title: Surveillance of emerging drugs of abuse in Hong Kong: validation of an analytical tool.
abstract: OBJECTIVE
  To validate a locally developed chromatography-based method to monitor emerging drugs of abuse whilst performing regular drug testing in abusers.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Eleven regional hospitals, seven social service units, and a tertiary level clinical toxicology laboratory in Hong Kong.
  
  
  METHODS
  A total of 972 drug abusers and high-risk individuals were recruited from acute, rehabilitation, and high-risk settings between 1 November 2011 and 31 July 2013. A subset of the participants was of South Asian ethnicity. In total, 2000 urine or hair specimens were collected.
  
  
  METHODS
  Proof of concept that surveillance of emerging drugs of abuse can be performed whilst conducting routine drug of abuse testing in patients.
  
  
  RESULTS
  The method was successfully applied to 2000 samples with three emerging drugs of abuse detected in five samples: PMMA (paramethoxymethamphetamine), TFMPP [1-(3-trifluoromethylphenyl)piperazine], and methcathinone. The method also detected conventional drugs of abuse, with codeine, methadone, heroin, methamphetamine, and ketamine being the most frequently detected drugs. Other findings included the observation that South Asians had significantly higher rates of using opiates such as heroin, methadone, and codeine; and that ketamine and cocaine had significantly higher detection rates in acute subjects compared with the rehabilitation population.
  
  
  CONCLUSIONS
  This locally developed analytical method is a valid tool for simultaneous surveillance of emerging drugs of abuse and routine drug monitoring of patients at minimal additional cost and effort. Continued, proactive surveillance and early identification of emerging drugs will facilitate prompt clinical, social, and legislative management.
authors.affiliation: Toxicology Reference Laboratory, Hospital Authority, Hong Kong.
authors.forename: Magdalene  H Y
authors.initials: M
authors.lastname: Tang
authors.affiliation: Toxicology Reference Laboratory, Hospital Authority, Hong Kong.
authors.forename: C K
authors.initials: CK
authors.lastname: Ching
authors.affiliation: Hong Kong Poison Information Centre, Hospital Authority, Hong Kong.
authors.forename: M L
authors.initials: ML
authors.lastname: Tse
authors.affiliation: Hong Kong Lutheran Social Service, the Lutheran Church - Hong Kong Synod, Homantin, Hong Kong.
authors.forename: Carol
authors.initials: C
authors.lastname: Ng
authors.affiliation: Toxicology Reference Laboratory, Hospital Authority, Hong Kong.
authors.forename: Caroline
authors.initials: C
authors.lastname: Lee
authors.affiliation: Toxicology Reference Laboratory, Hospital Authority, Hong Kong.
authors.forename: Y K
authors.initials: YK
authors.lastname: Chong
authors.affiliation: Toxicology Reference Laboratory, Hospital Authority, Hong Kong.
authors.forename: Watson
authors.initials: W
authors.lastname: Wong
authors.affiliation: Toxicology Reference Laboratory, Hospital Authority, Hong Kong.
authors.forename: Tony W L
authors.initials: TW
authors.lastname: Mak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000032:analysis; D003430:Cross-Sectional Studies; D005260:Female; D006197:Hair / Q000737:chemistry; D006306:Health Surveys; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis; D015994:Incidence; D008297:Male; D008694:Methamphetamine / Q000031:analogs & derivatives / Q000032:analysis; D008875:Middle Aged; D010879:Piperazines / Q000032:analysis; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D053719:Tandem Mass Spectrometry / Q000379:methods*; D014556:Urine / Q000737:chemistry; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D013287:Illicit Drugs; D010879:Piperazines; C106885:paramethoxymethamphetamine; C018406:1-(3-trifluoromethylphenyl)piperazine; D008694:Methamphetamine
keywords: Designer drugs; Hong Kong