Inside Diagnostics - Winter 2015 (EN) by nal von minden GmbH

new art laboratories

Inside Diagnostics Winter 2015

TROPONIN The gold standard

ONE CLICK ONE KICK How the internet changed the illegal drugs market

HIV Information is the best form of contraception :

In this issue

P R I Z E D R AW e More on pag

Rapid Tests Laboratory Diagnostics Laboratory Service Consulting & Service

Inside Diagnostics

Foreword

Dear readers, For this last issue of the year we would first of all like to wish you all a Merry Christmas and a Happy New Year. Because the first of December was World Aids Day, we decided to dedicate the main article of the issue to HIV: facts, figures and detection methods are highlighted in the article. In December we also sent out the recognizable red ribbons to our customers. These act as a symbol to show solidarity and tolerance with those also concerned about the spreading of the disease. We hope our campaign continues to raise awareness of the topic and are very proud to wear our ribbons with you on 1st December. In this issue we also cover the subject of heart attacks. We inform you about the three pillars used in the diagnosis of a heart attack, and refer to the protein troponin. Not least due to its long detectability and high specificity, troponin is a preferred indicator for a heart attack.

Click here and subscribe in one easy step!

Of course there are more drug-related articles for you to read in our latest magazine. For instance, you can read our detailed report on the current developments in the drug market and the fact that the internet is playing an increasingly important role in both the development and procurement of illegal substances such as ‚legal highs‘. Furthermo-

Executive editor: Inside Diagnostics Christopher Beiderbeck Tel.: 0941 29010-46 inside-diagnostics@nal-vonminden.com

Page 2

re, you can also read about the socalled ‘party drugs’ like LSD and ecstasy which have gained significant popularity among consumers over the past five years. In the article we refer to the European Drug Report which quite clearly points out their rapid growth within Europe. I would also like to share with you the fact that I will be leaving the editorial team and heading off to pastures new. Being chief editor of Inside Diagnostics for the past two years was a real pleasure and I am convinced that we have constantly been improving our work, issue after issue. The Inside Diagnostics team is extremely motivated and reader-orientated, meaning we are always strive to give the readers what they want to read, learn or discover. In order to continue in this direction, Christopher Beiderbeck will take over the responsibilities as chief editor. I wish him and the whole team even more fun with writing the upcoming issues of our customer’s magazine. Enjoy reading this issue and, once again, Merry Christmas and a Happy New Year! Best regards, Nicolas Kennof

Inside Diagnostics

Content Themes HIV & its history �� 4 Gold Standard: Troponin �� 8 One Click One Kick �� 12 Party Drugs �� 16

nvm Inside Prize Draw �� 10 Medica 2015 �� 18 NPS Symposium �� 19 Contact/Medical Man �� 20

HIV AND ITS HISTORY | Page 4

Last year, according to the Robert Koch Institute, 3525 new cases were documented in Germany, constituting a 7% increase when compared with 2013.

Flag Inside Diagnostics nal von minden GmbH Customer Magazine Chief Editor: Christopher Beiderbeck Editors: Torsten Winkler, Kristina Sambs, Christopher Beiderbeck, Anne Kaiser, Andrea Kreuzer, Helen Murr, Connor Archer, Lukas Eder, Sonay Öktem, Martina Kastenmaier, Ulrike Jahnke inside-diagnostics@nal-vonminden.com Layout: Martina Kastenmaier

Cover © istockphoto.com/dra_schwartz, Andrei Techmov

Page 3

Infectology HIV

HIV and its history – Information is the best form of contraception “I’m HIV positive” – this statement from Charlie Sheen has brought the immuno-deficiency disease right back into the spotlight, which is a good thing when you consider that the number of new HIV diagnoses in Germany has once again risen after a period of time during which the dangers which occur from the disease seemed to no longer be documented. For this reason, the disease is far from being completely eradicated. Last year, according to the Robert Koch Institute, 3525 new cases were documented in Germany, constituting a 7% increase when compared with 2013. According to the Germany ‘Aids Support’ charity, many of the infected people originate from countries where AIDS is more prevalent. This primarily includes countries south of the Sahara desert, where approximately 70% of the 36.9 million HIV sufferers worldwide are registered. In most cases, people contracting the disease also do so in this area. In order to be able to prevent this from occurring in the future, 29 billion euros must be invested every year, according to UN officials. And while those infected with the virus in the west are able to live fulfilled lives thanks to modern medicine,

which can in time develop in the body but does not necessarily have to. Highly sensitive medical attention is required to prevent such an outbreak. That this is required is something often overlooked by the person infected, since initial symptoms seem harmless and unnoticeable. Anything from a few days to months after the initial contraction can pass by with the only symptoms occurring being those that resemble a particularly bad cold, which then subside after anything from a few days to weeks. The affected person can then go years and even decades with no serious medical complaints. This is why the shock is even greater when the actual AIDS diagnosis is given. Throughout its chronic course the patient often loses weight, is extremely susceptible to infectious diseases and can develop specific strains of cancer, those for which AIDS is typically hallmark. Manageable, but still not curable. New medicines are able to prevent the virus from spreading throughout the whole body and delay the development of AIDS. These manage the disease but do not treat it. In every case the HI-Virus pathogen is able to integrate its genetic code into the genome of the host - the patient’s body. A patient can ascertain whether they have contracted HIV together with the help of a so called HIV-test, which is an anti-body test. If antibodies against the HI-virus are present in the blood it can be assumed that also HI-viruses are present. Nevertheless, a reactive HIV-test for antibodies always necessitates further diagnostics to make the diagnosis `HIV positive’. This is only possible after a combination of multiple tests which lead to the distinct and direct proof of the presence of HI-viruses.

