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Police in New Zealand are racing to trace sweets containing 'potentially lethal levels of methamphetamine' after they were distributed by a charity in Auckland. Up to people may have received the sweets from Auckland City Mission as part of a food parcel, said the anti-poverty charity. The sweets were donated anonymously by a member of the public in a sealed retail package, it added. At least three people, including a child, sought medical attention afterwards though none are currently in hospital. The charity alerted the authorities on Tuesday after being alerted by a recipient about the 'funny tasting' sweets. Helen Robinson, chief executive of Auckland City Mission, said that some of the charity's staff members tried the sweets themselves and agreed with the complaints, and started to 'feel funny' afterwards. They then sent sweets that were still on site to the NZ Drug Foundation for tests, which confirmed that potentially lethal levels of methamphetamine were contained in the samples. In a statement, the foundation said they found about 3g of methamphetamine in a sweet that was sent for testing. Methamphetamine can cause chest pain, racing heart, seizures, hyperthermia, delirium and loss of consciousness, according to the foundation. According to Ms Robinson, the mission distributes around 50, food parcels a year and only commercially manufactured food are included in these parcels. Police have asked people that have sweets wrapped in brand Rinda's yellow pineapple flavour packaging to contact them immediately. Describing it as a 'deeply concerning' matter, he said that such cases of food laced with meth had happened before and they would likely work with Interpol on the investigation, which may take some time. Rinda, a Malaysian confectioner, told BBC News that it has come to their attention that their products may have been misused in connection with illegal substances and the company 'does not use or condone the use of any illegal drugs' in their products. The authorities are still trying to understand the scale of the spread. Up to people have been contacted by the charity. Ms Robinson said the sweets likely came into the charity's posession in about mid-July, but that they are calling everyone as far back as 1 July to be safe. Ben Birks Ang, deputy director of the NZ Drug Foundation, said the organisation believes the incident was unlikely to be intentional as 'disclosing substances as something else to smuggle it into another area is common'. Ms Robinson said she had contacted other charities to check for their sweets. Additional reporting by Peter Hoskins from Singapore. Skip to content. US Election. NZ charity unknowingly distributes meth-laced sweets. The Auckland City Mission. The sweets were included in food parcels distributed by anti-poverty charity Aukland City Mission. New Zealand Drug Foundation. But there are still fears that other charities could be affected. New Zealand.

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Novel psychoactive substances NPS refer to synthetic compounds or derivatives of more widely known substances of abuse that have emerged over the last two decades. Case reports suggest that users combine substances to achieve desired psychotropic experiences while reducing dysphoria and unpleasant somatic effects. However, the pattern of combining NPS has not been studied on a large scale. Here, we show that posts discussing NPS describe combining nootropics with sedative-hypnotics and stimulants with plant hallucinogens or psychiatric medications. Discussions that mention sedative-hypnotics most commonly also mention hallucinogens and stimulants. We analyzed 20 years of publicly available posts from Lycaeum, an Internet forum dedicated to sharing information about psychoactive substance use. We used techniques from natural language processing and machine learning to identify NPS and correlate patterns of co-mentions of substances across posts. We found that conversations mentioning synthetic hallucinogens tended to divide into those mentioning hallucinogens derived from amphetamine and those derived from ergot. Conversations that mentioned synthetic hallucinogens tended not to mention plant hallucinogens. Conversations that mention bath salts commonly mention sedative-hypnotics or nootropics while more canonical stimulants are discussed with plant hallucinogens and psychiatric medications. Our results provide the largest analysis to date of online descriptions of patterns of polysubstance use and further demonstrate the utility of social media in learning about trends in substance use. We anticipate this work to lead to a more detailed