significantly

longer durations for those presenting with psychotic symptoms (131 vs 44 days)

CONCLUSIONS

In this case series use of K2 was associated with significant psychotoxicity requiring hospitalisation and indicates substantial risk associated with use of synthetic cannabinoids

Mephedrone (Schifano et al Psychopharmacology Nov 2010)

- Research chemical 4-Methylmethcathinone

- Appeared in or around 2007

- Stimulant compared variously to amphetamine ecstasy and cocaine

- Miaow 4-MMC MMCatMCAT MD3 Roxy Krabba Mefedron and various trade names

- Sold as powder or in capsules

- Sold as ldquoplant feederrdquo andor ldquonot for human consumptionrdquo

Flash Headaches

Tremors and Convulsions

Painful Nasal Drip

Fatigue

Insomnia and Nightmares

Cravings

Aggressivenes

Concentration and Memory

Anxiety

Paranoia

Dysphoria

Depression

Hallucinations

Mephedrone

GHB comunemente utilizzato nei SERT per ridurre il desiderio di bere alcoolici (Alcover) Ad elevate dosi induce progressivamente amnesia sedazione euforia coma e morte

T12 = 27 minuti

Nel trattamento Add On Baclofene

Ketamina egrave un anestetico dissociativo utilizzato in veterinaria Puograve essere inalata per via nasale ingerita o fumata

Come la PCP ketamina agisce su recettori NMDA

Induce episodi Schizophrenia-like

Special K fibrosi vescicale ndash Special M tossicitagrave cerebbellare

Research Triangle Institute

RTI 111 RTI 121 RTI 126

Composti giagrave disponibli online

BDZ

Quetiapina come NPS Q Ball

Pregabalin e Buproprione

Analgesici oppioidi

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

Disturbi emozionali comuni (talvolta sotto-soglia)

bull insonnia

bull irritabilitagrave

bull impulsivitagraveaggressivitagrave

bull ansia

bull somatizzazioni

bull pensiero perseverante

bull deflessione del tono dellrsquoumore

bull depressione anedonica

bull abulia

Disturbi mentali gravi

bull ciclotimia o disturbo bipolare

bull depressione maggiore

bull psicosi indotte

bull disturbi deliranti

bull addiction syndrome

Con insorgenza durante lrsquointossicazione cocaina cannabis GMSPICES ecstasy-like ketamina mefedrone metamfetamina (shaboo) altri psicostimolanti

Con insorgenza durante lrsquoastinenza oppiacei alcool GHBGBL BDZ altri sedativi

Flash Headaches

Tremors and Convulsions

Painful Nasal Drip

Fatigue

Insomnia and Nightmares

Cravings

Aggressivenes

Concentration and Memory

Anxiety

Paranoia

Dysphoria

Depression

Hallucinations

Mephedrone

GHB comunemente utilizzato nei SERT per ridurre il desiderio di bere alcoolici (Alcover) Ad elevate dosi induce progressivamente amnesia sedazione euforia coma e morte

T12 = 27 minuti

Nel trattamento Add On Baclofene

Ketamina egrave un anestetico dissociativo utilizzato in veterinaria Puograve essere inalata per via nasale ingerita o fumata

Come la PCP ketamina agisce su recettori NMDA

Induce episodi Schizophrenia-like

Special K fibrosi vescicale ndash Special M tossicitagrave cerebbellare

Research Triangle Institute

RTI 111 RTI 121 RTI 126

Composti giagrave disponibli online

BDZ

Quetiapina come NPS Q Ball

Pregabalin e Buproprione

Analgesici oppioidi

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

Disturbi emozionali comuni (talvolta sotto-soglia)

bull insonnia

bull irritabilitagrave

bull impulsivitagraveaggressivitagrave

bull ansia

bull somatizzazioni

bull pensiero perseverante

bull deflessione del tono dellrsquoumore

bull depressione anedonica

bull abulia

Disturbi mentali gravi

bull ciclotimia o disturbo bipolare

bull depressione maggiore

bull psicosi indotte

bull disturbi deliranti

bull addiction syndrome

Con insorgenza durante lrsquointossicazione cocaina cannabis GMSPICES ecstasy-like ketamina mefedrone metamfetamina (shaboo) altri psicostimolanti

Con insorgenza durante lrsquoastinenza oppiacei alcool GHBGBL BDZ altri sedativi

GHB comunemente utilizzato nei SERT per ridurre il desiderio di bere alcoolici (Alcover) Ad elevate dosi induce progressivamente amnesia sedazione euforia coma e morte

T12 = 27 minuti

Nel trattamento Add On Baclofene

Ketamina egrave un anestetico dissociativo utilizzato in veterinaria Puograve essere inalata per via nasale ingerita o fumata

Come la PCP ketamina agisce su recettori NMDA

Induce episodi Schizophrenia-like

Special K fibrosi vescicale ndash Special M tossicitagrave cerebbellare

Research Triangle Institute

RTI 111 RTI 121 RTI 126

Composti giagrave disponibli online

BDZ

Quetiapina come NPS Q Ball

Pregabalin e Buproprione

Analgesici oppioidi

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

Disturbi emozionali comuni (talvolta sotto-soglia)

bull insonnia

bull irritabilitagrave

bull impulsivitagraveaggressivitagrave

bull ansia

bull somatizzazioni

bull pensiero perseverante

bull deflessione del tono dellrsquoumore

bull depressione anedonica

bull abulia

Disturbi mentali gravi

bull ciclotimia o disturbo bipolare

bull depressione maggiore

bull psicosi indotte

bull disturbi deliranti

bull addiction syndrome

Con insorgenza durante lrsquointossicazione cocaina cannabis GMSPICES ecstasy-like ketamina mefedrone metamfetamina (shaboo) altri psicostimolanti