Highly sensitive

medical attention is required to prevent such an outbreak. the disease still remains deadly without qualitative, high-tech medical care – something often lacking in nations where it is originally contracted. The contraction of the disease is disguised by common cold symptoms. The reason potential for a lethal course of the disease is that the person infected with the Human Immunodeficiency Virus can subsequently develop AIDS. This is to say that HIV and AIDS are not the same thing. To prematurely speak of an `AIDS contraction’ is thus false. What has actually been contracted is the `HI-Virus’, the Acquired Immune Deficiency Syndrome,

Page 4

For those who want to remove any possibility that they may be infected with HIV should not get tested before it has been at least 6 weeks after the last ‘risk situation’ occurred. Such laboratory tests detect both a presence of the HIV antigen as well as the antibodies against HIV. 6 weeks after a possible infection is the earliest that infection with HIV can be reliably detected or ruled out.

Infectology HIV

www.istockphoto.com ÂŠ AtnoYdur

Page 5

Infectology HIV

However, there are also optional rapid tests available. If they only detect antibodies, at least 3 months should pass from the time of the possible infection to the time when the test is undertaken, in order to guarantee a reliable result and thus rule out a possible infection. HIV-rapid tests are well suited to this, and so are often offered in AIDS projects and prevention programmes. These tests do not detect any antigens but instead detect antibodies, and for some people it can be up to 3 months before these antibodies are detectable. Throughout these 3 months the patient should act accordingly so that they do not pose any risks to people in their vicinity. Clarification is the key to minimising the risk of contraction. A thorough clarification must be guaranteed in order to limit the further spreading of HIV infections and the immunodefi-

ciency disease AIDS. AIDS counselling and clarification play an important role in this respect. And although the disease has been known about for more than 30 years, many people still do not know enough about the risks – such as how you can actually get infected with it. And despite this, some rumours and myths stubbornly remain. Behaviour through which an AIDS infection is high-risk and for which it is completely impossible cannot be stressed enough – most important is a background knowledge, since those affected are often wrongly discriminated against. HIV is mainly transmitted through blood, sperm and breast milk. It cannot be passed on through so-called droplet infections, such as having a cold. For this reason, the risk of contracting the disease is very low in day-to-day life activities with people who have AIDS or HIV;

The risk of contracting the disease is very low in dayto-day life activities with people who have AIDS or HIV.

Page 6

www.istockphoto.com © Andrei Techmov

Infectology HIV

•

All social contact at work or in private life, such as handshakes, hugging and such is no danger

•

Similarly, shared use of cutlery, china, glasses and toilet paper and hand tissues is harmless

•

Joint trips to a swimming pool or sauna are no cause for concern

•

In addition to this, there is no evidence at all pointing towards an increased risk of infection for people who live in the same house as someone with the disease. Of course, general preventative measures should be adhered to, such as avoiding sharing razors since a low infection risk can arise from even a small injury.

However, the disease is very likely to be contracted through:

responsibly. Everybody should keep up to date with HIV and STI’s, no exceptions. Most importantly, information on how to best protect yourself and those around you should be part of your general knowledge. HIV tests are offered by health authorities and GP surgeries, and tests are sometimes offered by AIDS helpers and advice centres. You can find out exactly where you can get yourself tested at http://www.nhs.uk/chq/ Pages/3107.aspx?CategoryID=118&SubCategoryID=126 The big advantage here is the anonymity offered, since no personal information such as name and address etc. is collected.

Only those who take HIV virus seriously can prevent its spread.

•

Sexual contact

•

Breast milk

•

The sharing of contaminated needles, such as when needles are shared in drug use

•

Blood transfusions or the handling of non - disinfected medical equipment.

Unprotected sex is the number 1 cause of infection The most common form of contraction is still unprotected sexual contact – regardless of whether it is hetero or homosexual. Despite the fact that every person should be in a position to discover and carry out his preferred form of sexual activity, it is recommended to be in the form of safer sex. The basic rules for safer sex couldn’t be easier to understand: blood, sperm and vaginal secretion must not come in contact with open wounds or mucus membranes. A condom should therefore always be used during anal or vaginal sex. A higher risk of infection is present when a condom isn’t used, since small wounds can always occur during intercourse. It is always important during oral sex that neither sperm nor vaginal secretion come into contact with buccal mucosa, the tongue or the lips. When these safety measures are adhered to then an infection through sex is unlikely. Kissing also poses no risk.

