New Psychoactive Substances, New Behaviours, New Drug-drug Interactions: Pharmacology of a Slam Session. 2023

Benoit Schreck, and Marion Istvan, and Marylène Guerlais, and Edouard-Jules Laforgue, and Marie Gérardin, and Marie Grall-Bronnec, and Aurélie Aquizerate, and Caroline Victorri-Vigneau
Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000 Nantes, France.

BACKGROUND Slamming has been increasing internationally for ten years, mostly among men who have sex with men. Slamming consists of injecting psychostimulants (including new psychoactive substances-NPS) intravenously to increase sexual performance. OBJECTIVE The objective of our work was to analyse drug-drug interactions related to slamming. METHODS Drawing upon a reported case of a slam session describing hour by hour the intake of substances, we performed a drug-interaction analysis using international references and a comprehensive literature review. High doses of sildenafil, GBL and 3-MMC were reported during the 40-hour session described. The specific drug-interaction research was performed using 9 references and 65 of the 209 records identified in the literature review. RESULTS Pharmacological data regarding nonmedicated substances were scarce. Regarding pharmacodynamics, the risk was high at the cardiovascular level and was related to the vasodilatation effect of sildenafil and the adrenergic and serotoninergic properties of stimulants; this risk may increase with usual treatment (involving other vasodilators or central depressants). Regarding pharmacokinetics, the major interactions concerned metabolism by CYP3A4 and CYP2C9, leading to interactions, particularly with HIV medication. CONCLUSIONS This innovative work provides pharmacological information on drugs that are commonly used in slamming, allowing the development of effective medical-management protocols and the provision of risk-reduction counselling.

UI MeSH Term Description Entries
D008297 Male Males
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000068677 Sildenafil Citrate A PHOSPHODIESTERASE TYPE-5 INHIBITOR; VASODILATOR AGENT and UROLOGICAL AGENT that is used in the treatment of ERECTILE DYSFUNCTION and PRIMARY PULMONARY HYPERTENSION. 1-((3-(6,7-Dihydro-1-methyl-7-oxo-3-propyl-1H-pyrazolo(4,3-d)pyrimidin-5-yl)-4-ethoxyphenyl)sulfonyl)-4-methylpiperazine citrate,Acetildenafil,Desmethyl Sildenafil,Desmethylsildenafil,Homosildenafil,Hydroxyhomosildenafil,NCX-911,Revatio,Sildenafil,Sildenafil Lactate,Sildenafil Nitrate,UK 92480-10,UK-92,480-10,Viagra,Citrate, Sildenafil,Lactate, Sildenafil,NCX 911,NCX911,Nitrate, Sildenafil,Sildenafil, Desmethyl,UK 92,480 10,UK 92480 10,UK 9248010
D000072339 Sexual and Gender Minorities Individuals including lesbian, gay, bisexual, transgender, queer, intersex, gender non-conforming people, and other populations whose sexual orientation or GENDER IDENTITY and reproductive development is considered outside cultural, societal, or physiological norms. Gays,Gender Diverse,LGBTQ,LGBTQIA,Bisexuals,GLBT Persons,Gender Minorities,Homosexuals,LBG Persons,LGBT Persons,LGBTQ Persons,Lesbians,Lesbigay Persons,Men Who Have Sex With Men,Non-Heterosexual Persons,Non-Heterosexuals,Queers,Sexual Dissidents,Sexual Minorities,Women Who Have Sex With Women,Bisexual,Dissident, Sexual,Dissidents, Sexual,Diverse, Gender,GLBT Person,Gay,Gender Minority,Homosexual,LBG Person,LGBT Person,LGBTQ Person,Lesbian,Lesbigay Person,Minorities, Gender,Minorities, Sexual,Minority, Gender,Minority, Sexual,Non Heterosexual Persons,Non Heterosexuals,Non-Heterosexual,Non-Heterosexual Person,Person, GLBT,Person, LBG,Person, LGBT,Person, LGBTQ,Person, Lesbigay,Person, Non-Heterosexual,Persons, GLBT,Persons, LBG,Persons, LGBT,Persons, LGBTQ,Persons, Lesbigay,Queer,Sexual Dissident,Sexual Minority
D012725 Sexual Behavior Sexual activities of humans. Anal Sex,Oral Sex,Sexual Activity,Sexual Orientation,Premarital Sex Behavior,Sex Behavior,Sex Orientation,Sexual Activities,Activities, Sexual,Activity, Sexual,Behavior, Premarital Sex,Behavior, Sex,Behavior, Sexual,Orientation, Sexual,Sex, Anal,Sex, Oral
D018451 Homosexuality, Male Sexual attraction or relationship between males. Male Homosexuality

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