Abdala Amphetamines in Russia

The home-made production of Methamphetamines in Russia: 

The home-made production of Methamphetamines in Russia

In Russia:: 

HIV Epidemic driven by IDU drug use patterns: Injection as preferred form of intake Home-made production In Russia:

Drug Injection in Russia: 

The manufacture of home-made injectable drugs include: Opium extracts Ephedrine-based drugs: (17-27% IDUs in last 30 days) methamphetamine (“Vint”) methcathinone solutions (“Jeff”) Drug Injection in Russia

Slide4: 

METHCATHINONE (Jeff) (oxidation) EPHEDRINE (reduction) METHAMPHETAMINE (Vint)

Home-prepared drug use: association with: 

Home-prepared drug use: association with Injecting with groups higher likelihood of needle and syringe sharing higher HIV positivity

To investigate if the drugs themselves influence the survival of HIV: 

To investigate if the drugs themselves influence the survival of HIV

simulation of homemade ephedrine-based drug preparation in the laboratory: 

according to the reports of ethnographic observations of experienced manufacturers and users simulation of homemade ephedrine-based drug preparation in the laboratory

Slide8: 

Ethnographic notes : Ingredients Mode of preparation Heating conditions pHs of solutions

Can preparations inactivate HIV-1:: 

Can preparations inactivate HIV-1: equal parts of HIV-1 contaminated blood and methamphetamine or methcathinone solutions were mixed mixture tested for the presence of infectious HIV-1 in a cell culture system

Ephedrine: also known as:epitonin,ma huang or sinica: 

Ephedrine: also known as: epitonin,ma huang or sinica

Ephedra Plant (Ephedraceae) : 

Ephedra Plant (Ephedraceae) 12 species of Chinese Ephedra Ephedra sinica, E. equisetina, E. monosperma and E. intermedia var. tibetica; E. lomatolepis, E. przewalskii and E. lepidosperma etc Six ephedra (phenylethylamine) alkaloids ephedrine, pseudoephedrine, norephedrine, norpseudoephedrine, methylephedrine and methyl-pseudoephedrine content of pseudoephedrine and ephedrine varies in the different species in plants of same species from different regions plants cultured / grown in the wild

China as a major manufacturer of ephedrine and pseudoephedrine: 

China as a major manufacturer of ephedrine and pseudoephedrine China operates ephedra farms (Ephedra sinica) – government controlled Active alkaloids, pseudoephedrine and ephedrine, chemically extracted for pharmaceutical purposes India is second major producer of these chemicals

Mechanism of action of ephedrine derived drugs: 

Mechanism of action of ephedrine derived drugs drugs have similar molecular structures differ in their effect at receptors their action vary in intensity as periferal stimulants as CNS stimulants

Slide14: 

Ephedrine: major peripheral stimulant of adrenergic receptors will raise blood pressure and pulse far more “per unit of high” than methamphetamine Methcathinone: “'hangover' not as severe” “’a drug for goofing off’” (increases distractability) “Methamphetamine “increases concentration”

Ephedrine-based drugs: half-life: 

Ephedrine-based drugs: half-life unlike cocaine, methamphetamine and methcathinone aren’t readily broken down by the body effects are similar to cocaine, but their onset is slower and their duration is longer

Laboratory simulation study: 

Laboratory simulation study Based on ethnographic observations of the home manufacturing of Jeff and Vint Simulated preparation of drug after addition of HIV-contaminated whole blood - is viable HIV recovered?

Number of syringes with infectious HIV after rinsings with solutions at different pHs: 

Number of syringes with infectious HIV after rinsings with solutions at different pHs * Fisher exact test 1-tailed p-value; all others are chi-square test p-value All syringes tested contained 20 microliters of whole blood mixed with HIV

Inactivation of HIV-1 in 0.6ml solution heated in soda can bottom: 

Inactivation of HIV-1 in 0.6ml solution heated in soda can bottom Approx temperatures: t = 4: 66 Celsius t = 6: 72 Celsius t = 8: 77 Celsius t = 10: 79 Celsius t = 12: 87 Celsius

Inactivation of HIV-1 in 0.6ml solution heated in soda can bottom: 

Approx temperatures: t = 6: 72 Celsius t = 8: 77 Celsius t = 10: 79 Celsius t = 12: 87 Celsius Inactivation of HIV-1 in 0.6ml solution heated in soda can bottom

Slide20: 

Production of methcathinone room temperature, or slight heating of a large volume of solution mildly acidic pH (between 2.6 and 6) these conditions may inactivate HIV-1 but are not likely to inactivate HIV-1 at all times Methamphetamine preparation Intense heating (10-30 min) of small volumes (2ml) of solution high temperatures reached addition of strong acids to solution (pH 1-2) Conditions likely to inactivate HIV-1

Recovery of HIV-1 from mixtures of whole blood HIV-1 with methcathinone (Jeff) or methamphetamine (vint): 

Recovery of HIV-1 from mixtures of whole blood HIV-1 with methcathinone (Jeff) or methamphetamine (vint)

Preliminary: Conclusion: 

Preliminary: Conclusion HIV-1 contamination during drug preparation Such as, contaminated manufacturing equipment or cottons used to filter final solution etc Possible for methcathinone Unlikely in preparation of methamphetamine HIV-1 contamination of drugs in stages posterior to drug preparation Such as, equipment used for sale, use and sharing of these substances Possible for methcathinone Need to be verified for methamphetamines

Further experiments:: 

Further experiments: Make field observations of procedures with variations in compounds used, times, volumes and if possible of pHs of final preparations how often methods described are used

Slide24: 

Authors: Abdala, N. Grund, J.P. Heimer, R Irwin, K. Kozlov, A. Thanks to: Peter Hartsock Funding by NIDA Andrei Kozlov, PhD All colleagues and collaborations between Biomedical Center and Yale University