For those who are unsure regarding a possible HIV infection or simply want to play it safe, we recommend a reliable blood or saliva rapid test for HIV 1/2/0 by nal von minden. These can be undertaken at advice centres, with AIDS helpers or in a doctor’s practice. Nobody has to live as eccentric a life as Charlie Sheen to be exposed to the risk. Even the Hollywood star himself cannot say with certainty when and where he got infected with the HIV virus. What he does know, however, is that he has brought the malevolent disease back into public discussion with his admission, which is where it should be. It is, after all, only those who take HIV virus seriously who can prevent its spread. We would be happy to give you more information about our rapid tests. Just give us a call and we will give you further details: 0808 234 1237.

Those who are up to date can protect themselves and others.

More information about World Aids Day can be found at: http://www.worldaidsday.org/ Find AIDS advice centres in your area (Germany) at: www.gib-aids-keine-chance.de/beratung

In order to prevent both an infection and a passing on of the virus it is essential to know your own body, listen to it and act

SÖ

http://www.spiegel.de/gesundheit/diagnose/aids-bericht-der-uno-weniger-hiv-neuinfektion-weltweit-a-1043610.html vom 23.11.15 UN AIDS-Bericht 2014: http://www.unaids.org/en/resources/campaigns/HowAIDSchangedeverything/factsheet 3 http://www.onmeda.de/krankheiten/aids-vorbeugen-1746-11.html vom 23.11.15 4 http://www.gib-aids-keine-chance.de/wissen 1 2

Page 7

Cardiology Troponin

Gold standard: Troponin

What roles do cardiac makers play in the diagnosis of heart attack? In heart attack diagnoses, The World Health Organization (WHO) recommends a diagnosis-scheme which is composed of three pillars. However in many cases, pillar 1 (Angina pectoris- symptomatology) and pillar 2 (typical ECG variances) are not noticeable, despite the presence of a heart attack. As a consequence, pillar 3 (the detection of heart attack markers in blood), especially the protein Troponin, is seen as the gold standard detection method. The number of heart attack mortalities has fallen sharply Between 1992 and 2012 the number of deaths attributed to acute heart attack has fallen sharply. The mortality rate in Germany, measured per 100,000 inhabitants, reduced from 108.9 to 65.2. Important reasons behind this positive development are, among others, the improvement of emergency services and infrastructure as well as process improvements in hospitals and advances in diagnostics and therapy. The way to diagnose a myocardial infarction The most typical symptom of a heart attack is severe pains behind the breastbone, which last longer than 5 minutes and radiate predominantly on the left hand side up to the neck, back and upper arms. The first indications of a heart attack can also appear as nausea, abdominal pain and dizziness, especially amongst women and elderly individuals. Angina pectoris-symptomatology represents pillar 1 of the myocardial infarction diagnosis-scheme. However, the Framingham study revealed that in 35% of participating women and 28% of participating men a so-called â&#x20AC;&#x153;muteâ&#x20AC;? infarction was present. This is a myocardial infarction without any physical symptoms. Pillar 2 of the three-part diagnosis-scheme is the screening process with electrocardiogram (ECG). The ECG gives several clues. It can provide information about where the heart attack occurred, either be in the anterior wall or in the posterior wall of the heart, as well as indicating when. During the acute state of a heart attack, typical deviations occur, for example, the inflation of t-waves or the variation of the ST-segment. The ECG can additionally uncover cardiac arrhythmias which are common complications of a heart attack and consequently indicate its presence.

Page 8

50-70% of all heart attacks show modifications in the waves of the ECG. However, especially during the first 24 hours after the beginning of a heart attack, an ECG-report can be inconspicuous. In these cases an ECG alone would not always be able to provide indication of a heart attack. The WHO therefore advises to carry out laboratory investigations in cases of uncertainty. As the myocardial tissue dies, it releases proteins or enzymes which are verifiable in the blood. Up until the 1990s, the only known cardiac-specific biomarkers were creatine kinase (CK), its isoenzymes CK-MB and Aspartate Aminotransferase (AST). Since then more cardiac-specific biomarkers have been discovered in blood including Myoglobin, cardiac Troponins T and I, as well as glycogenphosphorylase BB (GPBB). With the detection of these enzymes in blood, via enzyme-diagnostic, a myocardial infarct can be determined without doubt. What are the main differences between these cardiac-specific biomarkers? The main criterion for deciding the right cardiac-specific biomarker for diagnosis of a heart attack is the detection timeframe of the enzyme in blood. Other criteria are the accuracy and ability to exclude other diseases. Myoglobin During a myocardial infarction, myoglobin increases in blood serum within one to four hours and the peak is reached after 12 hours. After a day, the amount of myoglobin will go back to normal levels due to its short half-life. The sensitivity is very high during the first six hours; however the specificity is highly limited, as myoglobin levels can also increase due to injuries of skeletal muscles, renal insufficiency and thyroid dysfunction. Isoenzyme of creatine kinase (CK-MB) The concentration of CK-MB, the isoenzyme in creatine kinase, rises three to twelve hours after a heart attack and reaches its peak within a day. After 48-72 hours, the concentration is back to normal. Due to the faster rise in comparison to Troponin, this marker enables the early detection of a myocar-

https://de.wikipedia.org/wiki/Myokardinfarkt http://www.internisten-im-netz.de/de_herzinfarkt-untersuchungen-diagnose_35.html http://dgk.org/daten/PA-Herzbericht-26012015-final.pdf http://flexikon.doccheck.com/de/Aspartat-Aminotransferase

