ORIGINAL RESEARCH article
Front. Toxicol.
Sec. Clinical Toxicology
Volume 7 - 2025 | doi: 10.3389/ftox.2025.1572324
New psychoactive substances in roadway crash victims in California
Provisionally accepted
Roy Gerona1*
Daniel Tomer1
Donovan Nielsen2
Allyson C Sage2
Deborah French1
Juliana Tolles3
James Alan Chenoweth2*- 1University of California, San Francisco, San Francisco, United States
- 2University of California, Davis, Davis, California, United States
- 3Harbor- UCLA, Los Angeles, CA, United States
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Background: Motor vehicle crashes (MVCs) are a major global health concern. While alcohol continues to be a significant contributor to MVCs, the role of illicit and prescription drugs has increased in the last four decades. Moreover, the proliferation of new psychoactive substances (NPS) in the United States since 2010 has reshaped recreational drug use. Despite this, its contribution to MVCs has not been systematically evaluated. In this study, we report the prevalence of NPS in roadway crash victims in California.Methods: Serum samples from 1000 roadway crash victims were collected and analyzed using liquid chromatography- quadrupole time-of-flight mass spectrometry (LC-QTOF/MS) against a comprehensive database of 1314 drugs, including 1008 NPS, and quantitative analysis was performed using isotope dilution. Alcohol was quantified in an autoanalyzer using an enzymatic method employing alcohol dehydrogenase. Results: Eight NPS (detection frequency= 26) were confirmed and quantified in 17 cases. Like current nationwide NPS surveillance studies, bromazolam, para-fluorofentanyl, and mitragynine were most frequently detected. NPS were detected in polypharmacy use, with traditional recreational drugs such as fentanyl, methamphetamine, and delta-9 THC most frequently co-detected. The serum geometric means detected for bromazolam (5.41 ng/mL; range: 0.22-26.59), para-fluorofentanyl (0.45 ng/mL; range: 0.28- 2.02) and mitragynine (7.02; range: 0.55- 90.55) were lower than those reported for overdose and death cases.Discussion: This study is the first to report quantitative levels of multiple NPS and multiple NPS classes in a large US roadway crash survey, with the high detection of CNS depressants and their co-occurrence with traditional recreational drugs highlighting the need for expanded NPS testing, roadside testing strategies, and guidelines for determining drug-induced impairment; the quantitative data may be valuable in establishing these guidelines.
Keywords: Impaired driving, roadway crashes, new psychoactive substances, Fentanyl analogs, Designer benzodiazepines, mitragynine, LC-QTOF/MS, California
Received: 06 Feb 2025; Accepted: 09 May 2025.
Copyright: © 2025 Gerona, Tomer, Nielsen, Sage, French, Tolles and Chenoweth. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor 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.
* Correspondence:
Roy Gerona, University of California, San Francisco, San Francisco, United States
James Alan Chenoweth, University of California, Davis, Davis, 95616, California, United States
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