Con insorgenza durante lrsquoastinenza oppiacei alcool GHBGBL BDZ altri sedativi

Ketamina egrave un anestetico dissociativo utilizzato in veterinaria Puograve essere inalata per via nasale ingerita o fumata

Come la PCP ketamina agisce su recettori NMDA

Induce episodi Schizophrenia-like

Special K fibrosi vescicale ndash Special M tossicitagrave cerebbellare

Research Triangle Institute

RTI 111 RTI 121 RTI 126

Composti giagrave disponibli online

BDZ

Quetiapina come NPS Q Ball

Pregabalin e Buproprione

Analgesici oppioidi

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

Disturbi emozionali comuni (talvolta sotto-soglia)

bull insonnia

bull irritabilitagrave

bull impulsivitagraveaggressivitagrave

bull ansia

bull somatizzazioni

bull pensiero perseverante

bull deflessione del tono dellrsquoumore

bull depressione anedonica

bull abulia

Disturbi mentali gravi

bull ciclotimia o disturbo bipolare

bull depressione maggiore

bull psicosi indotte

bull disturbi deliranti

bull addiction syndrome

Con insorgenza durante lrsquointossicazione cocaina cannabis GMSPICES ecstasy-like ketamina mefedrone metamfetamina (shaboo) altri psicostimolanti

Con insorgenza durante lrsquoastinenza oppiacei alcool GHBGBL BDZ altri sedativi

Research Triangle Institute

RTI 111 RTI 121 RTI 126

Composti giagrave disponibli online

BDZ

Quetiapina come NPS Q Ball

Pregabalin e Buproprione

Analgesici oppioidi

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

Disturbi emozionali comuni (talvolta sotto-soglia)

bull insonnia

bull irritabilitagrave

bull impulsivitagraveaggressivitagrave

bull ansia

bull somatizzazioni

bull pensiero perseverante

bull deflessione del tono dellrsquoumore

bull depressione anedonica

bull abulia

Disturbi mentali gravi

bull ciclotimia o disturbo bipolare

bull depressione maggiore

bull psicosi indotte

bull disturbi deliranti

bull addiction syndrome

Con insorgenza durante lrsquointossicazione cocaina cannabis GMSPICES ecstasy-like ketamina mefedrone metamfetamina (shaboo) altri psicostimolanti

Con insorgenza durante lrsquoastinenza oppiacei alcool GHBGBL BDZ altri sedativi

BDZ

Quetiapina come NPS Q Ball

Pregabalin e Buproprione

Analgesici oppioidi

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

Disturbi emozionali comuni (talvolta sotto-soglia)

bull insonnia

bull irritabilitagrave

bull impulsivitagraveaggressivitagrave

bull ansia

bull somatizzazioni

bull pensiero perseverante

bull deflessione del tono dellrsquoumore

bull depressione anedonica

bull abulia

Disturbi mentali gravi

bull ciclotimia o disturbo bipolare

bull depressione maggiore

bull psicosi indotte

bull disturbi deliranti

bull addiction syndrome

Con insorgenza durante lrsquointossicazione cocaina cannabis GMSPICES ecstasy-like ketamina mefedrone metamfetamina (shaboo) altri psicostimolanti

Con insorgenza durante lrsquoastinenza oppiacei alcool GHBGBL BDZ altri sedativi

1 Intossicazione acuta

2 Addiction

3 Disturbi neuro-psichiatrici correlati

4 Disturbi internistici correlati

5 Traumi correlati (incidenti)

Disturbi emozionali comuni (talvolta sotto-soglia)

bull insonnia

bull irritabilitagrave

bull impulsivitagraveaggressivitagrave

bull ansia

bull somatizzazioni

bull pensiero perseverante

bull deflessione del tono dellrsquoumore

bull depressione anedonica

bull abulia

Disturbi mentali gravi

bull ciclotimia o disturbo bipolare

bull depressione maggiore

bull psicosi indotte

bull disturbi deliranti

bull addiction syndrome

Con insorgenza durante lrsquointossicazione cocaina cannabis GMSPICES ecstasy-like ketamina mefedrone metamfetamina (shaboo) altri psicostimolanti

Con insorgenza durante lrsquoastinenza oppiacei alcool GHBGBL BDZ altri sedativi

Disturbi emozionali comuni (talvolta sotto-soglia)

bull insonnia

bull irritabilitagrave

bull impulsivitagraveaggressivitagrave

bull ansia

bull somatizzazioni

bull pensiero perseverante

bull deflessione del tono dellrsquoumore

bull depressione anedonica

bull abulia

Disturbi mentali gravi

bull ciclotimia o disturbo bipolare

bull depressione maggiore

bull psicosi indotte

bull disturbi deliranti

bull addiction syndrome

Con insorgenza durante lrsquointossicazione cocaina cannabis GMSPICES ecstasy-like ketamina mefedrone metamfetamina (shaboo) altri psicostimolanti

Con insorgenza durante lrsquoastinenza oppiacei alcool GHBGBL BDZ altri sedativi

Disturbi mentali gravi

bull ciclotimia o disturbo bipolare

bull depressione maggiore

bull psicosi indotte

bull disturbi deliranti

bull addiction syndrome

Con insorgenza durante lrsquointossicazione cocaina cannabis GMSPICES ecstasy-like ketamina mefedrone metamfetamina (shaboo) altri psicostimolanti

Con insorgenza durante lrsquoastinenza oppiacei alcool GHBGBL BDZ altri sedativi

Con insorgenza durante lrsquointossicazione cocaina cannabis GMSPICES ecstasy-like ketamina mefedrone metamfetamina (shaboo) altri psicostimolanti

Con insorgenza durante lrsquoastinenza oppiacei alcool GHBGBL BDZ altri sedativi