Monitoring in the technological age John Ramsey TICTAC Communications Ltd St. Georges, University of London London SW17 0RE

Monitoring in the technological age


John Ramsey

TICTAC Communications Ltd

St. George’s, University of London

London

SW17 0RE



Monitoring what ? drugs drug use drug users

Technological age ? computing communications

TICTAC Communications Ltd.


The internet Websites

* The Google effect Blogs, social networking Chat rooms Information sources

* EMCDDA* Wikipedia

* Erowid

* News feeds Daily dose

YouTube Sale of “Legal highs”

Mobile phones Drug dealing Databases



Most of our information about drug use is from questionnaire based surveys

“Surveys provide an important window on some types of drug use, but need to be complemented with targeted studies and statistical modelling if a more comprehensive picture is to be produced.“

Sampling problems and response bias remain major problems for survey techniques

Sensitivity to language differences



Indirect modelling“Indirect modelling of the unknown population from the observable population is complicated to achieve and requires a proportion of the population of interest to be observable in some fashion”

Observe by analysis of :-

drugs* Police, Customs

* Test purchasing, Amnesty bins

use of drugs (in biological samples)* Treatment of poisoning

* Workplace drug testing in urine, oral fluid, hair

impairment* Field impairment tests

* Admission to hospital



Laboratory based analytical techniques Mass spectrometry

* LC/MS/MS, High resolution Nuclear Magnetic Resonance (NMR)

Field drug detection technologies Trace - Ion motility Bulk – IR, Raman Immunoassay

× Impairment testing


Analytical capabilities


Analysis of drugs Law enforcement seizures

Police Customs Prisons

Test purchasing Illegal drugs Legal drugs – “not illegal yet”

Amnesty bin analysis Drugs surrendered on entry to clubs



TICTACTICTAC collects legal & illegal drugs (at St. George’s University of

London) to compile a database that is used by both Healthcare and Law & Order professionals

25,000 samples in secure storage

www.tictac.org.uk


Analysis of biological samples

Treatment of poisoning blood, urine

Treatment of addiction urine

Workplace drug testing urine, oral fluid, hair

Prison drug testing urine, oral fluid

Law enforcement driving – blood, urine drug facilitated sexual assault – urine, blood




Oral fluid testing collection more ‘dignified’ than urine detect drug closer to use issues:

variability of collection devices• variable volume

variability of oral fluids• stimulation changes pH

cannabis detected from smoking availability of identical second sample for donor difficult to adulterate low levels different compounds detected (unchanged drug)



Hair Testing

historical record (about 1cm per month)

detecting cannabis difficult issues:

variable growth rates• not all hairs in growth phase

external contamination hair colour short / long hair low levels

Natalie Portman as Sinéad O

Connor



Drug screening relies on Immunoassay

Analytical procedure that uses antibodies raised in animals or cell cultures to detect or measure drugs

implemented as simple dipstick tests or used in highly automated laboratory apparatus

adding new drugs requires substantial investment in time and money

needs large market before this becomes viable consequently new & emerging drugs are only

detectable if they react with existing antibodies



new compounds are used as drugs because they fall

outside legislation

new compounds are used as drugs because they fall

outside legislation

the law catches up

the law catches up

The driver for change



Piperazines

N N

DBZPdibenzylpiperazine

DBZPdibenzylpiperazine

N N

BZP1-benzylpiperazine

BZP1-benzylpiperazine

TFMPPm-trifluoromethylphenylpiperazine

TFMPPm-trifluoromethylphenylpiperazine

N N

CF3

mCPPm-chlorophenlypiperazine

mCPPm-chlorophenlypiperazine

N N

Cl

pMPPp-methoxyphenylpiperazine

pMPPp-methoxyphenylpiperazine

pFPPp-

fluorophenlypiperazine

pFPPp-

fluorophenlypiperazine

N N OCH3 N N F

HN NH

PiperazinePiperazine

NNCH3

MBZP1-methyl-4-benzylpiperazine

MBZP1-methyl-4-benzylpiperazine



Gas Chromatography / Mass Spectrometry

routinely used for

cocaine, heroin, amphetamine, ‘ecstasy’ and many other drugs general screening new drugs requires acquisition

of a reference sample

Cost of machine £50,000Consumables relatively low costRun time about 30 mins per sampleplus 30 mins for standardSensitivity High

Cost of machine £50,000Consumables relatively low costRun time about 30 mins per sampleplus 30 mins for standardSensitivity High


New high sensitivity equipment new possibilities – but at a high cost

LC / MS / MS Liquid chromatography with tandem mass spectrometry

Atmospheric pressure ionisation high resolution mass spectrometry DART

Direct inlet

Orbitrap LC interface with very high resolution mass spectrometry



LC / MS / MS

OR

RNG

Skimmer

Q 0

IQ1

ST Q 1 Q 2 Q 3DET

DF

OR

RNG

Skimmer

Q 0

IQ1

ST Q 1 Q 2 Q 3DET

DF

OR

RNG

Skimmer

Q 0

IQ1

ST Q 1 Q 2 Q 3DET

DF

tandem mass-spectrometry

Cost of machine £200,000Consumables relatively low costRun time about 10 mins per sampleplus 10 mins for standardSensitivity Very high


Assessing illicit drugs in waste water

Potential and limitations of a new monitoring approach

early days of the development of a new approach that appears to have considerable potential and may open up new possibilities for monitoring drug consumption trends

additional tool that complements and extends the possibilities of existing approaches to the fundamentally difficult problem of monitoring a complex, hidden and stigmatised behaviour



Assessing illicit drugs in waste water

Wastewater analysis is a promising tool to evaluate cocaine consumption at both local and national scale. This rapid and direct estimation of the prevalence of cocaine use in Belgium corresponds with socioepidemiological data.

