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Terza Edizione Dipartimento del Farmaco Istituto Superiore di Sanità - Roma SmartDrugs Terza edizione Il progetto è stato realizzato con il supporto tecnico e logistico del Comando Carabinieri per la tutela della salute (NAS) nelle fasi di pianificazione delle verifiche e di individuazione degli Smart Shop, dei siti internet e nel reperimento delle sostanze da analizzare. Reparto Farmacodipendenza, Tossicodipendenza e Doping Osservatorio Fumo Alcol e Droga Dipartimento del Farmaco Istituto Superiore di Sanità Viale Regina Elena, 299 - 00161 Roma Tel. 06 49902909 Fax 06 49902016 E-mail: [email protected] Volume realizzato grazie al finanziamento concesso dalla Presidenza del Consiglio dei Ministri Dipartimento della Gioventù e del Servizio Civile Nazionale a valere sul “Fondo per le Politiche giovanili” SmartDrugs Terza edizione Simona Pichini e Roberta Pacifici con Emilia Marchei, Ilaria Palmi, Manuela Pellegrini, Maria Concetta Rotolo Dipartimento del Farmaco - Osservatorio Fumo Alcol e Droga Istituto Superiore di Sanità - Roma Gen. D. Cosimo Piccinno, Magg. Pietro Della Porta, Cap. Francesco Saggio, Cap. Dario Praturlon Comando Carabinieri per la tutela della salute (NAS) Ufficio Comando - Sezione Operazioni Reparto Analisi Gruppo di lavoro dell’Osservatorio Fumo Alcol e Droga Antonella Bacosi, Simonetta Di Carlo, Rita di Giovannandrea, Patrizia Gori, Silvia Graziano, Laura Martucci, Luisa Mastrobattista, Adele Minutillo, Claudia Mortali, Giulia Scaravelli, Renata Solimini, Roberta Spoletini, Giacomo Toth Si ringraziano Rosanna Cammarano, Alessandra Ceccarini, Italo Gentilini, Scilla Pizzarelli del “Settore Documentazione” dell'Istituto Superiore di Sanità Indice Prefazione pag. 000 Presentazione pag. 000 Introduzione pag. 000 1 “Smart Drugs” di origine vegetale 1.1 Acorus calamus pag. 000 1.2 Amanita muscaria pag. 000 1.3 Anadenanthera peregrina pag. 000 1.4 Areca catechu pag. 000 1.5 Argemone mexicana pag. 000 1.6 Argyreia nervosa pag. 000 1.7 Artemisia absinthium pag. 000 1.8 Ayahuasca pag. 000 1.9 Brugmansia arborea pag. 000 1.10 Calea zacatechichi pag. 000 1.11 Citrus aurantium pag. 000 1.12 Datura stramonium pag. 000 1.13 Ephedra sinica pag. 000 1.14 Eurycoma longifolia pag. 000 1.15 Heimia salicifolia pag. 000 1.16 Hydrangea pag. 000 1.17 Ipomoea violacea pag. 000 1.18 Lactuca virosa pag. 000 1.19 Mimosa hostilis pag. 000 1.20 Mitragina speciosa pag. 000 1.21 Muira puama pag. 000 1.22 Pausinystalia yohimbe pag. 000 1.23 Piper methysticum pag. 000 1.24 Radula marginata pag. 000 1.25 Rivea corymbosa pag. 000 1.26 Salvia divinorum pag. 000 1.27 Sceletium tortuosum pag. 000 1.28 Sida cordifolia pag. 000 1.29 Tribulus terrestris pag. 000 1.30 I Cactus del genere Trichocereus pag. 000 1.31 Turnera aphrodisiaca pag. 000 1.32 Voacanga africana pag. 000 1.33 Withania somnifera pag. 000 2 Cannabinoidi sintetici 2.1 Introduzione pag. 000 2.2 Naftoilindoli pag. 000 2.2.1 JWH-022 pag. 000 2.2.2 JWH-122 e suoi analoghi pag. 000 2.2.3 AM-2201 e suo analogo pag. 000 2.3 Aminoalchilindoli pag. 000 2.3.1 JWH-200 pag. 000 2.4 Naftoilpirroli pag. 000 2.4.1 JWH-307 pag. 000 2.5 Benzoilindoli pag. 000 2.5.1 AM-694 e suoi analoghi pag. 000 2.5.2 AM-2233 pag. 000 2.5.3 RCS-4 pag. 000 2.6 Ciclopropilindolchetoni pag. 000 2.6.1 UR-144 pag. 000 3 Catinoni sintetici 3.1 Introduzione pag. 000 3.2 Catha edulis pag. 000 3.3 Mefedrone pag. 000 3.4 4-metiletcatinone pag. 000 