Journal of Analytical Toxicology, 2019;43:e9–e10 doi: 10.1093/jat/bky101 Advance Access Publication Date: 22 December 2018 Letter to the Editor Letter to the Editor Prevalence of New Psychoactive Substances in Oral Fluid Specimens from French and Belgian Drivers: Comparison 2016/2017 Camille Richeval 1,2 , Mélodie Nachon-Phanithavong 1 , Vincent Di Fazio 3 , Jean-François Wiart 1 , Luc Humbert 1 , Nele Samyn 3 , Sarah Maria Richarda Wille 3 , Delphine Allorge 1,2 , and Jean-michel Gaulier 1,2, * 1 CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000 Lille, France, 2 University of Lille, EA 4483—IMPECS—IMPact de l’Environnement Chimique sur la Santé humaine, F-59000 Lille, France, and 3 Federal Public Service Justice, National Institute of Criminalistics and Criminology, Brussels, Belgium *Author to whom correspondence should be addressed. Email: jean-michel.gaulier@chru-lille.fr To the Editor: New psychoactive substances (NPS) are new narcotic or psycho- tropic drugs which are not controlled by the 1961 United Nations Single Convention on Narcotic Drugs or the 1971 United Nations Convention on Psychotropic Substances. NPS are challenging in (i) international and European drug policies to respond as efficiently as possible to the increasing and dynamic NPS market with regard to human health and in (ii) analytical testing difficulties for detection of NPS in biological samples, in clinical and forensic situations (1, 2). These pitfalls require a greater emphasis in case of driving under the influence of drugs (DUID). Driving under the influence of NPS is a phenomenon that is only observed after additional analytical screen- ing procedures specifically performed in order identify possible NPS intake (when standard DOA assays revealed negative results). The reason is that action against DUID often starts with an on-site immu- nological screening test only focusing on “classical” DOA use (e.g. cannabis, cocaine, amphetamine derivatives and heroin use) that are not yet adapted for NPS detection. Currently, in Belgium as well in France, standard roadside test- ing is performed in oral fluid (OF) using an on-site immunological screening for DOA, specifically the Drugwipe ® 5S from Securetec. In 2017, we tested French and Belgian drivers’ OF samples for NPS (after a positive or negative roadside screening test for DOA) in the same way as in 2016 (3). OF samples consisted in dried saliva spots collected from used Drugwipe-5S ® tests. These roadside immuno- chemical tests for DOA were performed in drivers’ OF in two Belgian areas, Mons and Mechelen, and in drivers’ OF of one French area, Lille, after (mainly) unannounced roadside tests: these devices were broken down and, for each test, two of the three OF collection pads were analyzed using a liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) and high resolution mass spectrometry (LC-HRMS) previously reported method (3, 4). It is of note that analytical data processes were performed using home- made LC-MS/MS and LC-HRMS databases (containing NPS and their metabolites) that are continually improved: 440 NPS and meta- bolites at the end of 2016, and 550 at the end of 2017. Three hundred ninety-one OF samples from drivers were ana- lyzed in 2017: results are summarized in Table I. Even if these results can be challenged (limited and random sampling, sensibility of NPS detection in OF, …), a decrease in NPS prevalence (global percentage in France + Belgium of 8.4% in 2016 versus only 3% in 2017) was observed. In fact, the prevalence of NPS is 3% in all cases, except for 2016 in Belgium. One possible explanation for this discrepancy consists in the random sampling of OF: e.g. we retro- spectively notice that several samples were collected close to a music festival (Dour festival in July 2016 in Belgium). In the end, the sam- pling of drivers’ OF is so heterogeneous (location and time of collec- tion, initially roadside-tested negative or positive for DOA) that conclusions on the evolution of the observed percentages remain limited. In 2017 as in 2016, in France, as well as in Belgium, the identi- fied NPS mainly consist in cathinone derivatives. Nevertheless, there are variations in the kind of NPS used in 2017/2016: e.g. decrease of synthetic cannabinoids, increase of pipradol derivatives, emer- gence of alpha-PVP and isopropylphenidate. In addition, a global percentage of 8% (24 out of 300 in 2016) and 3% (3 out of 112 in 2017) of drivers initially roadside-tested negative for DOA were in fact driving under the influence of NPS. Even if these data only concern drivers who were submitted to a roadside drug testing and, thus cannot be extrapolated to the overall driver population, they highlight the reality of driving after NPS use in French and Belgian drivers. This issue emphasizes the limitation © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com e9 Downloaded from https://academic.oup.com/jat/article/43/2/e9/5257448 by guest on 18 August 2022