However, the strategy needs to be refined further to allow a more exact calculation of cocaine consumption from concentrations of BE in wastewater.


2009, Addiction, 104, 734–741


DART™DART™ new non-contact surface

sampling technique for mass spectrometry at atmospheric pressure under ambient conditions

analyse gases, liquid, solids & materials on surfaces

DART on Joel AccuTOFDART on Joel AccuTOF

time-of-flight mass spectrometer

Cost of machine £250,000Consumables very low costRun time about 1 min per sampleSensitivity Very high


DART™DART™


OrbitrapThermo Scientific Exactive TM


1. Exact mass measurements of organic compounds2. General unknown screening

• atmospheric pressure ionisation• high resolution, accurate mass measurements

>10,000 at m/z 200 up to over 100,000• extracted ion chromatogram in very complex matrix • high selectivity and sensitivity in full scan mode• sample introduction by direct infusion or LC

Potential to screen for compounds (even retrospectively) where we know the chemical structure but do not have a reference sample.

e.g. cannabinoid receptor agonists

Cost of machine £350,000Consumables low costRun time about 5 min per sampleSensitivity Very high


Spice Purports to be a herbal mixture

Damiana Wild Lettuce Skullcap Motherwort Red Clover Marshmallow Blue Lotus Baybean Pink Lotus Dwarf Skullcap Indian Warrior Lion’s Tail Maconha Brava White Lotus Siberian Motherwart Vanilla & Honey

Contains cannabinoid receptor agonists

Synthetic cannabis


JWH-018 HU-210 CP47497

“Spice is an exotic incense blend of the highest quality herbs and herbal extracts .

Unwind your mind! The only herbal smoke that actually works! anytime, anyplace...(except when operating heavy machinery)”


Access to specialist equipment to address the increasing number of new synthetic drugs

NMR Nuclear Magnetic Resonance Spectroscopy

1 Hydrogen 13 Carbon 19 Fluorine




Nuclear Magnetic Resonance (NMR)NMR (Bruker Avance 400 MHz)

identification of new unknown compounds amphetamines, ‘ecstasy’, piperazines, beta keto derivatives

quantitation of drugs in absence of reference sample drug comparisons

cocaine

Cost of machine £200,000Consumables moderate costRun time 30 mins or more per sampleSensitivity very LowRequires specialist to read the results

Cost of machine £200,000Consumables moderate costRun time 30 mins or more per sampleSensitivity very LowRequires specialist to read the results


4-Fluoroamphetamine


F

CH3

NH2

NMR required to confirm the structure in the absence of a reference sample.

1H19F


Transportable equipment for field testing

Bulk Infra red spectroscopy Xray immunoassay

Trace Ion motility spectroscopy immunoassay




Bulk identification

ATR Spectral Libraryover 25,000 unique ATR spectra

ATR Spectral Libraryover 25,000 unique ATR spectra

Hazmat IDHazmat ID

CBRN weapons or hazards CBRN weapons or hazards

Tends to only identify major component of a mixture.

e.g. impure cocaine identified as diluent (lactose), ketamine injection

as water.

Tends to only identify major component of a mixture.

e.g. impure cocaine identified as diluent (lactose), ketamine injection

as water.

GHB

GBLGBL

GHBGHB

BDOBDO



Trace detection

passive drug dogs

ion motility spectrometers surfaces swabbed and analysed

within 30 seconds

* Hands

* Phones

* Cars

* Premises


Portals used to detect metal, explosives, drugs

Metal detectors Xray Ion motility


Smiths - Bodyscan Braun – Conpass

Shows concealed items hidden on or inside a persons body

Drugs in the stomach


Detection of indoor cannabis cultivation

odour of cannabis very high electricity consumption criminal gangs, bypass the problem by wiring

directly - and often dangerously - into the electricity mains

high heat output fire is a serious risk - cannabis farms often

discovered as a result of fires


http://news.bbc.co.uk/1/hi/magazine/7412654.stm


Thermal imaging to detect indoor cannabis cultivation


http://news.bbc.co.uk/1/hi/magazine/7412654.stm


Impairment testing

In many situations it is more important to know if an individual is impaired than what is responsible for the impairment.

DrivingWorkplace



Preliminary Impairment tests


Finger to Nose TestPupil size assessment Modified Romberg Balance Test

Walk &Turn Test One Leg Stand

EyeCheck® digital pupillometer

allegedly used by Law enforcement agencies employers to detect substance

abuse by employees


British Crime Survey 2006 / 7illegal drug use (England & Wales)

Used in lifetime

Used in last year

Used in last month

16-24

44.7%

24.1%

14.3%

16-59

35.5%

10.0%

5.9%

n = 28,784


Positivity rate for UK workplace drug tests

01234567

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Year

% o

f s

am

ple

s t

es

ted

Maritime

Rail

Unregulated

5 - 6%

data set>12 years of analytical data>10m laboratory tests>700,000 samples

Documents

Monitoring in the technological age John Ramsey TICTAC Communications Ltd St. Georges, University of London London SW17 0RE