Although these provided some information about the toxic effects of these compounds, the data were inadequate to allow reliable comparison of harms between these carboxylate SCRAs and previously reported carboxamide compounds.
To investigate this expectation, we synthesized 2 in-dole (FUB-PB-22, NM-2201) and 3 indazole (FUBNPB-22, 5F-NPB-22, 5F-SDB-005) carboxylate SCRAs that were commercially unavailable at the time.
The first indole or indazole SCRAs detected in the IONA study were from an exposure in July 2015 with 7 cases recorded in 2015 and 10 cases in 2016.
The other 4 indole or indazole carboxylate SCRAs synthesized had already been notified to the EMCDDA by July 2016.
Specifically, we anticipated the appearance of several novel indole or indazole carboxylate SCRAs following detection of some of these compounds in drug product testing or international patient samples (12-18).
There were already reports of toxicity associated with some indole carboxylate SCRAs studied here at the time the research started, and further reports have been published during the conduct of this research (21, 22).
Concentrations associated with toxicity are not available for the 5 synthesized SCRAs, and we are not aware of published quantified clinical cases.
Additionally, research findings by other researchers as documented earlier were also considered when developing the SCRAS, including Blank (1993), Chappell (1995), Kirkland (1989), Levy (1989), Palmer (1995), and Phelan (1992).
With the intention of keeping the questionnaire brief to obtain better cooperation from the respondents, a total of 14 items were generated for the preliminary SCRAS scale.
Descriptive statistics for the SCRAS variables are presented in Table 2.
Development of the SCRAS scale was guided by Bolman and Deal's (1984, 1991) frames of organizational environment, and Davis and Newstrom's (1985), Dawis and Lofquist's (1984), and Glick's (1992) explanations on individual work environment.