analysis of the knowledge contained online about the patterns of usage and effects of novel psychoactive substances. Novel psychoactive substances NPS refer to novel synthetic compounds or derivatives of more widely known substances of abuse that have emerged over the last two decades 1. Examples include derivatives of cannabis, substituted phenylethylamines, or cathinones bath salts. The term NPS may include substances used by other cultures, but new to Western users, such as khat the progenitor of bath salts , kratom, or Salvia. The increasing use of NPS is linked with the rise of social media as a means to discuss NPS use and distribute the actual product 2. The use of NPS is a public health concern. Use of substituted amphetamines is associated with sudden cardiac death and renal failure 3. Use of bath salts is associated with acute and persistent psychosis 3. Use of tryptamine derivatives is associated with psychosis and long-term psychiatric impairment, including anxiety and paranoia 4. The authors could find no study in the literature quantifying the impact of novel psychoactive substances in terms of disease-adjusted life years or monetary impact. Chemical analyses of novel psychoactive substances voluntarily submitted by users suggest that novel psychoactive substances are frequently consumed with other substances rather than in isolation 5. A combination of substances may have fewer side effects than any individual substance. This combination was first described in the early s, a few years after MDMA became more widely available 7. MDMA is also known to be combined with other amphetamines, alcohol, and synthetic cannabinoids 8. Reports of polysubstance use may also reflect contamination during clandestine manufacture and dissemination. Social media have emerged as informative sources of data for tracking behavior in the general population. Adolescents and young adults, the most widely described consumers of NPS 3 , 9 , frequently communicate candidly online. Whether the quality of data from social media allows is similar to that from more traditional means of syndromic surveillance is still being established. Credible doses of dextromethorphan can be inferred from YouTube comments Estimates of the geographic distribution of opioid misuse across the United States from Twitter have outstanding agreement with those from the National Survey on Drug Usage and Health Language on Twitter correlates with the geographic distribution of heart disease Traditional means of syndromic surveillance are difficult to apply to the epidemiology of novel psychoactive substances. National surveys, such as the National Survey on Drug Usage and Health, occur once a year and involve in-person interviews. Analyses of calls to poison control centers or encounters with health care providers provide a biased picture of the patterns of NPS usage. Demonstrate that data concerning polysubstance use could be extracted from online user posts. Demonstrate that from these data we could infer novel as well as known combinations of substances. Inferring known combinations of substances will bolster the credibility of online posts as a source of this type of data. Our approach was to use techniques from natural language processing and Big Data to analyze Lycaeum. Lycaeum is a website and Internet forum dedicated to promoting information about psychoactive substances We wrote software in the programming language Python 14 to extract user posts from Lycaeum, identify novel psychoactive substances, and analyze the content of the posts. We included only public posts for analysis. We omitted posts that were marked as deleted or flagged by the moderator. We lemmatized the posts and removed stopwords using nltk , the Python Natural Language Toolkit Lemmatization refers to the conversion of all lexical and semantic variants of a word to one base form. One lemmatizes, for example, reading, reads , and reader to read. Lemmatization is one way to move from the actual unstructured text to a tractable representation of the underlying semantics. Removing stopwords is a common approach to make the frequency of words more accurately approximate the relative prevalence of concepts in a piece of text. We used a three-step process to identify substances. We used nltk to identify all nouns before lemmatization. Authors MC and AM each individually manually curated this list to identify those nouns that likely referred only to drugs. Only nouns that were identified by both AM and MC as likely relating only to drugs were used for subsequent analysis. Author DY cross-referencing this list with Wikipedia, PubChem, and DrugBank to provide the standard spelling and a list of synonyms for