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Monitoring in the technological age

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Presentation on theme: "Monitoring in the technological age"— Presentation transcript:

1 Monitoring in the technological age
John Ramsey TICTAC Communications Ltd St. George’s, University of London London SW17 0RE

2 Monitoring in the technological age
Monitoring what ? drugs drug use drug users Technological age ? computing communications  TICTAC Communications Ltd.

3 The internet Mobile phones Websites The Google effect
Blogs, social networking Chat rooms Information sources EMCDDA Wikipedia Erowid News feeds Daily dose YouTube Sale of “Legal highs” Mobile phones Drug dealing Databases  TICTAC Communications Ltd.

4 Most of our information about drug use is from questionnaire based surveys
“Surveys provide an important window on some types of drug use, but need to be complemented with targeted studies and statistical modelling if a more comprehensive picture is to be produced.“ Sampling problems and response bias remain major problems for survey techniques Sensitivity to language differences  TICTAC Communications Ltd.

5 Indirect modelling “Indirect modelling of the unknown population from the observable population is complicated to achieve and requires a proportion of the population of interest to be observable in some fashion” Observe by analysis of :- drugs Police, Customs Test purchasing, Amnesty bins use of drugs (in biological samples) Treatment of poisoning Workplace drug testing in urine, oral fluid, hair impairment Field impairment tests Admission to hospital  TICTAC Communications Ltd.

6 Analytical capabilities
Laboratory based analytical techniques Mass spectrometry LC/MS/MS, High resolution Nuclear Magnetic Resonance (NMR) Field drug detection technologies Trace - Ion motility Bulk – IR, Raman Immunoassay Impairment testing  TICTAC Communications Ltd.

7 Analysis of drugs Law enforcement seizures Test purchasing
Police Customs Prisons Test purchasing Illegal drugs Legal drugs – “not illegal yet” Amnesty bin analysis Drugs surrendered on entry to clubs  TICTAC Communications Ltd.

8 25,000 samples in secure storage
TICTAC 25,000 samples in secure storage TICTAC collects legal & illegal drugs (at St. George’s University of London) to compile a database that is used by both Healthcare and Law & Order professionals

9 Analysis of biological samples
Treatment of poisoning blood, urine Treatment of addiction urine Workplace drug testing urine, oral fluid, hair Prison drug testing urine, oral fluid Law enforcement driving – blood, urine drug facilitated sexual assault – urine, blood  TICTAC Communications Ltd.

10 Oral fluid testing collection more ‘dignified’ than urine
detect drug closer to use issues: variability of collection devices variable volume variability of oral fluids stimulation changes pH cannabis detected from smoking availability of identical second sample for donor difficult to adulterate low levels different compounds detected (unchanged drug)  TICTAC Communications Ltd.

11 Hair Testing historical record (about 1cm per month)
detecting cannabis difficult issues: variable growth rates not all hairs in growth phase external contamination hair colour short / long hair low levels Natalie Portman as Sinéad O Connor  TICTAC Communications Ltd.

12 Drug screening relies on Immunoassay
Analytical procedure that uses antibodies raised in animals or cell cultures to detect or measure drugs implemented as simple dipstick tests or used in highly automated laboratory apparatus adding new drugs requires substantial investment in time and money needs large market before this becomes viable consequently new & emerging drugs are only detectable if they react with existing antibodies  TICTAC Communications Ltd.

13 new compounds are used as drugs because they fall outside legislation
The driver for change new compounds are used as drugs because they fall outside legislation the law catches up  TICTAC Communications Ltd.

14 Piperazines BZP MBZP DBZP TFMPP m-trifluoromethylphenylpiperazine mCPP
1-benzylpiperazine MBZP 1-methyl-4-benzylpiperazine DBZP dibenzylpiperazine TFMPP m-trifluoromethylphenylpiperazine mCPP m-chlorophenlypiperazine pMPP p-methoxyphenylpiperazine pFPP p-fluorophenlypiperazine  TICTAC Communications Ltd.

