Фундаментал ва клиник тиббиёт ахборотномаси, 2022 №4

Maqola mavzusi



Абдуқахарова Гулноза Қурбановна, Ашуров Зариф Шарифович, Хайрединова Инара Илгизовна, Равшанов Жахонгир Азимжон ўғли


Тошкент тиббиёт академияси, Ўзбекистон, Тошкент ш.


Янги психофаол моддаларнинг (ЯПМ) пайдо бўлиши соғлиқни сақлашнинг катта эътиборини тортди ва ЯПМни қўллаш билан боғлиқ ўткир заҳарланиш ва ўлимлар ҳақида бир нечта хабарлар чоп этилди. Сўнгги йилларда дунё мамлакатлари қонунчилигида ушбу бирикмаларни истеъмол қилиш, сотиш ва синтез қилиш бўйича чуқур ўзгаришлар рўй берди. Тезкор огоҳлантириш тизимлари ҳам ривожланди, аммо дори ишлаб чиқарувчилар ва етказиб берувчилар ортда қолмади: асосан интернет орқали янги моддалар ва янги бозорлар пайдо бўлди. ЯПМнинг таъсири ва уларнинг фойдаланувчиларда қандай пайдо бўлиши ҳали ҳам номаълум, биринчи навбатда НПС дан тизимли фойдаланиш билан боғлиқ. Шарҳда ЯПМ таснифи, ЯПМни қўллаш билан боғлиқ асосий клиник таъсирлар ва Ўзбекистонда ЯПМ муаммосининг ҳолати кўриб чиқилади.

Kalit so'zlar

янги психоактив моддалар


  1. Arbo M.D., Bastos M.L., Carmo H.F. Piperazine compounds as drugs of abuse. Drug Alcohol Depend. 2012;122:174–185. doi: 10.1016/j.drugalcdep.2011.10.007.
  2. Argamany JR, Reveles KR, Duhon B. Synthetic cannabinoid hyperemesis resulting in rhabdomyolysis and acute renal failure. Am J Emerg Med 2016; 34: 765.e1–2.
  3. Armenian P, Darracq M, Gevorkyan J, et al. Intoxication from the novel synthetic cannabinoids AB Pinaca and ADB-Pinaca: a case series and review of the literature. Neuropharmacology 2018; 134: 82–91.
  4. Armstrong F, McCurdy MT, Heavner MS. Synthetic cannabinoid-associated multiple organ failure: case series and literature review. Pharmacotherapy 2019; 39: 508–513.
  5. Avellaneda-Ojeda A, Murtaza S, Shah AA, et al. Stimulant use disorders. Psychiatr Ann 2018; 48: 372– 378.
  6. Aydin G, Bakar B. Delayed intracerebral hemorrhage after synthetic cannabis (Bonsai) abuse; case report and literature review. Bull Emerg Trauma 2019; 7: 330–334.
  7. Bäckberg M, Tworek L, Beck O, et al. Analytically confirmed intoxications involving MDMB-CHMICA from the STRIDA project. J Med Toxicol 2017; 13: 52–60.
  8. Baumeister D, Barnes G, Giaroli G, et al. Classical hallucinogens as antidepressants? A review of pharmacodynamics and putative clinical roles. Ther Adv Psychopharmacol 2014; 4: 156–169.
  9. Bogenschutz MP, Podrebarac SK, Duane JH, et al. Clinical interpretations of patient experience in a trial of psilocybin-assisted psychotherapy for alcohol use disorder. Front Pharmacol 2018; 9: 100.
  10. Boland DM, Andollo W, Hime GW, et al. Fatality due to acute α-methyltryptamine intoxication. J Anal Toxicol 2005; 29: 394–397.
  11. Carpenter JE, Murray BP, Dunkley C, et al. Designer benzodiazepines: a report of exposures recorded in the National Poison Data System, 2014–2017. Clin Toxicol (Phila) 2019; 57: 282–286.
  12. Cherry SV, Rodriguez YF. Synthetic stimulant reaching epidemic proportions: flakka-induced STelevation myocardial infarction with intracardiac thrombi. J Cardiothorac Vasc Anaesth 2017; 31: e13–e14.