each potential substance. This cross-referencing, for example, mapped xanny , a variant of Xanax to alprazolam. Authors DY and MC annotated each drug as to its drug class. We considered the following classes: sedative-hypnotic, hallucinogen, stimulant, nootropic, psychiatric, anticholinergic, analgesic, antipyretic, antiemetic, antihypertensive, cannabinoid, or contaminant. We then calculated the correlation between the patterns of mention of all pairs of drugs across the Lycaeum corpus. Expressed another way, we treated each drug as a multidimensional vector. Each dimension corresponds to a post. The correlation between any two drugs over posts is the cosine of the angle formed between the two corresponding vectors. This equation is adapted from Ref. We obtained a threshold for statistical significance for the correlation between drug a and drug b, r a , b , by randomly shuffling the drug-post matrix 10, times and recalculating all drug pair correlations to derive an empiric probability distribution function for r a , b. The 20 most frequently mentioned substances included common hallucinogens, stimulants, sedative-hypnotics, as well as, interestingly, sound Figure 1. The x -axis in Figure 1 shows the number of posts that mention the substance at least once. In the following paragraphs, we discuss some of these substances in detail as they may be unfamiliar to the reader. Figure 1. Top 20 most frequently mentioned substances. We amalgamated the phrases binaural beats, binaural sound , and binaural music onto the token sound. All these refer to the presentation to each ear of pure-tone sine waves differing only by frequency. Posts to Lycaeum frequently described listening to binaural beats while using substances to enhance the experience. Binaural sound may enhance concentration on a task when compared to silence It has not been demonstrated to alter emotional arousal The authors could find no study investigating the combination of binaural sound with any psychoactive substance, despite its prevalence in our data set. We excluded mentions of binaural beats from subsequent analyses as the focus of this study was on drug—drug combinations. It is unclear why posts mentioned these sounds so frequently. A detailed analysis of the context in which binaural beats were mentioned was beyond the scope of this study. LSD lysergic diethyl amide is a canonical hallucinogen Salvia, i. Diazepam is a benzodiazepine sedative-hypnotic sold in the US under the trade name Valium. Ingesting diazepam along with a hallucinogen may mitigate the anxiety, dysphoria, or rapid heart rate associated with some hallucinogens. The administration of benzodiazepines is part of the initial treatment of symptomatic overdoses of hallucinogens Ethanol and caffeine are widely consumed psychoactive substances. MDMA 3,4-methylenedioxymethamphetamine; also called ecstasy is the canonical entactogen—empathogen, a substance that enhances feelings of closeness, bondedness, empathy, and sexual attraction DMT N,N -dimethyltryptamine is a hallucinogenic derivative of tryptamine. It is considered the main psychoactive compound in hallucinogenic plants such as Mimosa tenuiflora 24 and the melange ayahuasca Amphetamine also called speed is a long-recognized stimulant. Atropine, hyoscine also called scopolamine , and hyoscyamine are components of jimson weed, a soporific and hallucinogen. LSA lysergic acid amide; also called ergine is an ergot related to LSD and the most investigated hallucinogen in morning glory It emerged as an alternative to LSD; popular articles suggest that LSA is also a point of comparison when describing the effects of methylone Cannabis is a commonly consumed sedative, although some strains may have hallucinogenic or stimulatory effects The term cannabinoid likely refers to synthetic cannabinoids. Synthetic cannabinoids are agonists at cannabinoid receptors as well as dopaminergic, sertoninergic, and adrenergic receptors; synthetic cannabinoids may be more likely to precipitate psychosis than cannabis To better understand how posts described combining substances, we calculated the correlation across all documents for all pairs of substances. Figure 2 shows all combinations whose correlations are statistically significant. We used bootstrapping see Materials and Methods to determine the threshold for statistically significant correlations. Figure 2. Heat map of correlation coefficient of substance—substance co-mention pairs whose correlation was statistically significant. Each tiny box represents one pair of substances. Drug names on x - and y -axis specify the pair associated with each box. Color of tiny box indicates correlation, according to scale up in