15 Gas Chromatography / Mass Spectrometry
routinely used for cocaine, heroin, amphetamine, ‘ecstasy’ and many other drugs general screening new drugs requires acquisition of a reference sample Cost of machine £50,000 Consumables relatively low cost Run time about 30 mins per sample plus 30 mins for standard Sensitivity High  TICTAC Communications Ltd.

16 New high sensitivity equipment new possibilities – but at a high cost
LC / MS / MS Liquid chromatography with tandem mass spectrometry Atmospheric pressure ionisation high resolution mass spectrometry DART Direct inlet Orbitrap LC interface with very high resolution mass spectrometry  TICTAC Communications Ltd.

17 tandem mass-spectrometry
LC / MS / MS Cost of machine £200,000 Consumables relatively low cost Run time about 10 mins per sample plus 10 mins for standard Sensitivity Very high tandem mass-spectrometry

18 Assessing illicit drugs in waste water
Potential and limitations of a new monitoring approach early days of the development of a new approach that appears to have considerable potential and may open up new possibilities for monitoring drug consumption trends additional tool that complements and extends the possibilities of existing approaches to the fundamentally difficult problem of monitoring a complex, hidden and stigmatised behaviour  TICTAC Communications Ltd.

19 Assessing illicit drugs in waste water
Identification and measurement of illicit drugs and their metabolites in urban wastewater by liquid chromatography–tandem mass spectrometry. Castiglioni S.,et al. Anal Chem 2006; 78: 8421–9. Analysis of cocaine and its principal metabolites in waste and surface water using solid-phase extraction and liquid chromatography–ion trap tandem mass spectrometry. Gheorghe A., et. al. Anal Bioanal Chem 2008; 391: 1309–19. Occurrence of psychoactive stimulatory drugs in wastewaters in north-eastern Spain. Huerta-Fontela M. et al. Sci Total Environ 2008; 397: 31–40. Multiresidue methods for the analysis of pharmaceuticals, personal care products and illicit drugs in surface water and wastewater by solid-phase extraction and ultra performance liquid chromatography–electrospray tandem mass spectrometry. Kasprzyk-Hordern B. et. al. Anal Bioanal Chem 2008; 391: 1293–308. Fully automated determination in the low nanogram per liter level of different classes of drugs of abuse in sewage water by on-line solid-phase extraction-liquid chromatography–electrospray-tandem mass spectrometry. Postigo C., et. al . Anal Chem 2008; 80: 3123–34. Illicit drugs, a novel group of environmental contaminants. Zuccato E. et.al. Water Res 2008; 42: 961–8. Estimating community drug abuse by wastewater analysis. Zuccato E., et. al. Environ Health Persp 2008; 116: 1027–32. Cocaine and metabolites in waste and surface water across Belgium. Nuijs A. L. N., et. al. Environ Pollut 2009; 157: 123–29.  TICTAC Communications Ltd.

20 Assessing illicit drugs in waste water
2009, Addiction, 104, 734–741 Wastewater analysis is a promising tool to evaluate cocaine consumption at both local and national scale. This rapid and direct estimation of the prevalence of cocaine use in Belgium corresponds with socioepidemiological data. However, the strategy needs to be refined further to allow a more exact calculation of cocaine consumption from concentrations of BE in wastewater.  TICTAC Communications Ltd.

21 time-of-flight mass spectrometer
DART™ new non-contact surface sampling technique for mass spectrometry at atmospheric pressure under ambient conditions analyse gases, liquid, solids & materials on surfaces DART on Joel AccuTOF Cost of machine £250,000 Consumables very low cost Run time about 1 min per sample Sensitivity Very high  time-of-flight mass spectrometer 

22 DART™

23 Orbitrap Thermo Scientific Exactive TM
Cost of machine £350,000 Consumables low cost Run time about 5 min per sample Sensitivity Very high Orbitrap Thermo Scientific Exactive TM Exact mass measurements of organic compounds General unknown screening atmospheric pressure ionisation high resolution, accurate mass measurements >10,000 at m/z 200 up to over 100,000 extracted ion chromatogram in very complex matrix high selectivity and sensitivity in full scan mode sample introduction by direct infusion or LC Potential to screen for compounds (even retrospectively) where we know the chemical structure but do not have a reference sample. e.g. cannabinoid receptor agonists  TICTAC Communications Ltd.