  13. Contrucci RR, Brunt TM, Inan F, et al. Synthetic cathinones and their potential interactions with prescription drugs. Ther Drug Monit 2020; 42: 75–82.
  14. Cooper ZD. Adverse effects of synthetic cannabinoids: management of acute toxicity and withdrawal. Curr Psychiatry Rep 2016; 18: 52.
  15. Crawford C, Boyd C, Avula B, et al. A public health issue: dietary supplements promoted for brain health and cognitive performance. J Altern Complement Med 2020; 26: 265–272.
  16. Davis C, Boddington D. Teenage cardiac arrest following abuse of synthetic cannabis. Heart Lung Circ 2015; 24: e162–e163.
  17. De Luca MA, Fattore L. Therapeutic use of synthetic cannabinoids: still an open issue? Clin Ther 2018; 40: 1457–1466.
  18. Dean BV, Stellpflug SJ, Burnett AM, et al. 2C or not 2C: phenethylamine designer drug review. J Med Toxicol 2013; 9: 172–178.
  19. Dolder PC, Schmid Y, Müller F, et al. LSD acutely impairs fear recognition and enhances emotional empathy and sociality. Neuropsychopharmacology 2016; 41: 2638–2646.
  20. Domingo O, Roider G, Stöver A, et al. Mitragynine concentrations in two fatalities. Forensic Sci Int 2017; 271: e1–e7.
  21. Dos Santos RG, Hallak JEC. Therapeutic use of serotoninergic hallucinogens: a review of the evidence and of the biological and psychological mechanisms. Neurosci Biobehav Rev 2020; 108: 423–434.
  22. El Balkhi S, Monchaud C, Herault F, et al. Designer benzodiazepines’ pharmacological effects and potencies: how to find the information. J Psychopharmacol 2020; 34: 1021–1029.
  23. Ellsworth JT. Spice, vulnerability, and victimization: synthetic cannabinoids and interpersonal crime victimization among homeless adults. Subst Abuse. Epub ahead of print 7 November 2019. DOI: 10.1080/08897077.2019.1686725.
  24. European Monitoring Centre for Drugs and Addiction Spotlight on… Synthetic cannabinoids. (accessed on 16 November 2021); Available online: https://www.emcdda.europa.eu/spotlights/synthetic-cannabinoids_en
  25. European Monitoring Centre for Drugs and Drug Addiction New Benzodiazepines in Europe–A Review. (accessed on 20 November 2021); Available online: https://www.emcdda.europa.eu/publications/rapidcommunications/new-benzodiazepines-europe-review_en
  26. Fattore L. Synthetic cannabinoids-further evidence supporting the relationship between cannabinoids and psychosis. Biol Psychiatry 2016; 79: 539–548.
  27. Fels H, Lottner-Nau S, Sax T, et al. Postmortem concentrations of the synthetic opioid U-47700 in 26 fatalities associated with the drug. Forensic Sci Int 2019; 301: e20–e28.
  28. Ford LT, Berg JD. Analytical evidence to show letters impregnated with novel psychoactive substances are a means of getting drugs to inmates within the UK prison service. Ann Clin Biochem 2018; 55: 673–678.
  29. Franzén L, Bäckberg M, Beck O, et al. Acute intoxications involving α-pyrrolidinobutiophenone (αPBP): results from the Swedish STRIDA project. J Med Toxicol 2018; 14: 265–271.
  30. Gonçalves J., Luís Â., Gallardo E., Duarte A.P. Psychoactive substances of natural origin: Toxicological aspects, therapeutic properties and analysis in biological samples. Molecules. 2021;26:1397. doi: 10.3390/molecules26051397.
  31. Gonçalves J.L., Alves V.L., Aguiar J., Teixeira H.M., Câmara J.S. Synthetic cathinones: An evolving class of new psychoactive substances. Crit. Rev. Toxicol. 2019;49:549–566. doi: 10.1080/10408444.2019.1679087.
  32. Guirguis A. New psychoactive substances: A public health issue. Int. J. Pharm. Pract. 2017;25:323–325. doi: 10.1111/ijpp.12313.
