New challenges and innovation in forensic toxicology: Focus on the “New Psychoactive Substances”

In the recent years, new molecules have appeared in the illicit market, claimed to contain “non-illegal” compounds, although exhibiting important psychoactive effects; this heterogeneous and rapidly evolving class of compounds are commonly known as “New Psychoactive Substances” or, less properly, “Smart Drugs” and are easily distributed through the e-commerce or in the so-called “Smart Shops”. They include, among other, synthetic cannabinoids, cathinones and tryptamine analogs of psylocin. Whereas cases of intoxication and death have been reported, the phenomenon appears to be largely underestimated and is a matter of concern for Public Health. One of the major points of concern depends on the substantial ineffectiveness of the current methods of toxicological screening of biological samples to identify the new compounds entering the market. These limitations emphasize an urgent need to increase the screening capabilities of the toxicology laboratories, and to develop rapid, versatile yet specific assays able to identify new molecules. The most recent advances in mass spectrometry technology, introducing instruments capable of detecting hundreds of compounds at nanomolar concentrations, are expected to give a fundamental contribution to broaden the diagnostic spectrum of the toxicological screening to include not only all these continuously changing molecules but also their metabolites. In the present paper a critical overview of the opportunities, strengths and limitations of some of the newest analytical approaches is provided, with a particular attention to liquid phase separation techniques coupled to high accuracy, high resolution mass spectrometry.

► The new psychoactive molecules escape the traditional toxicological screenings.
► For this reason, the phenomenon is underestimated in both the EU and the USA.
► High resolution mass spectrometry (HRMS) improves the spectrum of drug screening.
► The advantages and limitations of LC coupled to HRMS are discussed.
► Discussion is also extended to the matrix effect and to the methods to control it.