{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:00:41Z","timestamp":1790308841616,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["88887.198549\/2025\u201300"],"award-info":[{"award-number":["88887.198549\/2025\u201300"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2024\/04999\u20137"],"award-info":[{"award-number":["2024\/04999\u20137"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Brazil has historically exhibited low illicit opioid prevalence, though forensic data indicate rising fentanyl seizures, often in combination with other substances. People who use Synthetic cannabinoid receptor agonists (SCRA) are particularly vulnerable to unintentional fentanyl exposure due to the unpredictable chemical composition of these products. This study aimed to investigate the discordance between self\u2010reported drug use and toxicological detection of fentanyl among individuals reporting recent SCRA use recruited from addiction treatment and psychosocial care centres in S\u00e3o Paulo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cross\u2010sectional study with 65 participants reporting SCRA use within the preceding 4\u2009days, recruited from a specialised addiction treatment centre and two community\u2010based psychosocial care centres in S\u00e3o Paulo. Oral fluid samples collected by independent research staff using the Quantisal device were analysed by liquid chromatography\u2013tandem mass spectrometry. Sociodemographic characteristics, self\u2010reported substance use and clinical symptoms were assessed by structured questionnaire. Exploratory multivariable logistic regression investigates factors associated with fentanyl detection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fentanyl was detected in 32% of participants (21\/65; 95% CI 21, 44), none of whom reported intentional opioid use. Fentanyl\u2010positive participants were more likely to be experiencing homelessness (52.4% vs. 13.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), to report longer SCRA use duration (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), and to present with nausea\/vomiting (90.5% vs. 43.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and myalgia (61.9% vs. 11.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). No independent factors associated with fentanyl detection were identified in exploratory multivariable analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>A substantial discordance between self\u2010reported drug use and toxicological findings was observed. While the small sample size limits generalizations, these findings provide preliminary evidence that the historical assumption of negligible illicit opioid exposure in this population warrants reassessment. Whether this reflects changes in the local drug supply, underreporting of opioid use, or other exposure pathways cannot be determined from the available data. These results underscore the need for systematic toxicological surveillance and drug checking to monitor the evolving drug supply in Brazil.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70266","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:19:21Z","timestamp":1789539561000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fentanyl Detection in Biological Samples From Individuals Reporting Synthetic Cannabinoid Use in S\u00e3o Paulo, Brazil"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9400-2347","authenticated-orcid":false,"given":"Ligia Goes","family":"Endo","sequence":"first","affiliation":[{"name":"Departamento de Medicina Legal, Bio\u00e9tica, Medicina Do Trabalho e Medicina F\u00edsica e Reabilita\u00e7\u00e3o, Faculdade de Medicina Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo Alves","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Legal, Bio\u00e9tica, Medicina Do Trabalho e Medicina F\u00edsica e Reabilita\u00e7\u00e3o, Faculdade de Medicina Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7180-8873","authenticated-orcid":false,"given":"Ivan Dieb","family":"Miziara","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Legal, Bio\u00e9tica, Medicina Do Trabalho e Medicina F\u00edsica e Reabilita\u00e7\u00e3o, Faculdade de Medicina Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Yonamine","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Legal, Bio\u00e9tica, Medicina Do Trabalho e Medicina F\u00edsica e Reabilita\u00e7\u00e3o, Faculdade de Medicina Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Departamento de An\u00e1lises Cl\u00ednicas e Toxicol\u00f3gicas, Faculdade de Ci\u00eancias Farmac\u00eauticas Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Maur\u00edcio","family":"Castaldelli\u2010Maia","sequence":"additional","affiliation":[{"name":"Departamento de Psiquiatria, Faculdade de Medicina Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Instituto Perdizes, Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina, Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5101-1290","authenticated-orcid":false,"given":"Vilma","family":"Leyton","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Legal, Bio\u00e9tica, Medicina Do Trabalho e Medicina F\u00edsica e Reabilita\u00e7\u00e3o, Faculdade de Medicina Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3408-7119","authenticated-orcid":false,"given":"Henrique Silva","family":"Bombana","sequence":"additional","affiliation":[{"name":"Departamento de An\u00e1lises Cl\u00ednicas e Toxicol\u00f3gicas, Faculdade de Ci\u00eancias Farmac\u00eauticas Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Nitazenos: Caracteriza\u00e7\u00e3o e Presen\u00e7a no Brasil [Nitazenes: Characterisation and Presence in Brazil]","author":"Centro de Estudos Sobre Drogas e Desenvolvimento Social Comunit\u00e1rio (Cdesc)","year":"2025"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13011\u2010021\u201000348\u2010z"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0104\u201012902025240397en"},{"key":"e_1_2_11_5_1","volume-title":"INSPEQT 2.0: Relat\u00f3rio de Detec\u00e7\u00e3o de Subst\u00e2ncias em Amostras Apreendidas [INSPEQT 2.0: Report on Substance Detection in Seized Samples]","author":"Centro de Estudos Sobre Drogas e Desenvolvimento Social Comunit\u00e1rio (Cdesc)","year":"2025"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2023.100507"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsir.2024.100375"},{"key":"e_1_2_11_8_1","volume-title":"Novas Subst\u00e2ncias Psicoativas em S\u00e3o Paulo: Relat\u00f3rio 2025 \u2013 Dados Relativos ao Ano de 2024 [New Psychoactive Substances in S\u00e3o Paulo: 2025 Report \u2013 Data Relative to the Year 2024]","author":"Guedes C. D.","year":"2025"},{"key":"e_1_2_11_9_1","unstructured":"Subsistema de Alerta R\u00e1pido Sobre Drogas (SAR) \u201c1\u00b0 Informe do Subsistema de Alerta R\u00e1pido Sobre Drogas [1st Report of the Rapid Alert System on Drugs] \u201d(2022)."},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3310\/phr07140"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1108\/DHS\u201011\u20102024\u20100038"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bkaf027"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2019.05.020"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954\u2010021\u201000585\u20102"},{"key":"e_1_2_11_15_1","volume-title":"Fentanil: Caracteriza\u00e7\u00e3o e Presen\u00e7a no Brasil \u2013 4\u00b0 Alerta R\u00e1pido Sobre Drogas [Fentanyl: Characterisation and Presence in Brazil \u2013 4th Report of the Rapid Alert System on Drugs]","author":"Subsistema de Alerta R\u00e1pido Sobre Drogas (SAR)","year":"2023"},{"key":"e_1_2_11_16_1","unstructured":"Inter\u2010American Drug Abuse Control Commission (CICAD) Information Bulletin: The Emergence of Nitazenes in the Americas \u201d(2024)."},{"key":"e_1_2_11_17_1","volume-title":"State Unintentional Drug Overdose Reporting System (SUDORS): Overdose Fatality Data","author":"New York State Department of Health","year":"2024"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2025.112672"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11419\u2010023\u201000666\u2010w"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954\u2010024\u201001062\u20102"}],"container-title":["Drug and Alcohol Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.70266","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dar.70266","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.70266","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T03:32:37Z","timestamp":1790307157000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dar.70266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":19,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/dar.70266"],"URL":"https:\/\/doi.org\/10.1111\/dar.70266","archive":["Portico"],"relation":{},"ISSN":["0959-5236","1465-3362"],"issn-type":[{"value":"0959-5236","type":"print"},{"value":"1465-3362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-05-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70266"}}