title: Analysis of anonymized pooled urine in nine UK cities: variation in classical recreational drug, novel psychoactive substance and anabolic steroid use.
abstract: BACKGROUND
  Analysis of anonymous pooled urine samples from street urinals has been used to demonstrate time-trends in the detection of classical recreational drugs and novel psychoactive substances (NPS).
  
  
  OBJECTIVE
  This study aimed to expand this to undertake a geographical trend analysis of classical recreational drugs/NPS across UK.
  
  
  METHODS
  Samples of anonymous pooled urine were collected from street urinals that had been in place for one night in April 2014 in nine cities across the UK. Collected samples were then analysed for the presence of recreational drugs, NPS anabolic steroids using high-performance liquid chromatography coupled to high-resolution accurate mass full-scan mass spectrometry and gas chromatography coupled to electron impact ionization mass spectrometry operating in selected ion monitoring and full-scan modes.
  
  
  RESULTS
  Ten classical recreational drugs, nine NPS and four anabolic steroids were detected across the nine cities; the range of detection was from 1 in Leeds to 14 in London. The most common classical drugs were cocaine (9 cities) and 3,4-methylenedioxy-methamphetamine (8 cities); the most common NPS was 4-methylmethcathinone (5 cities). In addition there was variation in the detection of NPS, with methylhexaneamine detected only in Bristol and London, piperazines (3-trifluoromethylphenylpiperazine and 1-benzylpiperazine) and pentedrone only detected in Birmingham and the cathinone methylone only detected in London.
  
  
  CONCLUSIONS
  There is variability in the detection of classical recreational drugs, NPS and anabolic steroids across UK, likely reflecting variation in their use. This technique can be used to supplement drug use surveys to determine geographical and time trends in the use of these substances. This is important to ensure appropriate targeting of drug-related interventions.
authors.affiliation: From the Clinical Toxicology Service Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.
authors.forename: J R H
authors.initials: JR
authors.lastname: Archer
authors.affiliation: Laboratory and Managed Services, LGC, Fordham, UK.
authors.forename: S
authors.initials: S
authors.lastname: Hudson
authors.affiliation: Hull York Medical School, Hull, UK and.
authors.forename: O
authors.initials: O
authors.lastname: Jackson
authors.affiliation: From the Clinical Toxicology Service Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.
authors.forename: T
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: From the Clinical Toxicology Service Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Lovett
authors.affiliation: From the Clinical Toxicology Service Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.
authors.forename: H M
authors.initials: HM
authors.lastname: Lee
authors.affiliation: From the Clinical Toxicology Service Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Rao
authors.affiliation: From the Clinical Toxicology Service Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.
authors.forename: L
authors.initials: L
authors.lastname: Hunter
authors.affiliation: From the Clinical Toxicology Service Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK, King's College London, London, UK.
authors.forename: P I
authors.initials: PI
authors.lastname: Dargan
authors.affiliation: From the Clinical Toxicology Service Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK, King's College London, London, UK David.Wood@gstt.nhs.uk.
authors.forename: D M
authors.initials: DM
authors.lastname: Wood
mesh_terms: D045930:Anabolic Agents / Q000652:urine; D035041:Anonymous Testing / Q000379:methods; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D003430:Cross-Sectional Studies; D006801:Humans; D013287:Illicit Drugs / Q000652:urine; D008297:Male; D011619:Psychotropic Drugs / Q000652:urine; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D014038:Toilet Facilities / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D045930:Anabolic Agents; D013287:Illicit Drugs; D011619:Psychotropic Drugs