Cardiology Troponin

Blood concentration Levels

Development of important â&#x20AC;&#x17E;heart markersâ&#x20AC;&#x153; in case of a heart attack

Troponin Decision limit for the diagnosis of a heart attack

CK-MB (Mass)

Myoglobin 0

No. of days after presentation of heart attack symptoms. After heart damage occurs and pain sets in, Troponin-I is released into the blood within 4-6 hours. The release of cardial TnI is similar to that of CK-MB; however while CK-MB is reduced to its normal level after 72 hours, the Troponin I level remains increased for up to 6-10 days, therefore providing a greater time frame in which heart damage can be detected.

dial infarction. Furthermore, CK-MB can be used to monitor a myocardial infarction. Its fast descent enables further CK-MB concentration increases to be monitored, which is the evidence of a secondary infarction. However, both sensitivity and specificity are limited and a variety of others diseases and long lasting skeletal muscular burdens can lead to concentration increases. Aspartat-Aminotransferase (AST) The AST value increases four to eight hours after a heart attack and the peak is reached within 16 to 48 hours. Within three to six days, the value of AST returns to normal levels. Nowadays, AST plays practically no role in heart attack diagnoses. Cardiac Troponin Troponin I and T appear already four to six hours after the onset of a heart attack. Troponin I is detectable in blood for seven to ten days, whereas Troponin T is detectable for seven

to 14 days. Hence, Troponin offers a much longer timeframe for the diagnosis of a myocardial injury than the other above mentioned enzymes. Furthermore, Troponin is more specific than the other markers. Whereas the value of Troponin T can occasionally increase with other damage to the regular muscular system or with kidney failure, there are no reports known where the value of Troponin I is increased due to other diseases, with the solemn exception of rheumatism. Multiple measurements of this parameter (at admission and after 3 to 6 hours) can facilitate the diagnosis of a myocardial infarction. On these grounds, Troponin has lately become the preferred biomarker. The value of Troponin has emerged as a good indicator not only regarding risk assessment, but also in the choice of treatment and the successful handling of the treatment.

Page 9

nvm inside Prize Draw

Join in &

win!

Dear reader,

We congratulate the winners of our USB fans from our last issue. The correct answer was of course: Medical Man is the sexiest superhero alive! We are pleased once again to give you the opportunity to win a great prize! For the winter issue, we are giving away a fully automatic coffee machine from Bosch.

AIDS day d rl o W s e o d n e h W ear? take place every y c) 24.12. . 2 .1 1 0 ) b . 1 .1 1 a) 1

Good luck!

Your Inside Diagnostics team Win a BOSCH TASSIMO coffee machine! ✓ Customize your beverages with a single touch of a button ✓ Instant heat-up and fast first cup ✓ Trendy and compact design ✓ Make Coffee, Cappuccino, Latte, Hot Chocolate, Tea & More with TDiscs Participate via the following link: www.nal-vonminden.com/gewinnspiel.html or by email to: gewinnspiel@nal-vonminden.com Otherwise send the following fax form to: +49 941 29010 50

Closing date is 03.02.2016

Page 10

nvm inside Prize Draw

Please mark the right answer,

simply fill the form & win!