lower right. Figure 2 is a clustered heat map, a graphical depiction of the drug-post matrix. The color of the ij th box indicates the correlation between drug i and drug j. Warmer colors indicate correlations closer to 1. This heat map is symmetric across the diagonal because the correlation between drug i and drug j is the same as the correlation between drug j and drug i. The diagonal is not drawn to avoid a ceiling effect distorting the figure. The orders of substances on the x and y axes are the same. The ordering of substances along the x -axis is the same as that along the y -axis. This ordering was chosen to group together pairs of drugs with similar correlations. Three large clusters are apparent. Proceeding from left to right along the horizontal axis, one cluster begins with pramipexole and ends with butalbital. This cluster contains substances commonly labeled as nootropics pramipexole, ginko, levomethamphetamine or cathinones bath salts; pentylone, butyrone, naphyrone. The next cluster begins with modafinil and ends with chaliponga. It contains hallucinogenic plants zacatechichi, chaliponga and psychiatric medications venlafaxine, olanzipine. The third cluster contains stimulants caffeine, cocaine, nicotine, methylphenidate and hallucinogenic plants. The mostly blue square in the lower left indicates that compounds from the first cluster nootropics and cathinones are rarely discussed with compounds from the third cluster stimulants and certain hallucinogenic plants. A negative correlation blue color between two substances means that when the first substance is mentioned the second substance is less likely to be mentioned. It does not mean that when one substance is mentioned posts explicitly discuss avoiding the second substance. The term piper likely refers to Piper methysticum a source of kava, a herbal anxiolytic Piper may also refer to phenylpiperazines, a novel class of stimulants marketed as alternatives to bath salts Huperzine is an acetylcholinesterase inhibitor marketed as a nootropic cognitive enhancer , although human studies show minimal effects Figure 2 demonstrates the face validity of this approach to toxicosurveillance and provides novel insights. Caffeine is a common adulterant in samples of cocaine 34 , Those who use cocaine are more likely to consume nicotine and caffeine The correlation between patterns of mention of pentylone, butylone, and naphyrone upper left group likely reflects debates on the relative effects of each substance, although they might reflect unreported patterns of use. A novel finding is that discussions mentioning bk-MDMA also called methylone , another cathinone, significantly frequently mentioned methamphetamine, and hallucinogens bufotenin, mimosa , but not other bath salts. Amphetamines are a frequent contaminant of bath salts Some reported patterns of use are not observed here. Figure 2 shows no significant co-mentions of monoamine oxidase inhibitors MAOIs with derivatives of tryptamine, such as dimethyltryptamine. Mimosa 38 and chaliponga 39 are plant sources of DMT. Perhaps because the combination of MAOIs and hallucinogens has been described 42 , the topic is assumed knowledge in online fora. Or, the topic may be more discussed in other fora. To identify patterns of co-ingestion across classes, Figure 3 groups substance mentions by class. The most commonly co-mentioned classes are sedative-hypnotics, hallucinogens, and stimulants, followed by nootropics, psychiatric medications, and anticholinergics. For the purpose of Figure 3 , each drug was assigned to one class only. In reality, a drug may have multiple effects, with only different effects manifesting at various doses. We chose the class that reflects the effects of the drugs at commonly ingested doses. We, for example, would classify diphenhydramine Benadryl as an antihistamine even though it is an anticholinergic at higher doses. We were unable to extract dosing information to further guide classification. Figure 3. Heat map of substance-substance co-mentions by class. Each tiny box represents one pair of substance classes. Labels on the x - and y -axes specify the substance classes associated with each box. Color of tiny box indicates absolute frequency of mentions, according to colorbar scale in lower right. To identify patterns of substance use involving more than two substances, we constructed a social network of drugs Figure 4 as follows. We created a connection between two drugs if those two drugs had a significant correlation. We depicted that connection graphically as a line. The width of the line reflects the strength of the correlation. Piecing together these pairwise connections creates a larger network as