title: Analysis of anonymous pooled urine from portable urinals in central London confirms the significant use of novel psychoactive substances.
abstract: OBJECTIVE
  Analysis of urine samples collected across a city centre, for the detection of novel psychoactive substances (NPS).
  
  
  METHODS
  Cross-sectional study of anonymized urine samples used for the analysis of classical recreational drugs, NPS and metabolites.
  
  
  METHODS
  Pooled urine samples collected from portable stand-alone four-person urinals across a city centre were analysed using full-scan accurate-mass high-resolution liquid chromatography coupled to tandem mass spectrometry. Data were processed against compound databases containing >1700 drug compounds and metabolites.
  
  
  RESULTS
  Seven established recreational drugs (3,4-methylenedioxyamphetamine, cocaine, cannabis, ketamine, 3,4-methylenedioxy-N-methylamphetamine, methamphetamine and amphetamine) and six potential NPS [hordenine (all 12 urinals), cathine (11), methylhexaneamine (9), 4-methylmethcathinone (6), methiopropamine and metabolites (2) and methoxetamine and metabolites (1)] were detected. Methylhexaneamine, methiopropamine and hordenine are currently uncontrolled in the UK, whereas methoxetamine is currently subject to a Temporary Class Drug Order. Metabolites of the anabolic steroid nandrolone were found in two urinals and trenbolone metabolites and clenbuterol in one urinal.
  
  
  CONCLUSIONS
  Analysis of pooled urine samples collected anonymously from stand-alone urinals in a large inner city can detect the use of recreational drugs, NPS and anabolic steroids. Metabolite detection indicates actual drug use, metabolism and elimination rather than simply discarded drugs in the urinals. This technique by confirming the actual drug(s) used has the potential to be additive to currently used datasets/key indicators providing more robust information for healthcare authorities, legislative and law enforcement on the drugs actually being used.
authors.affiliation: Medical Toxicology Office, 3rd Floor, Block C, South Wing, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK. john.archer@gstt.nhs.uk
authors.forename: J R H
authors.initials: JR
authors.lastname: Archer
authors.forename: P I
authors.initials: PI
authors.lastname: Dargan
authors.forename: S
authors.initials: S
authors.lastname: Hudson
authors.forename: D M
authors.initials: DM
authors.lastname: Wood
mesh_terms: D045930:Anabolic Agents / Q000032:analysis / Q000652:urine*; D035041:Anonymous Testing; D002853:Chromatography, Liquid / Q000379:methods*; D003430:Cross-Sectional Studies; D004784:Environmental Monitoring; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis / Q000652:urine*; D008099:Liver / Q000378:metabolism*; D008131:London / Q000453:epidemiology; D008297:Male; D011619:Psychotropic Drugs / Q000032:analysis / Q000652:urine*; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000379:methods*; D053719:Tandem Mass Spectrometry / Q000379:methods*; D014038:Toilet Facilities / Q000706:statistics & numerical data
chemical_list: D045930:Anabolic Agents; D013287:Illicit Drugs; D011619:Psychotropic Drugs