Name

Address

City

E-Mail

Signature Conditions of Participation 1. The Promoter is nal von minden GmbH. 2. To enter simply fill in your details on the form here above and fax it to +49 941 290 10-50 or send it by post to: nal von minden GmbH, Christopher Beiderbeck, Friedenstrasse 32, 93053 Regensburg, Germany. Participation is also possible by email; please send an email with your answer and your complete address with the subject line as “Prize Draw” to gewinnspiel@nal-vonminden.com. You also can participate online: http://goo.gl/QruV82. The winner will be chosen at random and be drawn from those who have entered the correct answer. 3. This prize draw is open to European residents aged 18 years or over, with the exception of employees of the Promoter, their families, agents and anyone else connected with this promotion. Only one entry per person. No entrant may win more than one prize. 4. No purchase necessary to enter the prize draw and the participation is free. By entering the prize draw each entrant agrees to be bound by these terms and conditions. Entries must be received by the 3rd of February 2016. 5. The winner will be notified via email or post and will receive the prize by post. 6. Prizes are subject to availability. In the event of unforeseen circumstances, the Promoter reserves the right (a) to substitute alternative prizes of equivalent or greater value and (b) in exceptional circumstances to amend or foreclose the promotion without notice. No correspondence will be entered into. 7. The prize is a Bosch Tassimo coffeemachine. No cash or prize alternatives will be offered. The winner‘s entitlement to the prize is not transferable. 8. The Promoter shall not be responsible for damages, losses or liabilities of any kind, including without limitation, direct, indirect or consequential loss or damages arising out of or in relation to the prize draw. 9. Any liability for damages of nal von minden GmbH and their officers, employees and agents in connection with the competition, irrespective of the legal reason, is, as far as legally permissible, limited to cases of intent or gross negligence. 10. The promoter’s decision in respect of all matters to do with the competition will be final and no correspondence will be entered into. Legal recourse is excluded. Data protection 1. Being a responsible entity as defined by the German Federal Data Protection Act, nal von minden GmbH collects, processes, and uses personal data (first name and last name, date of birth, street address, postal code, place, country, and email address) disclosed to nal von minden GmbH in connection with the Prize Draw only in compliance with the applicable laws and regulations referring to data protection. nal von minden GmbH will not disclose your personal data to any third party. Your personal data will be collected, processed and used exclusively for the purpose of carrying out the Prize Draw. The promoter is allowed to send future issues of the “Inside Diagnostics” by e-mail. Unsubscribe at any time by sending an informal e-mail to gewinnspiel@nal-vonminden.com 2. You are entitled by law to request free information about the personal data nal von minden has stored in relation to your person, and to request that nal von minden GmbH corrects, blocks or deletes these personal data. Please contact nal von minden GmbH if you want to claim any of these rights referred to above. 3. If you request that your personal data be deleted before the Prize Draw is completed, your entry into the Prize Draw is deemed to be terminated as well. In that case, you are no longer eligible for a prize.

Page 11

Drug Rapid Tests Online market

One click, one kick

How the internet changed the illegal drugs market `The internet is just a hype.‘ Who said that? Microsoft cofounder and Harvard dropout Bill Gates and that was in the year 1993.1 17 years later, in 2011, according to estimates one third of the world population was online, the `hype‘ had prevailed and has become indispensable in today‘s everyday life. Information gathering, communication, entertainment, commerce, the list of applications of the World Wide Web is endless. Meanwhile, it is completely normal to procure latest information on Google or needed goods on Amazon. But what impact have the rapid developments of the digital age on the world drug market and on the usage behavior of drug users? How easy is it to gain the next kick by a mouse click or to come into contact with previously unknown substances? The answer is: at first glance too easy. Coke from the digital `Silk Road‘ As the word `Silkroad‘ haunted through the Internet at the beginning of 2011 for the first time, the idea seemed even more absurd that any illegal drugs such as cannabis, cocaine or heroin can be ordered with a few simple clicks via mail. But these virtual black market on which the users communicating encrypted with each other and the goods were paid for with the digital currency `Bitcoin‘, made a turnover of an estimated $ 22 million, to which the operators were involved with 6% commission in the first year of operation. The site was closed in October 2013, and the alleged operator was arrested, but numerous other black market platforms in Darknet followed. Also, the boom of the many new synthetic stimulants was additionally fueled by the possibilities of the World Wide Web. In just the past 4 years, 243 new legal intoxicants were recorded by the authorities.2 As soon as a substance is banned, a few days later a new legal substitute appears. Until the mechanisms of supervisory work, the new materials have long been disseminated on the Internet. On the hunt for new drugs The development and manufacture of new psychoactive substances is facilitated by the digital exchange of information that allows for easy replacement of new formulations and synthesis processes. In the laboratory, all synthetic structures of organic chemistry can now be assembled by modifying chemical formulas and the effect can be enhanced, expanded or otherwise altered.

Page 12

Consumers can choose new substances from an unprecedented choice and procure them easily on their home computers, armed only with an Internet connection and a credit card. Here, the fact that some drugs are legally available, makes some users believe that these substances are harmless. But synthetic materials are often highly effective, even very small doses can be harmful. Still, there are no findings about interactions or long-term consequences and one can rarely find out about accurate dosing information. The fight against the rapid development of new drugs seems already lost from the outset. The instances of drug control are overwhelmed by the ingenuity and pace of providers, no institution can still control this market. Anonymous, but among `friends‘ Another effect of the anonymous drug procurement in the network is that the personal relationship, the consumers may have had with their dealers will vanish. For that reason the user won’t get further application tips or hints for efficiency, as it might have been the case with a personal trading. The fact that you can exchange ideas on the net with thousands more consumers, some with users, the reports about their very extreme addictive behaviour online, their own consumption may appear almost normal or harmless, the relation to the majority of the population is lost. Some product features of the illegal online drug dealers seem like an extensive catalog. Countless substances, whether conventional or new drugs, are offered. Who does not know a substance can learn something about it with a couple of clicks. Country borders disappear, inhibitions decline. As the network has boosted the legal trade of consumer goods, the same thing happens also in the trading of illegal drugs. According to the latest census of the EMCDDA (European Monitoring Centre for Drugs and Drug Addiction), there are about 690 internet shops where at least one synthetic drug is sold.2 But what can be done about it? What measure can be put in place to reduce the flood of new substances? Like all other pioneering innovations, the invention of the Internet can not be undone, there is no off button for the World Wide Web. The only effective means in the fight against online drug trafficking would be to illuminate worldwide all postal and parcel deliveries, to prevent that the substances reach their recipients.

