The synthetic cannabinoid 5F-MDMB-PICA: A case series.

Area of Science:

• Forensic Toxicology
• Clinical Chemistry
• Pharmacology

Background:

• 5F-MDMB-PICA has been identified in illicit products and biological samples since 2016.
• This synthetic cannabinoid is associated with severe adverse health effects, including fatalities.

Observation:

• Twelve cases of confirmed 5F-MDMB-PICA consumption are presented, involving three deaths, four instances of drug-impaired driving, and five other criminal acts.
• The substance was detected in postmortem blood/serum at concentrations ranging from 0.1-16 ng/mL.
• Co-consumption with other substances like alcohol, cannabis, and other synthetic cannabinoids was common (9/12 cases).

Findings:

• Adverse physical effects included balance issues, reddened conjunctivae, glassy eyes, and abnormal pupil responses.
• Mental and behavioral effects comprised mood swings, aggression, confusion, erratic behavior, disorientation, and slowed reactions.
• The metabolite M12 was also detected in some samples, along with 4F-MDMB-BINACA in five cases.

Implications:

• This case series underscores the diverse and severe clinical effects of 5F-MDMB-PICA.
• Findings contribute valuable data on a novel synthetic cannabinoid, aiding interpretation of forensic and clinical toxicology cases.
• Understanding the impact of emerging synthetic cannabinoids is crucial due to the rapidly evolving illicit drug market.