  33. Hearne E, Van Hout MC. “Trip-sitting” in the black hole: a netnographic study of dissociation and indigenous harm reduction. J Psychoactive Drugs 2016; 48: 233–242.
  34. Helander A, Bäckberg M, Signell P, et al. Intoxications involving acrylfentanyl and other novel designer fentanyls–results from the Swedish STRIDA project. Clin Toxicol (Phila) 2017; 55: 589–599.
  35. Hinshaw SP, Scheffler RM. The ADHD explosion: myths, medication, money, and today’s push for performance. New York, NY: Oxford University Press, 2014.
  36. Hoffman AF, Hwang EK, Lupica CR. Impairment of synaptic plasticity by cannabis, Δ 9 -THC, and synthetic cannabinoids. Cold Spring Harb Perspect Med. Epub ahead of print 27 May 2020. DOI: 10.1101/cshperspect.a039743.
  37. https://lex.uz/docs/2815342
  38. https://www.unodc.org/documents/scientific/NPS_leaflet_2016_Russian.pdf.
  39. https://www.unodc.org/LSS/Page/NPS.
  40. Hupli A. Cognitive enhancement with licit and illicit stimulants in the Netherlands and Finland: what is the evidence? Drugs Alcohol Today 2020; 20: 62–73.
  41. Hutton F. (ed.). Cultures of intoxication: ‘new’ psychoactive substances. In: Cultures of intoxication. Cham: Palgrave Macmillan, 2020, pp.87–110.
  42. Hvozdovich JA, Chronister CW, Logan BK, et al. Case report: synthetic cannabinoid deaths in state of Florida prisoners. J Anal Toxicol 2020; 44: 298–300.
  43. Ikeda A, Sekiguchi K, Fujita K, et al. 5-methoxy-N, N-diisopropyltryptamine-induced flashbacks. American Journal of Psychiatry. 2005. April 1;162(4): 815–815.
  44. Iwersen-Bergmann S, Lehmann S, Heinemann A, et al. Mass poisoning with NPS: 2C-E and BromoDragonFly. Int J Legal Med 2019; 133: 123–129.
  45. Joseph A, Lekas H-M, Manseau M, et al. A polydrug and psychosocial profile of synthetic cannabinoid use in a New York City community sample, 2016–2017. Subst Use Misuse 2019; 54: 282–287.
  46. Jovel A, Felthous A, Bhattacharyya A. Delirium due to intoxication from the novel synthetic tryptamine 5-MeO-DALT. J Forensic Sci 2014; 59: 844–846.
  47. Kamour A, James D, Spears R, et al. Patterns of presentation and clinical toxicity after reported use of alpha methyltryptamine in the United Kingdom. A report from the UK National Poisons Information Service. Clin Toxicol (Phila) 2014; 52: 192–197.
  48. Koch K, Auwärter V, Hermanns-Clausen M, et al. Mixed intoxication by the synthetic opioid U-47700 and the benzodiazepine flubromazepam with lethal outcome: pharmacokinetic data. Drug Test Anal. Epub ahead of print 10 April 2018. DOI: 10.1002/dta.2391.
  49. Kriikku P, Pelander A, Rasanen I, et al. Toxic lifespan of the synthetic opioid U-47,700 in Finland verified by re-analysis of UPLC-TOF-MS data. Forensic Sci Int 2019; 300: 85–88.
  50. Le Boisselier R, Alexandre J, Lelong-Boulouard V, et al. Focus on cannabinoids and synthetic cannabinoids. Clin Pharmacol Ther 2017; 101: 220–229.
  51. Li L, Vlisides PE. Ketamine: 50 years of modulating the mind. Front Hum Neurosci 2016; 10: 612.
  52. Lo Faro A.F., Di Trana A., La Maida N., Tagliabracci A., Giorgetti R., Busardò F.P. Biomedical analysis of New Psychoactive Substances (NPS) of natural origin. J. Pharm. Biomed. Anal. 2020;179:112945. doi: 10.1016/j.jpba.2019.112945.
