How can I buy cocaine online in Kuala Lumpur

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How can I buy cocaine online in Kuala Lumpur

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How can I buy cocaine online in Kuala Lumpur

Official websites use. Share sensitive information only on official, secure websites. Correspondence: xli urban. Southeast Asian countries including Malaysia play a major role in global drug trade and abuse. Use of amphetamine-type stimulants has increased in the past decade in Malaysia. This study aimed to apply wastewater-based epidemiology for the first time in Kuala Lumpur, Malaysia, to estimate the consumption of common illicit drugs in urban population. Influent wastewater samples were collected from two wastewater treatment plants in Kuala Lumpur in the summer of Concentrations of twenty-four drug biomarkers were analyzed for estimating drug consumption. Among the monitored illicit drugs, 3,4-methylenedioxy-methamphetamine MDMA or ecstasy had the highest estimated per capita consumptions. Consumption and dose of amphetamine-type stimulants methamphetamine and MDMA were both an order of magnitude higher than those of opioids heroin and codeine, methadone and tramadol. Amphetamine-type stimulants were the most prevalent drugs, replacing opioids in the drug market. The prevalence trend measured by wastewater-based epidemiology data reflected the shift to amphetamine-type stimulants as reported by the Association of Southeast Asian Nations Narcotics Cooperation Center. Most of the undetected drug residues were new psychoactive substances NPSs , suggesting a low prevalence of NPSs in the drug market. According to the United Nations Office on Drug and Crime, both the range of drugs and drug markets are consistently expanding and diversifying more than ever before \[ 1 \]. Production of opium and manufacturing of cocaine are at the highest levels ever recorded, and markets for cocaine and methamphetamine are extending beyond their usual regions \[ 1 \]. Southeast Asian countries including Malaysia play a major role in global drug trade and abuse \[ 2 , 3 \]. Together with trafficking activities, the use of illicit drugs causes a major problem in Southeast Asian countries, with an increasing rate of drug use in Malaysia \[ 4 \]. Opioids i. As a popular club drug, use of ketamine has also increased in recent years \[ 2 \]. In order to formulate appropriate evidence-based public health and law enforcement policies to protect the public from adverse effects of drug abuse, it is important to have timely and accurate information about the prevalence of drug consumption in the population \[ 6 \]. Over the last decade, wastewater-based epidemiology, a cost-effective approach to monitor total drug consumption in the population, has been widely applied across Europe \[ 7 , 8 , 9 , 10 \], North America \[ 11 , 12 \], Australia \[ 13 , 14 , 15 \] and Asia \[ 16 , 17 , 18 \]. After years of development, results of wastewater-based epidemiology studies have been adopted as complementary approaches for monitoring drug consumption by authorities in some countries \[ 19 \]. A synchronized global wastewater-based epidemiology study can provide rapid, objective and up-to-date information to display a world map of drug use \[ 20 \]. It can be especially useful in supporting drug use evaluation and in comparing different countries and regions from a global perspective. Such vision can be achieved with more wastewater-based epidemiology studies conducted in countries where traditional surveys are difficult to be done. For example, Archer et al. Causanilles et al. Subedi et al. Addressing the illicit drug problem is the top priority of Malaysian authorities \[ 24 \], which requires good estimates of illicit drug consumption as a prerequisite for planning any drug control measures. However, the illicit nature of drug use and the cultural and social stigma against drug addicts in Asia have so far prevented relevant authorities to obtain good estimates of illicit drug consumption in Malaysia. Wastewater-based epidemiology could be used as a complementary monitoring approach, as it provides the total population consumption without revealing any individual information \[ 25 \]. A recent report on the contemporary drug policy of the region has recommended the use of wastewater-based epidemiology to improve illicit drug demand estimates \[ 26 \]. Thus, the objective of this work was to obtain, for the first time, a snapshot of the level and profile of illicit drug use in Kuala Lumpur, the capital city of Malaysia, using a wastewater-based epidemiology approach. Wastewater samples were