title: Detection of "bath salts" and other novel psychoactive substances in hair samples of ecstasy/MDMA/"Molly" users.
abstract: BACKGROUND
  Ecstasy (MDMA) in the US is commonly adulterated with other drugs, but research has not focused on purity of ecstasy since the phenomenon of "Molly" (ecstasy marketed as pure MDMA) arose in the US.
  
  
  METHODS
  We piloted a rapid electronic survey in 2015 to assess use of novel psychoactive substances (NPS) and other drugs among 679 nightclub/festival-attending young adults (age 18-25) in New York City. A quarter (26.1%) of the sample provided a hair sample to be analyzed for the presence of select synthetic cathinones ("bath salts") and some other NPS. Samples were analyzed using fully validated UHPLC-MS/MS methods. To examine consistency of self-report, analyses focused on the 48 participants with an analyzable hair sample who reported lifetime ecstasy/MDMA/Molly use.
  
  
  RESULTS
  Half (50.0%) of the hair samples contained MDMA, 47.9% contained butylone, and 10.4% contained methylone. Of those who reported no lifetime use of "bath salts", stimulant NPS, or unknown pills or powders, about four out of ten (41.2%) tested positive for butylone, methylone, alpha-PVP, 5/6-APB, or 4-FA. Racial minorities were more likely to test positive for butylone or test positive for NPS after reporting no lifetime use. Frequent nightclub/festival attendance was the strongest predictor of testing positive for MDMA, butylone, or methylone.
  
  
  CONCLUSIONS
  Results suggest that many ecstasy-using nightclub/festival attendees may be unintentionally using "bath salts" or other NPS. Prevention and harm reduction education is needed for this population and "drug checking" (e.g., pill testing) may be beneficial for those rejecting abstinence.
authors.affiliation: New York University Langone Medical Center, Department of Population Health, New York, NY, USA; Center for Drug Use and HIV Research, New York University College of Nursing, New York, NY, USA. Electronic address: joseph.palamar@nyumc.org.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Palamar
authors.affiliation: Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Orbassano, Turin, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Salomone
authors.affiliation: Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Orbassano, Turin, Italy; Dipartimento di Chimica, Università di Torino, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Vincenti
authors.affiliation: Center for Drug Use and HIV Research, New York University College of Nursing, New York, NY, USA; New York University College of Nursing, New York, NY, USA.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Cleland
mesh_terms: D000293:Adolescent; D000328:Adult; D000470:Alkaloids / Q000032:analysis; D000818:Animals; D055030:Drug Users; D005260:Female; D006197:Hair / Q000737:chemistry*; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis* / Q000737:chemistry; D008297:Male; D008694:Methamphetamine / Q000031:analogs & derivatives / Q000032:analysis; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000031:analogs & derivatives / Q000032:analysis*; D009519:New York City; D057566:Self Report; D019966:Substance-Related Disorders / Q000378:metabolism*; D011795:Surveys and Questionnaires; D053719:Tandem Mass Spectrometry; D055815:Young Adult
chemical_list: D000470:Alkaloids; D013287:Illicit Drugs; D008694:Methamphetamine; C023665:cathinone; D018817:N-Methyl-3,4-methylenedioxyamphetamine; C400939:methylone
keywords: Dance festivals; Ecstasy; Nightclubs; Novel psychoactive substances; Synthetic cathinones