  53. Luethi D., Liechti M.E. Designer drugs: Mechanism of action and adverse effects. Arch. Toxicol. 2020;94:1085. doi: 10.1007/s00204-020-02693-7.
  54. Majchrzak M, Celiński R, Kowalska T, et al. Fatal case of poisoning with a new cathinone derivative: αpropylaminopentiophenone (N-PP). Forensic Toxicol 2018; 36: 525–533.
  55. McAuley A, Yeung A, Goldberg DJ, et al. Emergence of novel psychoactive substance injecting associated with rapid rise in the population prevalence of hepatitis C virus. Int J Drug Policy 2019; 66: 30–37.
  56. Meireles V., Rosado T., Barroso M., Soares S., Gonçalves J., Luís Â., Caramelo D., Simão A.Y., Fernández N., Duarte A.P., et al. Mitragyna speciosa: Clinical, Toxicological Aspects and Analysis in Biological and Non-Biological Samples. Medicines. 2019;6:35. doi: 10.3390/medicines6010035.
  57. Miliano C, Serpelloni G, Rimondo C, et al. Neuropharmacology of new psychoactive substances (NPS): focus on the rewarding and reinforcing properties of cannabimimetics and amphetamine-like stimulants. Front Neurosci 2016; 10: 153.
  58. Morris H, Wallach J. From PCP to MXE: a comprehensive review of the non-medical use of dissociative drugs. Drug Test Anal 2014; 6: 614–632.
  59. Murray RM, Quigley H, Quattrone D, et al. Traditional marijuana, high-potency cannabis and synthetic cannabinoids: increasing risk for psychosis. World Psychiatry 2016; 15: 195–204.
  60. Nash C, Butzbach D, Stockham P, et al. A fatality involving furanylfentanyl and MMMP, with presumptive identification of three MMMP metabolites in urine. J Anal Toxicol 2019; 43: 291–298.
  61. Nelson M.E., Bryant S.M., Aks S.E. Emerging Drugs of Abuse. Emerg. Med. Clin. N. Am. 2014;32:1– 28. doi: 10.1016/j.emc.2013.09.001.
  62. Nielson EM, May DG, Forcehimes AA, et al. The psychedelic debriefing in alcohol dependence treatment: illustrating key change phenomena through qualitative content analysis of clinical sessions. Front Pharmacol 2018; 9: 132.
  63. Okujava M, Todua F, Janelidze M, et al. Pattern of MRI findings in ephedronic encephalopathy. In: Movement disorders. Vol. 32 Hoboken, NJ: Wiley, 2017, pp.805–949.
  64. Ozturk HM, Yetkin E, Ozturk S. Synthetic cannabinoids and cardiac arrhythmia risk: review of the literature. Cardiovasc Toxicol 2019; 19: 191–197.
  65. Pacher P, Steffens S, Haskó G, et al. Cardiovascular effects of marijuana and synthetic cannabinoids: the good, the bad, and the ugly. Nat Rev Cardiol 2018; 15: 151–166.
  66. Partridge E, Trobbiani S, Stockham P, et al. A case study involving U-47700, diclazepam and flubromazepam-application of retrospective analysis of HRMS data. J Anal Toxicol 2018; 42: 655–660.
  67. Pinterova N., Horsley R.R., Palenicek T. Synthetic Aminoindanes: A Summary of Existing Knowledge. Front. Psychiatry. 2017;8:236. doi: 10.3389/fpsyt.2017.00236.
  68. Prosser J.M., Nelson L.S. The toxicology of bath salts: A review of synthetic cathinones. J. Med. Toxicol. 2012;8:33–42. doi: 10.1007/s13181-011-0193-z.
  69. Qneibi M, Jaradat N, Hawash M, et al. Ortho versus meta chlorophenyl-2, 3-benzodiazepine analogues: synthesis, molecular modeling, and biological activity as AMPAR antagonists. ACS Omega 2020; 5: 3588– 3595.
  70. Ralphs R, Williams L, Askew R, et al. Adding spice to the porridge: the development of a synthetic cannabinoid market in an English prison. Int J Drug Policy 2017; 40: 57–69.