24 Spice Purports to be a herbal mixture
Damiana Wild Lettuce Skullcap Motherwort Red Clover Marshmallow Blue Lotus Baybean Pink Lotus Dwarf Skullcap Indian Warrior Lion’s Tail Maconha Brava White Lotus Siberian Motherwart Vanilla & Honey Contains cannabinoid receptor agonists Synthetic cannabis “Spice is an exotic incense blend of the highest quality herbs and herbal extracts . Unwind your mind! The only herbal smoke that actually works! anytime, anyplace...(except when operating heavy machinery)” JWH-018 HU-210 CP47497  TICTAC Communications Ltd.

25 Access to specialist equipment to address the increasing number of new synthetic drugs
NMR Nuclear Magnetic Resonance Spectroscopy 1 Hydrogen 13 Carbon 19 Fluorine  TICTAC Communications Ltd.

26 Nuclear Magnetic Resonance (NMR)
NMR (Bruker Avance 400 MHz) identification of new unknown compounds amphetamines, ‘ecstasy’, piperazines, beta keto derivatives quantitation of drugs in absence of reference sample drug comparisons cocaine Cost of machine £200,000 Consumables moderate cost Run time 30 mins or more per sample Sensitivity very Low Requires specialist to read the results  TICTAC Communications Ltd.

27 4-Fluoroamphetamine 1H 19F
NMR required to confirm the structure in the absence of a reference sample. 1H 19F  TICTAC Communications Ltd.

28 Transportable equipment for field testing
Bulk Infra red spectroscopy Xray immunoassay Trace Ion motility spectroscopy  TICTAC Communications Ltd.

29 Bulk identification Hazmat ID CBRN weapons or hazards
Tends to only identify major component of a mixture. e.g. impure cocaine identified as diluent (lactose), ketamine injection as water. ATR Spectral Library over 25,000 unique ATR spectra  TICTAC Communications Ltd.

30 GHB GHB GBL BDO

31 Trace detection passive drug dogs ion motility spectrometers
surfaces swabbed and analysed within 30 seconds Hands Phones Cars Premises  TICTAC Communications Ltd.

32 Portals used to detect metal, explosives, drugs
Metal detectors Xray Ion motility Drugs in the stomach Braun – Conpass Shows concealed items hidden on or inside a persons body Smiths - Bodyscan  TICTAC Communications Ltd.

33 Detection of indoor cannabis cultivation
odour of cannabis very high electricity consumption criminal gangs, bypass the problem by wiring directly - and often dangerously - into the electricity mains high heat output fire is a serious risk - cannabis farms often discovered as a result of fires  TICTAC Communications Ltd.

34 Thermal imaging to detect indoor cannabis cultivation
 TICTAC Communications Ltd.

35 Impairment testing In many situations it is more important to know if an individual is impaired than what is responsible for the impairment. Driving Workplace  TICTAC Communications Ltd.

36 Preliminary Impairment tests
Pupil size assessment Modified Romberg Balance Test Walk &Turn Test One Leg Stand Finger to Nose Test EyeCheck® digital pupillometer allegedly used by Law enforcement agencies employers to detect substance abuse by employees  TICTAC Communications Ltd.

37 British Crime Survey 2006 / 7 illegal drug use (England & Wales)
16-24 44.7% 24.1% 14.3% 16-59 35.5% 10.0% 5.9% Used in lifetime Used in last year Used in last month n = 28,784

38 Positivity rate for UK workplace drug tests
 % data set >12 years of analytical data >10m laboratory tests >700,000 samples


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