follows. Figure 4. Social network of drug discussions. Each node text represents a substance. Each edge connecting line represents the correlation between mentions of the two connected substances. The thicker the line the stronger the correlation. We identified six groups containing more than three members. We term these larger groups semantic islands. Posts that mention one drug in a semantic island usually only mention substances from that same island if they mention more than one substance. There is an opioid island in the center top. Proceeding clockwise there is a stimulant island caffeine is the hub , an SSRI hub paroxetine is the hub , a plant hallucinogen island DMT and mimosa are the hubs , a synthetic hallucinogen island LSD and sound are the hubs , and a benzodiazepine island. The SSRI island is formed by citalopram, sertraline, paroxetine, fluoxetine, and venlafaxine. In the SSRI island, paroxetine forms the hub it is directly connected to every other member of the island. One interpretation of this arrangement is that paroxetine trade name Paxil forms a frame of reference for evaluating other SSRIs. In the synthetic hallucinogen, LSD is a hub that bridges two subislands. The left subisland of the hallucinogen island contains substances canonically thought to be anticholinergic. Hyoscine and hyoscyamine are tropane alkaloids found in jimson weed. The triad formed by ethanol, calamus, and thujone reflects discussion on absinthe, which was thought to have hallucinogenic properties. Calamus, referring to Acorus calamus , was also thought to be a hallucinogenic component of absinthe. The triad formed by armodafanil, modafinil, and adrafinil reflect discussions on how to obtain modafinil without a prescription. Modafinil trade name Provigil and Armodafinil trade name Nuvigil are currently only available with a prescription in the United States. Adrafinil is metabolized to modafinil and is not designated a controlled substance in the United States. Nor have there been reports of combining pramipexole a dopamine agonist with nefazodone an SSRI. This study presents the first formal analysis of patterns of discussion in online fora describing patterns of substance—substance co-ingestion. Our aim was to simultaneously demonstrate the validity of using internet fora for syndromic surveillance and discover novel substance—substance co-mentions. Our analysis of Lycaeum identified combinations. Of those combinations, 44 have never been directly studied but are similar to combinations that have been directly studied. Three combinations, nefazodone and pramipexole, zacatechichi mugwort and skullcap, and niacin and GABA, have no antecedents in the literature. We also found that bath salts are commonly discussed with sedative-hypnotics and nootropics, while more canonical stimulants are discussed with plant hallucinogens and psychiatric medications. There are many limitations to this study. It analyzes the patterns of discussion of those who chose to share information about patterns of drug use. There are no analytic data to support that any substances mentioned together were ingested together. This study did not perform a detailed linguistic analysis of all text. We looked for explicit mentions of each substance. It is possible that posts mask mentions of usage with slang, even in online fora dedicated to discussion about novel psychoactive substances. To the knowledge of the authors, there exists no comprehensive or independently validated dictionary of slang relating novel psychoactive substances. We attempted to standardize vocabulary using manual curation. The classification system used in Figure 2 deviates from accepted best practices in biomedical ontology. For example, anticholinergic and contaminant are not mutually exclusive and describe properties at different levels of abstraction. The former term describes a binding property of the chemical. The latter term describes a property a substance has by virtue of its location. The term citalopram is not a property but a substance. The classification system also simplifies the reality that many NPS bind to many receptors and have active metabolites. We chose this simple classification system to reflect the categorization used by clinicians. Subsequent investigations that aim to join data from social media with existing knowledge repositories may have to develop a more formal and logically consistent representation of knowledge in this domain. The textual analysis is also limited in that no attempt was made to infer why posts selected one pair of substances over another. Perhaps more sophisticated techniques from natural language processing or artificial intelligence could uncovert such latent variables. MC wrote the software to analyze the data from Lycaeum, manually curated some drug categories, wrote, and edited the manuscript. DY wrote the software to acquire the data from Lycaeum and manually curated some drug categories. AM provided guidance during analyzing the data and helped revise the manuscript. