Mass spectrometric investigation of intoxications with plant-derived psychoactive substances

Abstract: The flora of the world contains many plants and fungi with stimulant, hallucinogenic and narcotic effects. For centuries, many of these have been used in initiation rites, physical and spiritual healing and rites of divination. Many of the plants are not placed under any restrictions regarding their use and sale and, with use of the Internet, they are easily obtained. LC-MS/MS and GC-MS methods were developed and used for the detection of 12 plantderived psychoactive substances, in urine samples, in cases of intoxication. The investigated substances were: asarones, atropine, DMT, ephedrine, harmaline, harmine, ibogaine, LSA, mescaline, psilocin, scopolamine and yohimbine. Urine samples (n=462) from patients admitted to the Maria youth clinic were analyzed for the presence of mescaline. No samples were positive for mescaline, but the method was validated using a clinical sample from a German intoxication case. Urine samples (n=103) from patients admitted to emergency departments all over Sweden were investigated for all 12 substances included in this study. All patients either admitted intake of a psychoactive plant substance or were suspected thereof. In 41 of the 103 samples at least one of the investigated substances was present. The most common substance was psilocin, found in 22 urine samples. Mydriasis, tachycardia, visual hallucinations, nausea and vomiting were the symptoms most often reported. These symptoms can be regarded as minor or moderate in terms of severity. The results suggest a low occurrence of psychoactive plant use in Sweden. Studies were done in attempt to elucidate the metabolic pattern of α- and b-asarone in humans. Cis(b)-2,4,5-trimethoxycinnamic acid was regarded to be the most abundant metabolite, evidence of a hydroxylated metabolite, thought to be hydroxylated b-asarone, was also found. Today these substances are often marketed on the Internet as safe and legal highs , which may lead to an increased use and calls for continuous investigation into psychoactive plant intoxications.