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Fatal intoxications associated with the designer opioid AH-7921
R Kronstrand1, G Thelander2, D Lindstedt2
1Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden Division of Drug Research, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden robert.kronstrand@rmv.se.
Journal of Analytical Toxicology
|September 14, 2014
Summary
Designer opioid AH-7921 was linked to nine deaths in Sweden. Fatalities occurred at various concentrations, suggesting no clear lethal threshold. AH-7921 metabolites were also identified in blood samples.
Area of Science:
- Forensic Toxicology
- Pharmacology
Background:
- AH-7921 is a potent designer opioid with significant µ-agonist activity, comparable to morphine.
- The emergence of novel psychoactive substances (NPS) like AH-7921 poses challenges for public health and forensic investigations.
Purpose of the Study:
- To investigate the involvement of AH-7921 in fatal cases.
- To determine the concentration range of AH-7921 in postmortem blood.
- To identify potential metabolites of AH-7921.
Main Methods:
- Case series analysis of deaths involving AH-7921 over a six-month period.
- Quantitative analysis of AH-7921 in blood using liquid chromatography-tandem mass spectrometry (LC-MS/MS).
- Identification of AH-7921 metabolites in postmortem blood samples.
Main Results:
- AH-7921 was detected in nine fatal cases, with blood concentrations ranging from 0.03 to 0.99 µg/g.
- Six cases involved co-ingestion of other drugs of abuse, but these were deemed unlikely to be primary contributors to death.
- Six metabolites of AH-7921 were identified, with two N-demethylated forms predominating.
Conclusions:
- Fatalities associated with AH-7921 occurred across a wide range of blood concentrations, indicating that tolerance may influence toxicity.
- A distinct lethal concentration for AH-7921 could not be established.
- Poly-drug use did not appear to be a significant factor in the fatal outcomes observed in these cases.
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