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Novel psychoactive substances. Eur Psychiatry S59— Dissemination of psychoactive substance information by innovative drug users. Cyberpsychol Behav 10 1 :1—6. Emerging drugs of abuse. Dis Mon 60 3 — Recreational use, analysis and toxicity of tryptamines. Curr Neuropharmacol 13 1 — Scand J Clin Lab Invest 73 5 —6. Schechter MD. Eur J Pharmacol 2 —4. LSD and ecstasy: pharmacology, phenomenology, and treatment. Psychiatr Ann 24 3 —3. Drug Alcohol Depend 52 1 — Prevalence and patterns of polysubstance use in a nationally representative sample of 10th graders in the United States. J Adolesc Health 52 6 — PLoS One 9 2 :e Epidemiology from tweets: estimating misuse of prescription opioids in the USA from social media. J Med Toxicol 13 4 — Psychological language on twitter predicts county-level heart disease mortality. Psychol Sci 26 2 — Hallucinogens on the internet: a vast new source of underground drug information. Am J Psychiatry 3 —3. Python Language Reference Manual. Bristol: Network Theory Google Scholar. Choosing scrapy. J Comput Sci Coll 31 1 —9. Dayan P, Abbott LF. Theoretical Neuroscience. High-frequency binaural beats increase cognitive flexibility: evidence from dual-task crosstalk. Front Psychol Binaural beat: a failure to enhance EEG power and emotional arousal. Front Hum Neurosci Prevalence and correlates of co-ingestion of prescription tranquilizers and other psychoactive substances by us high school seniors: results from a national survey. Addict Behav — Use of diazepam in hallucinogenic drug crises. JAMA 9 —5. Downing J. The psychological and physiological effects of MDMA on normal volunteers. J Psychoactive Drugs 18 4 — Indole alkaloids of Acer saccharinum the silver maple , Dictyoloma incanescens, Piptadenia colubrina , and Mimosa hostilis. J Org Chem 24 9 —7. J Ethnopharmacol 10 2 — Hallucinogenic mushrooms. Clin Pediatr 27 2 —3. Hofmann A. Bull Narc 23 1 :3— Power M. Drugs 2. Thomas H. Psychiatric symptoms in cannabis users. Br J Psychiatry 2 —9. Spice drugs are more than harmless herbal blends: a review of the pharmacology and toxicology of synthetic cannabinoids. Prog Neuropsychopharmacol Biol Psychiatry 39 2 — Ernst E. A re-evaluation of kava Piper methysticum. Br J Clin Pharmacol 64 4 —7. Methylone and mCPP, two new drugs of abuse? Addict Biol 10 4 —3. PLoS One 8 9 :e Caffeine and other adulterants in seizures of street cocaine in Brazil. Int J Drug Policy 14 4 —4. Schneider S, Meys F. Analysis of illicit cocaine and heroin samples seized in Luxembourg from — Forensic Sci Int 1 —6. Nicotine and caffeine use in cocaine-dependent individuals. J Subst Abuse 5 2 — The toxicology of bath salts: a review of synthetic cathinones. J Med Toxicol 8 1 — Alkaloid profiles of Mimosa tenuiflora and associated methods of analysis. Ayahuasca exposure: descriptive analysis of calls to us poison control centers from to J Med Toxicol 13 3 —8. Ott J. Pharmahuasca: human pharmacology of oral DMT plus harmine. J Psychoactive Drugs 31 2 —7. Novel psychoactive substances: the pharmacology of stimulants and hallucinogens. Expert Rev Clin Pharmacol 9 7 — Keywords: natural language processing, computational biology, computer simulation, psychedelic drug use, toxicology. Psychiatry The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. Top bar navigation. About us About us. Sections Sections. About journal About journal. Article types Author guidelines Editor guidelines Publishing fees Submission checklist Contact editorial office. Psychiatry , 30 April Manini 3. Introduction Novel psychoactive substances NPS refer to novel synthetic compounds or derivatives of more widely known substances of abuse that have emerged over the last two decades 1. Our approach had two broad aims: 1. Demonstrate that data concerning polysubstance use could be extracted from online user posts 2. Materials and Methods 2. Overview We wrote software in the programming language Python 14 to extract user posts from Lycaeum, identify novel psychoactive substances, and analyze the content of the posts. Identification of Substances We used a three-step process to identify substances. Results The 20 most frequently mentioned substances included common hallucinogens, stimulants, sedative-hypnotics, as well as, interestingly, sound Figure 1.

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