title: Parachuting: a dangerous trend in recreational psychoactive substance delivery.
abstract: Medicine diversion for recreational use is a constant concern for health authorities. Parachuting, also refered to as bombing, is used in order to increase the expected effect, to accelerate time-to-onset and to create mixtures of medicines and substances. Aeras covered: Firstly, we analyzed all available scientific literature (PRISMA) and internet forums without any limiting timeframe. Secondly, we collected cases of parachuting reported in the west of France by the addictovigilance and poison control centres. Our study confirms the reality of this emerging issue associated with a higher medical risk (60% of intoxication cases were moderate-to-severe in our study). The substances involved in parachuting were primarily stimulants, with a majority of MDMA, although the use of diverted medication and psychotropes is also of concern. Expert opinion: Parachuting is a dangerous way of using substances and of diverting medicines. This type of administration gives users a certain pharmacokinetic latitude to 'play' with respect to substances and medicines. Medicine abuse deterrent formulations do not seem to be sufficient in preventing diversions. This dangerous method of using substances and of diverting medicines should drive pharmaceutical companies to innovate in the interest of public health and safety.
authors.affiliation: a Poison Control Center , Angers University Hospital , Angers , France.|b EA 4275, SPHERE, Methods for Patients-centered outcomes and Health Research , Nantes University Hospital , Nantes , France.
authors.forename: David
authors.initials: D
authors.lastname: Boels
authors.affiliation: b EA 4275, SPHERE, Methods for Patients-centered outcomes and Health Research , Nantes University Hospital , Nantes , France.|c Addictology and Psychiatry Department , Nantes University Hospital , Nantes , France.
authors.forename: Marie
authors.initials: M
authors.lastname: Grall-Bronnec
authors.affiliation: d Pharmacology Department - Addictovigilance , Nantes University Hospital , Nantes , France.
authors.forename: Marylène
authors.initials: M
authors.lastname: Guerlais
authors.affiliation: a Poison Control Center , Angers University Hospital , Angers , France.
authors.forename: Gael
authors.initials: G
authors.lastname: Le Roux
authors.affiliation: d Pharmacology Department - Addictovigilance , Nantes University Hospital , Nantes , France.
authors.forename: Andrew
authors.initials: A
authors.lastname: Spiers
authors.affiliation: d Pharmacology Department - Addictovigilance , Nantes University Hospital , Nantes , France.
authors.forename: Marie
authors.initials: M
authors.lastname: Gerardin
authors.affiliation: d Pharmacology Department - Addictovigilance , Nantes University Hospital , Nantes , France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Lomenech
authors.affiliation: a Poison Control Center , Angers University Hospital , Angers , France.
authors.forename: Marie
authors.initials: M
authors.lastname: Bretaudeau-Deguigne
authors.affiliation: e Pharmacology Department , Bordeaux University Hospital , Bordeaux , France.
authors.forename: Amélie
authors.initials: A
authors.lastname: Daveluy
authors.affiliation: f Pharmacology Department - Laboratory , Angers University Hospital , Angers , France.
authors.forename: Alain
authors.initials: A
authors.lastname: Turcant
authors.affiliation: b EA 4275, SPHERE, Methods for Patients-centered outcomes and Health Research , Nantes University Hospital , Nantes , France.|d Pharmacology Department - Addictovigilance , Nantes University Hospital , Nantes , France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Jolliet
authors.affiliation: b EA 4275, SPHERE, Methods for Patients-centered outcomes and Health Research , Nantes University Hospital , Nantes , France.|d Pharmacology Department - Addictovigilance , Nantes University Hospital , Nantes , France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Victorri-Vigneau
mesh_terms: D002491:Central Nervous System Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002626:Chemistry, Pharmaceutical; D006801:Humans; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D019966:Substance-Related Disorders / Q000453:epidemiology*
chemical_list: D002491:Central Nervous System Agents; D004364:Pharmaceutical Preparations
keywords: Parachuting; abuse; bombing; diversion; drug formulation; tampering