Postmortem findings of organ damage in novel psychoactive substances users: a comprehensive review

Beatrice Benedetti; Celeste Conte; Eva Bergamin; Riccardo Di Santo; Gabriele Ciasca; John M Corkery; Marta Bassi; Giorgia Corli; Sabrine Bilel; Fabrizio Schifano; Matteo Marti; Fabio De-Giorgio

doi:10.1016/j.neubiorev.2024.105927

Postmortem findings of organ damage in novel psychoactive substances users: a comprehensive review

Beatrice Benedetti, Celeste Conte, Eva Bergamin, Riccardo Di Santo, Gabriele Ciasca, John M Corkery, Marta Bassi, Giorgia Corli, Sabrine Bilel, Fabrizio Schifano, Matteo Marti, Fabio De-Giorgio

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Abstract

INTRODUCTION: Despite the rising number of NPS-related deaths, comprehensive data on their prevalence, identification, and associated organ damage remain scarce.

MATERIALS AND METHODS: A literature search was conducted. Predefined inclusion and exclusion criteria were applied, resulting in the identification of 197 articles.

RESULTS: We identified 446 cases of NPS-related deaths, involving a total of 176 different substances. Synthetic opioids were the most prevalent class (34%), followed by synthetic cannabinoids (22%) and cathinones (21%). Co-ingestion of NPS with other substances occurred in 77% of cases. Macroscopic findings varied across organs, with congestion and edema most observed in the brain (23%) and lung (56%), respectively.

DISCUSSION: The existing literature lacks comprehensive descriptions of organs subjected to autopsy and histological examination in NPS-positive subjects. Despite this limitation, our findings underscore the prominence of lung pathology. Moreover, the prevalence of normal organs in cases of acute intoxication is a significant observation. We advocate for future research to provide more detailed insights to enhance our understanding of the multifaceted landscape of NPS-related deaths.

Original language	English
Article number	105927
Number of pages	12
Journal	Neuroscience and Biobehavioral Reviews
Volume	167
Early online date	22 Oct 2024
DOIs	https://doi.org/10.1016/j.neubiorev.2024.105927
Publication status	Published - 30 Dec 2024

Keywords

Novel psychoactive substances (NPS)
synthetic opioids
synthetic cannabinoids
cathinones
substance abuse
polydrug use
Autopsy
Synthetic opioids
Cathinones
Polydrug use
Synthetic cannabinoids
Substance abuse
Humans
Brain/pathology
Illicit Drugs/adverse effects
Psychotropic Drugs/adverse effects
Lung/pathology
Substance-Related Disorders/pathology

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10.1016/j.neubiorev.2024.105927Licence: CC BY

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© 2024 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Final published version, 3.37 MBLicence: CC BY

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Benedetti, B., Conte, C., Bergamin, E., Di Santo, R., Ciasca, G., Corkery, J. M., Bassi, M., Corli, G., Bilel, S., Schifano, F., Marti, M., & De-Giorgio, F. (2024). Postmortem findings of organ damage in novel psychoactive substances users: a comprehensive review. Neuroscience and Biobehavioral Reviews, 167, Article 105927. https://doi.org/10.1016/j.neubiorev.2024.105927

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abstract = "INTRODUCTION: Despite the rising number of NPS-related deaths, comprehensive data on their prevalence, identification, and associated organ damage remain scarce.MATERIALS AND METHODS: A literature search was conducted. Predefined inclusion and exclusion criteria were applied, resulting in the identification of 197 articles.RESULTS: We identified 446 cases of NPS-related deaths, involving a total of 176 different substances. Synthetic opioids were the most prevalent class (34%), followed by synthetic cannabinoids (22%) and cathinones (21%). Co-ingestion of NPS with other substances occurred in 77% of cases. Macroscopic findings varied across organs, with congestion and edema most observed in the brain (23%) and lung (56%), respectively.DISCUSSION: The existing literature lacks comprehensive descriptions of organs subjected to autopsy and histological examination in NPS-positive subjects. Despite this limitation, our findings underscore the prominence of lung pathology. Moreover, the prevalence of normal organs in cases of acute intoxication is a significant observation. We advocate for future research to provide more detailed insights to enhance our understanding of the multifaceted landscape of NPS-related deaths.",

