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Color Spot Test As a Presumptive Tool for the Rapid Detection of Synthetic Cathinones
Published on: February 5, 2018
Severe paramethoxymethamphetamine (PMMA) and paramethoxyamphetamine (PMA) outbreak in Israel.
Yael Lurie1, Asher Gopher, Ophir Lavon
1Rambam Health Care Campus, Israel Poison Information Center, Haifa, Israel.
Clinical Toxicology (Philadelphia, Pa.)
|December 14, 2011
Summary
A severe outbreak of paramethoxymethamphetamine (PMMA) and paramethoxyamphetamine (PMA) caused 24 fatalities. Forensic analysis identified PMMA and PMA in fatal cases, leading to PMMA
Area of Science:
- Forensic Toxicology
- Clinical Toxicology
- Drug Abuse Research
Background:
- Paramethoxymethamphetamine (PMMA) is a synthetic amphetamine with hallucinogenic properties.
- PMMA was not initially regulated under the Israeli Controlled Substance Act (CSA).
- This study addresses a significant public health issue involving PMMA and PMA.
Purpose of the Study:
- To document and analyze a severe outbreak of paramethoxymethamphetamine (PMMA) and paramethoxyamphetamine (PMA) poisoning.
- To determine the toxicological and demographic profiles of affected individuals.
- To inform regulatory action regarding novel psychoactive substances.
Main Methods:
- Utilized screening immunoassays and chromatographic confirmation for detecting PMMA and PMA in biological samples.
- Analyzed data from unnatural deaths referred by the Israeli Forensic Medicine Institute and Poison Information Center.
- Conducted a 1-year descriptive analysis of laboratory and demographic data for confirmed PMMA/PMA cases.
Main Results:
- Confirmed 32 cases of amphetamine-related fatalities, with 24 testing positive for PMMA and PMA.
- Identified high post-mortem blood concentrations of PMMA (0.35 ± 0.24 mcg/mL) and PMA (2.72 ± 1.67 mcg/mL).
- Observed frequent co-exposures to other substances, including MDMA, cocaine, and cannabinoids, in fatal and non-fatal cases.
Conclusions:
- The study highlights a significant outbreak of PMMA and PMA poisoning with substantial fatalities.
- Paramethoxyamphetamine (PMA) is likely a metabolite of PMMA.
- Co-ingestion of stimulants may exacerbate the toxicity of PMMA and PMA, underscoring the need for robust forensic and poison control collaboration.
- The findings led to PMMA's inclusion in the CSA, reducing subsequent fatalities.
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