3.5 Efedrone pag. 000 3.6 Metilendiossipirovalerone pag. 000 3.7 Butilone pag. 000 3.8 Metilone pag. 000 3.9 Bufedrone pag. 000 3.10 Pentedrone pag. 000 4 Designer Drugs 4.1 Introduzione pag. 000 4.2 Dimetilamilammina pag. 000 4.3 Metossietamina pag. 000 4.4 (2-aminopropil)benzofurani: 4, 5 e 6-APB pag. 000 4.5 4-Fluoroamfetamina pag. 000 4.6 Metaclorofenilpiperazina pag. 000 4.7 Benzilpiperazina pag. 000 5 Potenziatori delle performance sessuali 5.1 Introduzione pag. 000 5.2 Sildenafil, Vardenafil e Tadalafil pag. 000 5.3 Analoghi del Sildenafil, Vardenafil e Tadalafil pag. 000 5.3.1 Tioanaloghi del Sildenafil pag. 000 5.3.2 Altri analoghi del Sildenafil pag. 000 5.3.3 Analoghi del Vardenafil pag. 000 5.3.4 Analoghi del Tadalafil pag. 000 6 Bevande Energetiche 6.1 Introduzione pag. 000 6.2 Caffeina pag. 000 6.3 Teofillina pag. 000 6.4 Teobromina pag. 000 6.5 Taurina pag. 000 6.6 Carnitina pag. 000 6.7 Glucuronolattone pag. 000 6.8 Vitamine del gruppo B pag. 000 6.9 Ginkgo biloba pag. 000 6.10 Paullinia cupana pag. 000 6.11 Panax quinquefolius pag. 000 Prefazione L’universo giovanile è in continua evoluzione e, come tale, anche la manifestazione delle problematiche che i ragazzi vivono cambia repentinamente ed inaspettatamente. Per le istituzioni e, in particolare, per il Dipartimento della Gioventù e del Servizio civile nazionale che ha come mission quella di occuparsi dei giovani e delle politiche che trasversalmente li interessano, risulta di fondamentale importanza studiare quei fenomeni che pongono a serio rischio il loro sviluppo e la loro crescita e possono comprometterne la salute fisica e psicologica. Nella nostra società in cui è ormai evidente che gli adolescenti rappresentano una delle fasce più a rischio, a maggior ragione se appartenenti a realtà sociali e territoriali più svantaggiate e con problematiche legate all’esclusione sociale, risulta fondamentale predisporre un sistema di protezione efficace. In quest’ottica, diviene prioritario, da una parte conoscere approfonditamente i rischi correlati al consumo di sostanze più o meno legali che i nostri giovani trovano facilmente negli ambienti che frequentano, dall’altra individuare interventi di contrasto al disagio giovanile che prevengano la diffusione di fenomeni quali il consumo di sostanze stupefacenti e l’abuso di alcool. Per questo motivo, il Dipartimento della Gioventù e del Servizio civile nazionale, che ho il piacere di coordinare, intende promuovere lo studio e la ricerca sulle “Smart Drugs”; il fine non è soltanto quello, seppur importante, di offrire agli adulti di riferimento, come gli educatori ed i familiari, gli strumenti necessari per essere consapevoli ed informati sui rischi che i nostri giovani incontrano quotidianamente, ma anche e soprattutto stimolare i giovani stessi a “recitare” una parte attiva per contrastare la cultura dello “sballo” e degli stati d’animo artificiali. Il duplice obiettivo che si intende raggiungere è, quindi, quello di informare i ragazzi sui rischi derivanti dall’uso di queste sostanze, che spesso hanno forme ed effetti accattivanti, ma anche di lavorare sulla loro crescita personale e sulla promozione di stili di vita salutari. La conoscenza è senz’altro importante per promuovere la consapevolezza delle azioni e dei comportamenti ma, altrettanto vitale risulta essere un intervento preventivo che intercetti le problematicità nel momento in cui si manifestano, fermando, per tempo, comportamenti