Drug Rapid Tests Online market

Reaping the benefits of the network The basic idea of the Internet was to create a network of resources, in which each individual can bring his contribution. There is no central control point, no supervisory authority and no responsible chief. The individual is less important than the collective. From this principle, some effects that can also positively influence the revolutionary development of the online drug trafficking arise. Social networks play a major part in the new generation of drug users. Within the exchange with other users, potential buyers can obtain important information on virtually every imaginable drug. In addition to public counseling centers and

institutions for combating addiction, who are represented online and provide important contents, many users are looking for advices of other consumers, as their hints appear to be more credible. Itâ&#x20AC;&#x2DC;s a bit like asking his older brother, instead of sharing the problem with parents. Some consumers who share their experiences via the World Wide Web possess more knowledge than any doctors, policemen or politicians. The crucial point is that the exact knowledge of application, dosage or side effects can save lives. Consumers can check in positive and negative reports by other users about the precise effect of the substances, avoid unwanted bad trips, potentially fatal pills or health problems. The range of reports is huge.

Social networks play a central role in the new generation of drug users.

www.istockphoto.com ÂŠ STILLFX

Page 13

Drug Rapid Tests Online market

The question is whether this mass of information is encouraging the users to consume? But if anyone actually plans to procure a drug, it is of the utmost importance that he is informed about the risks and proper use. This is a task that canâ&#x20AC;&#x2122;t be handled by any public institution due to the flood of new substances. Information can save lives One example of such a page we want to mention www.erowid.org, a community that was actually founded with the focus on the consumption of herbal drugs such as poppies, cactuses or magic mushrooms. The site includes 4.1 million files

to all sorts of drugs and records about 90,000 clicks per day. Only about half of the reports submitted is published after a detailed examination. Again and again the operators get feedback from individual users, who claim that the site has saved their live - just by exchanging information.2 On many websites, like the German homepage www.bluelight. org, information about the synthesis of drugs are prohibited as well as the naming of sources, but not the advice for consumption.2 But of course these kind of reports just draw attention to new substances. But one can also find sub-forums, including self-help groups for addicts.

Almost a third of all

young people is looking for a legal way to become intoxicated.

Page 14

www.istockphoto.com ÂŠ Pogonici

Drug Rapid Tests Online market

The American provider ecstasydata.org has set itself the task to inform consumers. Therefore the operators have a special permission from the US Drug Enforcement Administration to test pills to their composition, anonymously send in from users, in order to prevent the potentially fatal drug consumption of wrongly marked MDMA pills which might contain other substances. In addition, findings on particularly harmful substances are passed to different online communities. The same goal pursues the page www.pillreports.com, where one can find experience reports, analyzes and pictures of pills, acquired as Ecstasy.2 These reports are a much more recent display of the quality of Ecstasy, as official reports can ever be. As with many other sites here Moderators pursue the individual threads to prevent abuse of dealers. Another, in this respect interesting online service is www.SafeOrScam.com, a user-generated rating of online drug dealers.2 By encrypting the database it is ensured that no provider lists are available. The user must enter a address himself, he can not choose from a adress list. Than he can check if other consumers judged this dealer as `safe‘ or as a `scam‘, meaning fraudulent. Therfore one can find out whether the seller actually delivers the ordered drug or rather a substitute, and if

he returns at all. With various techniques it is ensured that this service is not abused by dealers. This page also has saved some lives and is an integral part of the community with 10,000 visits per day and 3,086 registered users. Where does the digital way lead? According to a survey of the Angelus Foundation from 2012 almost a third of young people is looking for a legal way to become intoxicated. Even more frightening it is the result of a Mixmag survey of the same year, which recors that 25% of the participants would willingly consume any `mysterious white powder‘, without knowing its contents. The problem of drug addiction is not a new one, and the goal to finally win the fight against drugs is an utopia. But the frightening fact that technological innovations and impulses from the drug culture together lead to an increasingly wide range of hazardous substances, cannot be denied. The digital age is still young and will involve many revolutionary upheavals with it. The hope is that the synergies of the online community can be used to limit damage, to deter and to protect drug users from deadly substances, to prevent that by clicking and downloading the overdoses come via mail.

Most of the information of this article relate to the content of the book `Your Crack is in the mail - how the internet revolutionised the world of drugs‘ by Mike Power, first published in May 2003 in the UK under the title `Drugs 2.0‘. Journalist and drug expert Mike Power has gone deep into the hidden world of the online drug trafficking for his research and talked to manufacturers, dealers and consumers.

