The potential of high resolution mass spectrometry (HRMS) for the investigation of human in vivo metabolism of 3,4-methylenedioxypyrovalerone (MDPV) using urine collected from a consumer (this is, in non-controlled experiments) has been investigated. As a control sample was not available, the common approach based on the comparison of a control/blank sample and samples collected after drug intake could not be used. Alternatively, an investigation based on common fragmentation pathways was applied, assuming that most metabolites share some fragments with the parent drug. An extension of this approach was also applied based on the fragmentation pathway of those metabolites identified in urine samples in the first step. The use of MS E experiments (sequential acquisition of mass spectra at low and high collision energy) has been crucial to this aim as it allowed promoting fragmentation in the collision cell without any previous precursor ion selection. MDPV belongs to the group of new psychoactive substances (NPS), being known as the "cannibal drug". This substance is being more and more abused and associated with dangerous side effects. The human metabolites (both phase I and phase II) were detected and tentatively identified by accurate-mass full-spectrum measurements using ultra-high performance liquid chromatography coupled to hybrid quadrupole time of flight mass spectrometry (UHPLC-QTOF MS). Following this strategy, up to 10 phase I metabolites, together with some glucuronides and sulphates, were detected and tentative structures were proposed. Several compounds identified in this work have not been previously reported in the literature.

Little data are available for women diagnosed with a dual diagnosis. However, dual diagnosis in women presents increased stigma, social penalties, and barriers to access to treatment than it does for men. Indeed, it increases the probability of suffering physical or sexual abuse, violent victimization, gender-based violence, unemployment, social exclusion, social-role problems, and physical and psychiatric comorbidities. Thus, a transversal sex and gender-based perspective is required to adequately study and treat dual diagnosis. For this, sex and gender factors should be included in every scientific analysis; professionals should review their own prejudices and stereotypes and train themselves specifically from a gender perspective; administrations should design and provide specific treatment resources for women; and we could all contribute to a structural social transformation that goes beyond gender mandates and norms and reduces the risk of abuse and violence inflicted on women.

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