lesivi e dannosi per se stessi e per gli altri. Questo è il motivo per cui il Dipartimento, in collaborazione con l’Istituto Superiore di Sanità, ha realizzato questa pubblicazione, ormai giunta alla terza edizione, perché, riprendendo una frase di Papa Francesco, “non abbiamo mai avuto più informazioni di adesso, ma continuiamo a non sapere che cosa succede”. Le istituzioni, invece, devono scoprirlo ed intervenire. Il Capo del Dipartimento della Gioventù e del Servizio civile nazionale Cons. Calogero Mauceri 9 Presentazione Il termine “Smart Drugs” (“droghe furbe”) appare nella letteratura scientifica negli anni ′90 del ventesimo secolo per indicare tutti quei composti di origine naturale o sintetica in grado di agire sulle “performance” generali dell’individuo. Mentre alcune di queste sostanze sono semplici integratori dietetici, miscele di vitamine, oligoelementi, aminoacidi, altre possiedono presunte o accertate proprietà psicoattive. Il determinante comune di tutte le “Smart Drugs” è in ogni caso la libera vendita e la mancanza di informazioni scientifiche per quanto riguarda il potenziale di abuso di queste sostanze con caratteristiche tali da essere incluse nell’elenco delle sostanze stupefacenti soggette a controllo (DPR 309/90) e quindi includerle nelle leggi vigenti sugli stupefacenti. Negli anni successivi, una serie di studi ha chiarito che tra le “Smart Drugs”, la maggior parte delle sostanze esaminate era rappresentata da integratori o “nootropici” (smart nutrients) sostanze in grado di stimolare le capacità cognitive, sebbene in alcuni altri casi si trattasse di sostanze farmacologicamente attive o psicoattive per le quali era necessario un approfon- dimento scientifico per poterle classificare accuratamente e includerle nei giusti termini di legge. Questo approfondimento è stato fatto dal Reparto “Farmacodipendenza, Tossicodipendenza Doping” del Dipartimento del Farmaco dell’Istituto Superiore di Sanità che, a partire dall’anno 2003, su incarico del Ministro della Salute, ha ese- guito senza soluzione di continuità analisi chimiche quali-quantititative e valutazioni farmacotossicologiche su reperti provenienti da sequestri dei Nuclei Antisofisticazioni dell’arma dei Carabinieri (NAS) e delle Procure della Repubblica di diverse città in “Smart Shops”, erboristerie, negozi di etnobotanica e infine su negozi telematici. Negli anni 2003-2004, i prodotti analizzati erano soprattutto di origine naturale: estratti secchi di piante, foglie essiccate, preparati per decotti, capsule contenenti materiale erbaceo, distillati alcolici di piante, ecc. Sulla base del lavoro analitico, valutativo e di catalogazione il Ministero della Salute ha emanato una serie di decreti legi- slativi che hanno inserito alcune piante ed alcuni principi attivi in esse contenuti nella Tabella I della lista delle sostanze stupefacenti o psicotrope sottoposte alla vigilanza ed al controllo di cui all’articolo 14 del decreto del Presidente della Repubblica 309/90 (Testo unico delle leggi in materia di disciplina degli stupefacenti e sostanze psicotrope) e successive modifiche ed integrazioni. Nell’anno della pubblicazione della prima Edizione di “Smart Drugs” (2006), sul mercato telematico e nei negozi specia- lizzati in articoli “etno” compaiono miscele di “Smart Drugs”, denominate “Spice”, che potevano essere fumate ottenendo effetti simili a quelli della cannabis.
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