UniSPIEGEL 5/2012 (http://www.spiegel.de/unispiegel/studium/ die-schlimmsten-fehlprognosen-von-wissenschaftlern-und-managern-a-868979-3.html) 2 Mike Power: Dein Crack ist in der Post: Wie das Internet die Welt der Drogen revolutioniert. 2013/2014. Eichborn Verlag in der Bastei Lübbe AG, Köln 1

Page 15

Drug rapid tests Party drugs

Party drugs

The drug trend getting Europe high Party drugs (an umbrella term for substances such as MDMA/ Ecstasy, LSD and Speed) are once again on the rise in Europe. These drugs, reaching their zenith during the house music rave scene of the late 1980’s and 90’s, had decreased in popularity in most European nations from the early-mid noughties onwards as new drug trends emerged and perceived ‘better’ alternatives, such as heroin and cocaine, emerged on the drug market. Despite this, the complex nature of the drug market means that it is now these psychoactive substances which are gaining a considerable foothold in the European Union drug market. Although the current trend for those seeking a new high, it is not so long ago that drugs such as MDMA and LSD were seen as a ‘thing of the past’. Ecstasy, for example, experienced its lowest levels of popularity only in 2008/2009, a fate often attributed to a low quality product found on the market at the time which in turn lead people to seek after their much sought-after highs elsewhere; namely, other drugs. The presence of these substances within the drug market has, however, swelled across the continent in the past 5 years and this decline in popularity has been reversed. But what are the reasons for this? Tracing the causes There are various causes attributed to this rapid growth in popularity, one of which being the increased quantity of the active substance MDMA (3,4-methylenedioxymethamphetamine) being found in many Ecstasy tablets currently on sale, thus leasing to a higher quality product. In Britain, for example, a charity called The Loop has estimated that the average Ecstasy tablet found in the country now contains roughly 100mg of MDMA – a five-fold increase compared with 2009 . Compounding this is the European Drug Report of 2015, which similarly confirms an increase in MDMA-content of Ecstasy tablets since 2010 in tablet, powder and crystal forms . In addition to the largely increased purity of the product currently on offer, there is also a significant ‘external’ cultural influence on the consumption of these substances: music. Often seen as the original ‘designer drugs’ of the 80’s and 90’s, Ecstasy/MDMA and LSD have long been the perennial drugs of choice for ravers and clubbers. The stimulating side effects, namely an increased sense of euphoria and bursts of energy, allow the consumer to dance for hours on end without tiring, whilst also heightening the sensation

of the music and strobe lights often found in clubs. Indeed, these so-called ‘party drugs’ are more often than not the substances of choice whenever house music and clubbing is concerned. Fiona Measham, a lecturer in Criminology at the University of Durham, North-East England, reaffirms this in saying ‘you have these sort of revivals and cycles’ when referencing the tangible link between drug habits and music. Can this trend be stopped? It is clear that the problem they are facing is growing. Once again, the European Drug Report, revealed that over 12.3 million people among the adult population of the EU are said to have tried MDMA at least once in their lifetime (a higher figure than the entire population of Belgium), and roughly 4.8 million ecstasy tablets were seized within the continent in 2013 alone. According to the most recent figures compiled by the Drug Report, the 3 countries with the most individual MDMA seizures were the UK (3,700), Spain (2,300) and Germany (2,200). Comparing these figures with Amphetamine seizures, it is interestingly the same countries that appear at the top of the list. These figures are of particular concern to health experts, as the dangers posed by such drugs are too frequently underestimated by those consuming them. The number of MDMA-induced deaths in England and Wales has increased steadily from just eight in 2010 to 43 in 2013, constituting an increase of more than 500% . However, hard-line drug approaches by governments do not seem to be having their desired effect. In fact, quite the opposite has occurred in Britain. Despite a Conservative government taking a hard-line stance against substance abuse, the number of people taking Ecstasy and LSD has spiked since David Cameron’s became Prime Minister in 2010, with the number of people having tried each drug increasing by 84% and 175% respectively in the past year alone. Worldwide, the Global Drugs Survey of this year has estimated that the number of people across the globe seeking emergency treatment for MDMA abuse has tripled between 2013 and 2015. So what can be done to help? Unfortunately, those who want to obtain drugs will inevitably succeed, regardless of the amount of restrictive measures imposed by law. The online market causes further issues as we‘ve got a generation who get everything off the internet – why not drugs?’, as Mike Power, author of ‘The Web Revolution That’s Changing

Page 16

1 The Guardian; ‘On a high: why Britain is back on Ecstasy’: http://www.theguardian.com/society/2015/sep/16/ecstasy-clubbers-dance-music-legal-high 2 João Goulão, European Drug Report 2015, Luxembourg Publications Office of the European Union, 2015. 3 The Guardian: http://www.theguardian.com/uk-news/2015/jul/23/ ecstasy-and-lsd-use-reaches-new-high-among-young 4 European Drug Report 2015

5 The Guardian: ‘Clubbers warned of overdose risk from super-strength ecstasy’: http://www.theguardian.com/society/2014/nov/28/clubbers-warn-overdose-risk-from-superstrength-ecstasy-mdma 6 The Guardian: ‘On a high: why Britain is back on Ecstasy’: http:// www.theguardian.com/society/2015/sep/16/ecstasy-clubbersdance-music-legal-high