  71. Rosado T., Gonçalves J., Luís Â., Malaca S., Soares S., Vieira D.N., Barroso M., Gallardo E. Synthetic cannabinoids in biological specimens: A review of current analytical methods and sample preparation techniques. Bioanalysis. 2018;10:1609–1623. doi: 10.4155/bio-2018-0150.
  72. Ross S. Therapeutic use of classic psychedelics to treat cancer-related psychiatric distress. Int Rev Psychiatry 2018; 30: 317–330.
  73. Salahshour B, Sadeghi S, Nazari H, et al. Determining undeclared synthetic pharmaceuticals as adulterants in weight loss herbal medicines. Int J Med Toxicol Forensic Med 2020; 10: 26253.
  74. Shafi A., Berry A.J., Sumnall H., Wood D.M., Tracy D.K. New psychoactive substances: A review and updates. Ther. Adv. Psychopharmacol. 2020;10:204512532096719. doi: 10.1177/2045125320967197.
  75. Shearer K, Bryce C, Parsons M, et al. Phenazepam: a review of medico-legal deaths in South Scotland between 2010 and 2014. Forensic Sci Int 2015; 254: 197–204.
  76. Siddiqi S, Verney C, Dargan P, et al. Understanding the availability, prevalence of use, desired effects, et al. Clin Toxicol (Phila) 2015; 53: 54–59.
  77. Springer YP, Gerona R, Scheunemann E, et al. Increase in adverse reactions associated with use of synthetic cannabinoids-Anchorage, Alaska, 2015–2016. MMWR Morb Mortal Wkly Rep 2016; 65: 1108– 1111.
  78. Srisuma S, Bronstein AC, Hoyte CO. NBOMe and 2C substitute phenylethylamine exposures reported to the National Poison Data System. Clin Toxicol (Phila) 2015; 53: 624–628.
  79. Stoller A, Dolder PC, Bodmer M, et al. Mistaking 2C-P for 2C-B: what a difference a letter makes. J Anal Toxicol 2017; 41: 77–79.
  80. Sumnall H.R., Evans-Brown M., McVeigh J. Social, policy, and public health perspectives on new psychoactive substances. Drug Test. Anal. 2011;3:515–523. doi: 10.1002/dta.310.
  81. Suzuki J., El-Haddad S. A review: Fentanyl and non-pharmaceutical fentanyls. Drug Alcohol Depend. 2017;171:107–116. doi: 10.1016/j.drugalcdep.2016.11.033.
  82. Tabarra I., Soares S., Rosado T., Gonçalves J., Luís Â., Malaca S., Barroso M., Keller T., Restolho J., Gallardo E. Novel synthetic opioids–toxicological aspects and analysis. Forensic Sci. Res. 2019;4:111–140. doi: 10.1080/20961790.2019.1588933.
  83. Tait RJ, Caldicott D, Mountain D, et al. A systematic review of adverse events arising from the use of synthetic cannabinoids and their associated treatment. Clin Toxicol (Phila) 2016; 54: 1–13.
  84. Tracy DK, Wood DM, Baumeister D. Novel psychoactive substances: types, mechanisms of action, and effects. BMJ 2017; 356: i6848.