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author = "Beatrice Benedetti and Celeste Conte and Eva Bergamin and {Di Santo}, Riccardo and Gabriele Ciasca and Corkery, {John M} and Marta Bassi and Giorgia Corli and Sabrine Bilel and Fabrizio Schifano and Matteo Marti and Fabio De-Giorgio",

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doi = "10.1016/j.neubiorev.2024.105927",

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T1 - Postmortem findings of organ damage in novel psychoactive substances users: a comprehensive review

AU - Benedetti, Beatrice

AU - Conte, Celeste

AU - Bergamin, Eva

AU - Di Santo, Riccardo

AU - Ciasca, Gabriele

AU - Corkery, John M

AU - Bassi, Marta

AU - Corli, Giorgia

AU - Bilel, Sabrine

AU - Schifano, Fabrizio

AU - Marti, Matteo

AU - De-Giorgio, Fabio

PY - 2024/12/30

Y1 - 2024/12/30

N2 - INTRODUCTION: Despite the rising number of NPS-related deaths, comprehensive data on their prevalence, identification, and associated organ damage remain scarce.MATERIALS AND METHODS: A literature search was conducted. Predefined inclusion and exclusion criteria were applied, resulting in the identification of 197 articles.RESULTS: We identified 446 cases of NPS-related deaths, involving a total of 176 different substances. Synthetic opioids were the most prevalent class (34%), followed by synthetic cannabinoids (22%) and cathinones (21%). Co-ingestion of NPS with other substances occurred in 77% of cases. Macroscopic findings varied across organs, with congestion and edema most observed in the brain (23%) and lung (56%), respectively.DISCUSSION: The existing literature lacks comprehensive descriptions of organs subjected to autopsy and histological examination in NPS-positive subjects. Despite this limitation, our findings underscore the prominence of lung pathology. Moreover, the prevalence of normal organs in cases of acute intoxication is a significant observation. We advocate for future research to provide more detailed insights to enhance our understanding of the multifaceted landscape of NPS-related deaths.

AB - INTRODUCTION: Despite the rising number of NPS-related deaths, comprehensive data on their prevalence, identification, and associated organ damage remain scarce.MATERIALS AND METHODS: A literature search was conducted. Predefined inclusion and exclusion criteria were applied, resulting in the identification of 197 articles.RESULTS: We identified 446 cases of NPS-related deaths, involving a total of 176 different substances. Synthetic opioids were the most prevalent class (34%), followed by synthetic cannabinoids (22%) and cathinones (21%). Co-ingestion of NPS with other substances occurred in 77% of cases. Macroscopic findings varied across organs, with congestion and edema most observed in the brain (23%) and lung (56%), respectively.DISCUSSION: The existing literature lacks comprehensive descriptions of organs subjected to autopsy and histological examination in NPS-positive subjects. Despite this limitation, our findings underscore the prominence of lung pathology. Moreover, the prevalence of normal organs in cases of acute intoxication is a significant observation. We advocate for future research to provide more detailed insights to enhance our understanding of the multifaceted landscape of NPS-related deaths.

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KW - synthetic cannabinoids

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KW - polydrug use

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KW - Synthetic opioids

KW - Cathinones

KW - Polydrug use

KW - Synthetic cannabinoids

KW - Substance abuse

KW - Humans

KW - Brain/pathology

KW - Illicit Drugs/adverse effects

KW - Psychotropic Drugs/adverse effects

KW - Lung/pathology

KW - Substance-Related Disorders/pathology

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DO - 10.1016/j.neubiorev.2024.105927

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VL - 167

JO - Neuroscience and Biobehavioral Reviews

JF - Neuroscience and Biobehavioral Reviews

M1 - 105927

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Postmortem findings of organ damage in novel psychoactive substances users: a comprehensive review

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