Drug rapid tests Party drugs

So-called party drugs are on the rise in Europe

How the World Gets Highâ&#x20AC;&#x2DC; states. The conclusion can thus be drawn that combinations of increased quality, increased demand and indeed increased availability have equally contributed to the drastic growth in popularity of these drugs. That the consumption of MDMA, LSD and other psychoactive substances will never be fully eradicated is cleat, but an informed approach at dissuading those who want to take them ought to drastically reduce the demand, and hopefully reverse the spike in popularity that these dangerous designer drugs are currently experiencing. *nal von minden offer tests for both Amphetamine and MDMA/Ecstasy

www.istockphoto.com ÂŠ innovatedcaptures

Page 17

nvm inside Medica 2015

Medica 2015 nal von minden was present again this year at MEDICA in DĂźsseldorf. In cooperation with our partners BIOSCITEC and bioactive diagnostic, we met with customers at the joint exhibition stand in hall 3. To accommodate our customers more comfortably, we opted for a much larger stand this year. Weâ&#x20AC;&#x2122;d like to thank our visitors for their interest in our company, products and the pleasant conversation! Hopefully we will meet again at the same place next year. Furthermore, we would like to thank our organizational team for their excellent work in setting up the stand and all the colleagues of nal von minden, BIOSCITEC and bioactive diagnostica who took part. MK

Page 18

nvm inside NPS Seminar

New psychoactive substances seminar

A huge success!

On the 12th and 13th of November nal von minden hosted its first international seminar on New Psychoactive Substances in partnership with chemical reference material experts Chiron. We were grateful to Waters, Phenomenex, Capital Antibodies, ACQ Science and Carl Roth, whose kind support was a great help in maintaining a high registration rate, securing world class speakers and providing a fitting venue. Thanks also goes out to all the professional bodies who helped in advertising this event, and in particular to GTFCh for their recognition of outstanding scientific content by granting us 8 certification points. We chose the Bavarian city of Munich, Germany as the location, much to the delight of all beer loving attendees! Despite Lufthansaâ&#x20AC;&#x2122;s best efforts to cause chaos with their untimely strike, the meeting went ahead as scheduled and attracted over 100 delegates from no high than 16 different countries! Special acknowledgement is also paid to our furthest travelling delegate, who came all the way from Abu Dhabi.

Twenty speakers gave presentations on subjects ranging from clinical perspective, harm reduction, customs seizures, developing and monitoring of drug trends, legal challenges, proactive reference material production, novel methods and matrices, worldwide projects, compounds of emerging concern and much, much more! As soon as we have sought the permission of our speakers, we will be delighted to share with you some of the proceedings from the two days.

For our social dinner delegates were treated to a rich feast of traditional Bavarian fare at the renowned LĂśwenbrĂ¤ukeller, washed down with a selection of local beers and a generous portion of good company! Our final thanks must go to all our delegates for their participation and welcome contributions during the meeting. We look forward to sharing with you again in the future!

Page 19

Contact Details nal von minden GmbH Carl-Zeiss-Straße 12 47445 Moers Germany Friedenstraße 32 93053 Regensburg Germany

Tel.: +49 941 29010-0 Fax: +49 941 29010-50 info@nal-vonminden.com www.nal-vonminden.com Commerical Reg: HRB 5679 Steuer-Nr. 244/133/00130 UST-ID-Nr. DE 189 016 086

Discover our comprehensive product range! For all products and innovations please visit: www.nal-vonminden.com

THE adventures of medical Man Who is the prettiest one of all? dR. fRÖHLICH, a passionate fan of the series didn‘t seem bothered by Medical man‘s malicous comments.

But the program was not really Medical man‘s cup of tea! My Goodness! What nonsense, Fröhlich! How can you watch this rubbish??

Oh, you have no idea. The show is more popular than you!

our We can celebrate ther day! anniversary ano ENough is Forget about it! divorce!!! enough, I want

That he didn‘t need to be told twice. AS USUAL oUR SUPERHERO HAS ALREADY A PLAN. thE PRIZE DRAW QUESTION IN iNSIDE DIAGNOSTICS SHALL BRING CLARITY.

What? This crap? Never! Wanna bet...?!!!!

a FEW WEEKS LATER THE FIRST ANSWERS ARRIVE,…

then Dr. Fröhlich passed by to talk about What to do in the evening.

wHAT THE… ?

Hey, old friend. It‘s time for „Private anatomy“! In the mood to watch another episode with me?

lET‘S SEE Who IS MORE POPULAR…

*whO IS THE sexiest MEDICAL SUPERHERO ALIVE? a: Medicus, B: Medical Man, c: dR. dEREK sHEPHERD

not at all!!!!!!!!!!!!!!!!

... but the result WAS clear!

Rapid Tests

Damn you, shepHeerd!!!

Laboratory Diagnostics Laboratory Service Consulting & Service

www.nal-vonminden.com/inside-diagnostics *c: dR. dEREK sHEPHERD

Rev 01 / IMAGE-DE / 01-13

derek?! HOW COULD YOU, the had to do it. I am Don‘t you see, I y. eon In the countr urg ros neu t bes . died without me he would have

Rev 01 / IMAGE-DE / 01-13

A while ago Dr. Fröhlich and Medical Man had a Relaxing evening in front of the television.