  85. ttps://lex.uz/acts/86028
  86. United Nations Office on Drugs and Crime . Current NPS Threats Volume II. UNODC; Vienna, Austria: 2020.
  87. United Nations Office on Drugs and Crime Early Warning Advisory on New Psychoactive Substances: NPS Substance Groups. (accessed on 17 November 2021). Available online: https://www.unodc.org/LSS/SubstanceGroup/GroupsDashboard?testType=NPS
  88. United Nations Office on Drugs and Crime Early Warning Advisory on New Psychoactive Substances: Synthetic Cathinones. (accessed on 19 November 2021). Available online: https://www.unodc.org/LSS/SubstanceGroup/Details/67b1ba69-1253-4ae9-bd93-fed1ae8e6802
  89. United Nations Office on Drugs and Crime Early Warning Advisory on New Psychoactive Substances: Phenethylamines. (accessed on 21 November 2021). Available online: https://www.unodc.org/LSS/SubstanceGroup/Details/275dd468-75a3-4609-9e96-cc5a2f0da467
  90. United Nations Office on Drugs and Crime Early Warning Advisory on New Psychoactive Substances: Tryptamines. (accessed on 8 December 2021). Available online: https://www.unodc.org/LSS/SubstanceGroup/Details/68c027b6-0ed9-4c07-a139-7f1ca7ffce84
  91. United Nations Office on Drugs and Crime Early Warning Advisory on New Psychoactive Substances: Synthetic Cannabinoids. (accessed on 8 December 2021). Available online: https://www.unodc.org/LSS/SubstanceGroup/Details/ae45ce06-6d33-4f5f-916a-e873f07bde02
  92. United Nations Office on Drugs and Crime Early Warning Advisory on New Psychoactive Substances: Phencyclidine-Type Substances. (accessed on 8 December 2021). Available online: https://www.unodc.org/LSS/SubstanceGroup/Details/6bf165ed-82e7-47e0-9eaa-daacc42d99cd
  93. United Nations Office on Drugs and Crime Early Warning Advisory on New Psychoactive Substances: Other substances. (accessed on 8 December 2021). Available online: https://www.unodc.org/LSS/SubstanceGroup/Details/01f2d3e0-91d1-4406-87db-e7129d40a371
  94. United Nations Office on Drugs and Crime The challenge of New Psychoactive Substances. (accessed on 3 November 2021). Available online: https://www.unodc.org/unodc/en/scientists/the-challenge-of-newpsychoactive-substances---global-smart-programme.html
  95. United Nations Office on Drugs and Crime What are NPS? (accessed on 13 November 2021). Available online: https://www.unodc.org/LSS/Page/NPS
  96. United Nations Office on Drugs and Crime. Current NPS threats. Volume II. January 2020, https://www.unodc.org/documents/scientific/Current_NPS_Threats_Volume_II_Web.pdf (accessed 18 April 2020).
  97. Van Hout MC, Hearne E. User experiences of development of dependence on the synthetic cannabinoids, 5f-AKB48 and 5F-PB-22, and subsequent withdrawal syndromes. Int J Ment Health Addict 2017; 15: 565–579.
  98. Varì M.R., Mannocchi G., Tittarelli R., Campanozzi L.L., Nittari G., Feola A., Ronchi F.U., Ricci G. New Psychoactive Substances: Evolution in the Exchange of Information and Innovative Legal Responses in the European Union. Int. J. Environ. Res. Public Health. 2020;17:8704. doi: 10.3390/ijerph17228704.
  99. Verma S, Kumar S, Kumar S. Design, synthesis, computational and biological evaluation of new benzodiazepines as CNS agents. Arab J Chem 2020; 13: 863–874.
  100. Walterscheid JP, Phillips GT, Lopez AE, et al. Pathological findings in 2 cases of fatal 25I-NBOMe toxicity. Am J Forensic Med Pathol 2014; 35: 20–25.
  101. White CM. The pharmacologic and clinical effects of illicit synthetic cannabinoids. J Clin Pharmacol 2017; 57: 297–304.
  102. Whitmore CA, Hopfer C. Youth club, prescription, and over-the-counter drug use. In: Kaminer Y, Winters KC. (eds) Clinical manual of youth addictive disorders. Washington, DC: The American Psychiatric Association Publishing, 2019, p.229.
  103. Wood DM, Sedefov R, Cunningham A, et al. Prevalence of use and acute toxicity associated with the use of NBOMe drugs. Clin Toxicol (Phila) 2015; 53: 85–92.
  104. Yırgın G, Ateş İ, Katipoğlu B, et al. Pulmonary embolism due to synthetic cannabinoid use: case report. Turk Kardiyol Dern Ars 2018; 46: 411–413.
  105. Zahnow R, McVeigh J, Bates G, et al. Motives and correlates of anabolic-androgenic steroid use with stimulant polypharmacy. Contemp Drug Probl 2020; 47: 118–135.
  106. 106. Zawilska JB, Wojcieszak J. An expanding world of new psychoactive substances–designer benzodiazepines. Neurotoxicology 2019; 73: 8–16.