collected from an urban, dense residential community and analyzed for 24 drug biomarkers covering a range of common illicit drugs. Consumption of drugs was estimated and compared with data available in the literature to evaluate the drug use situation in Malaysia. The selected targets covered a range of common illicit drugs that are prevalent in Asia, including Malaysia, and most other countries around the world. Having those drugs analyzed in this study facilitated the comparison with previous studies. WWTP-A WWTP-B WWTP-B serves a hospital where illicit drug consumption is not expected. Samples on weekends were not collected in both WWTPs because entry was denied during this period. Twenty-four-hour time-proportional composite samples were collected through auto-samples programmed to draw 1 L per hour in each WWTP. Sample pretreatment and analysis followed the procedure described in previous publications \[ 27 , 28 \] with minor modifications. The sample was loaded to the conditioned Oasis MCX cartridge under vacuum at the same flow rate. The final extract was filtered through a 0. The mobile phase was composed of 30 mM ammonium formate in ultrapure water, with pH adjusted to 3. The elution gradient was as follows: 0—0. The quantification of the mass spectrometry MS system was operated in multiple reaction monitoring MRM mode. Details of MS parameters declustering potential, collision energy, quantifier and qualifier ions , IS and retention time are described in Table S2. The analytical procedures were subjected to strict quality control and quality assurance measures. The limit of detection LOD , limit of quantification LOQ , recoveries, matrix effects, repeatability and reproducibility were examined according to previously established protocol \[ 29 \]. The recoveries and matrix effects of target compounds ranged from More details can be found in the Supplementary Materials Table S3. The daily mass load of each drug residue per inhabitants at a specific WWTP was estimated by Equation 1. The human excretion factors of the target drug are shown in Table S4. Uncertainties involved in the above estimation process have been discussed in previous studies \[ 30 , 31 \]. The Kolmogorov—Smirnov K-S test was employed for a normal test before other analyses. Pearson correlation analysis was used to assess the correlation between loads of the unchanged parent and metabolite. This suggested that the drug residues measured in our samples were primarily from human consumption rather than from random dumping. Emerging illicit drugs such as cathinone, p-methoxymethamphetamine, methylone, mephedrone, 4-iodo-2,5-dimethoxyphenethylamine, 3,4-methylenedioxypyrovalerone, benzylpiperazine, 3-trifluoromethylphenylpiperazine, 1- 3-chloro-phenyl piperazine and low-dose fentanyl were not detected. The results indicated that the use of these new psychoactive substances was not as prevalent as the other common illicit drugs in the studied area. For the discussion of illicit drug consumption in the community, only data from WWTP-A were used, as they are representative of a large population of Kuala Lumpur where people could have easier access to drug and locations for drug use than inside the hospital served by WWTP-B. Our monitoring study estimated the consumption of common illicit drugs such as MDMA, methamphetamine, ketamine, cocaine, heroin as well as prescribed drugs prone to abuse such as codeine, tramadol and methadone. As shown in Table 3 , MDMA, methamphetamine and ketamine were the three most popular illicit drugs consumed in this population. This finding was in agreement with the recent report in which methamphetamine, MDMA and ketamine were listed as synthetic drugs of concern in the region \[ 26 \]. The mean MDMA consumption in this study was much higher than those reported in other countries Figure 1. This result suggested that Malaysia is not only a substantial point of entry for MDMA to the regional market \[ 26 \] but also a large consumer of this drug. Consumption of methamphetamine and ketamine measured by wastewater-based epidemiology in Kuala Lumpur was also higher than in most cities around the world Figure 1. These results indicated that synthetic drugs were highly prevalent in the city. It could be explained by the fact that Kuala Lumpur is located in one of the most important trafficking routes of synthetic drugs in Southeast Asia \[ 21 , 22 \]. In general, the profile of illicit drug consumption of Kuala Lumpur was different to that of other cities around the world. For example, although the levels of methamphetamine consumptions were similar between this study and two cities in South Africa \[ 18 \], the prevalence of MDMA was significantly higher in Kuala Lumpur, while cocaine consumption was popular in the South African cities Figure 1. Heroin and codeine are two traditional opiates. It can be metabolized into morphine by the human body. Thus, we assumed the morphine measured in the influent samples was from heroin consumption because the morphine from actual codeine consumption was within the range of measurement error of morphine loads. Meanwhile, morphine was not mentioned as a substance of abuse in any reports about illicit drugs in Malaysia. This assumption will get an overestimated value, but it is acceptable within the allowable range of error. Obviously, it was not as prevalent as the mentioned drugs in Kuala Lumpur, and the low consumption was consistent with the low levels of seizures cocaine in Malaysia \[ 48 \]. In , traditional surveys showed that the prevalence of drug abuse in Malaysia has been shifting from opiates to amphetamine-type stimulants \[ 24 \]. The number of users of methamphetamine and MDMA have substantially increased while that of opiate users has decreased, especially heroin users Table S5 \[ 24 \]. Furthermore, recent data of amphetamine-type stimulants showed seizures were two orders of magnitude higher than that of opiates and synthetic opioids in recent years \[ 23 , 48 \]. However, the survey and seizure data showed indirect and delayed information of drug use rather than the actual drug consumption \[ 49 \]. Wastewater-based epidemiology estimated that amphetamine-type stimulant methamphetamine and MDMA consumption and doses were both an order of magnitude higher than those of opioids heroin and codeine, methadone and tramadol , even if the consumption of heroin was overestimated Table 3. The wastewater-based epidemiology-estimated profile of drug use reflected the changing profile of drug use and trafficking recorded by the traditional methodologies in Malaysia. This result implied that wastewater-based epidemiology could assess the prevalence and consumption of drug use more specifically, objectively and in real-time, which in turn indicated a good response of wastewater-based epidemiology to the change of profile of drug use compared to traditional monitoring approaches. The limitations of the back-estimation process by wastewater-based epidemiology have been discussed in detail elsewhere \[ 30 , 50 , 51 \]. Most notably, wastewater-based epidemiology cannot provide information on prevalence and frequency of use, characteristics and types of consumers as well as the purity of drugs. Illegal synthesis processes used for the manufacturing of these drugs or dumping can also overestimate the final estimates if the parent compounds are used as biomarkers for back-estimation. Because of the limited numbers of samples and WWTPs, the findings in this study can be considered as preliminary for the urban area of Kuala Lumpur. Further research in the field should be conducted to get spatial-temporal variations and involve more communities in Southeast Asian countries for longer sampling periods. Using wastewater-based epidemiology, this study provides the first objective snapshot of local drug use in a population of Kuala Lumpur, Malaysia. MDMA had the highest estimated per capita consumption, and it was higher than most other countries around the world. The amphetamine-type stimulants methamphetamine and MDMA were the most prevalent drugs, replacing opioids in the drug market. The prevalence trend measured by wastewater-based epidemiology data reflected the shift to amphetamine-type stimulants, as reported by the traditional survey data in Malaysia. This study can guide and promote future wastewater-based epidemiology monitoring in Southeast Asia, and it can provide additional understanding of the drug market for the authorities. The authors are extremely thankful to all the personnel at the sampled wastewater treatment plants for their assistance in wastewater sampling. All authors have read and agreed to the published version of the manuscript. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Find articles by Peng Du. Find articles by Xin Liu. Find articles by Guangcai Zhong. Find articles by Zilei Zhou. Find articles by Margaret William Thomes. Find articles by Choon Weng Lee. Find articles by Chui Wei Bong. Find articles by Xuan Zhang. Find articles by Fanghua Hao. Find articles by Xiqing Li. Find articles by Gan Zhang. Find articles by Phong K Thai. Open in a new tab. Click here for additional data file. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. 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How can I buy cocaine online in Kuala Lumpur