Novel synthetic opioids - toxicological aspects and analysis

Area of Science:

• Forensic Toxicology
• Public Health
• Pharmacology

Background:

• Emerging New Psychoactive Substances (NPS) are increasingly prevalent, often marketed as "legal highs" or "research chemicals."
• Novel synthetic opioids represent a growing trend among NPS, posing a significant threat due to their high fatality rates.
• These substances are designed to mimic controlled psychoactive drugs, complicating identification and treatment.

Purpose of the Study:

• To review reported fatalities associated with novel synthetic opioids.
• To detail the pharmacology, metabolism, and toxic effects of these compounds.
• To highlight analytical techniques for detecting and quantifying synthetic opioids in biological matrices.

Main Methods:

• Review of diverse reported fatalities linked to new synthetic opioids.
• Analysis of pharmacological and toxicological data.
• Examination of sample preparation and analytical methodologies for biological matrices.

Main Results:

• Synthetic opioids are a critical concern in public health, with numerous fatalities reported.
• Accurate identification in biological samples is essential for clinical management of intoxication.
• Routine toxicological screening should include synthetic opioids and alternative matrices to detect poly-drug use.

Conclusions:

• Effective management of synthetic opioid-related public health issues requires international collaboration, legislation, and control of online sales.
• Clinicians must consider synthetic opioid analogues in cases of suspected fentanyl intoxication.
• Enhanced toxicological screening protocols are necessary for timely and accurate diagnosis.