Synthetic Cannabinoid Receptor Agonists in Postmortem Casework in Scotland

Area of Science:

• Forensic Toxicology
• Pharmacology
• Public Health

Background:

• Synthetic cannabinoid receptor agonists (SCRAs) are a growing concern as drugs of abuse.
• While overall SCRA use in Scotland appears low, concerns exist regarding prevalence in prison populations.
• Routine postmortem analysis is crucial for identifying emerging drug threats.

Purpose of the Study:

• To analyze SCRA compounds in postmortem blood and urine samples.
• To investigate the prevalence and patterns of SCRA use in Scotland.
• To correlate SCRA presence with demographic data and cause of death.

Main Methods:

• Analysis of blood and urine samples from routine postmortem examinations (April 2017 - March 2019).
• Toxicological screening for a range of SCRA compounds.
• Collection and review of circumstantial and demographic information for positive cases.

Main Results:

• Thirteen out of 133 (10%) cases tested positive for one or more SCRA compounds.
• 5F-MDMB-PINACA or its metabolite was the most frequently detected SCRA.
• SCRA-positive cases were predominantly male (92%), aged 21-49 years, and associated with drug-related deaths, natural causes, or suicide.

Conclusions:

• SCRAs were present in a notable proportion of postmortem cases, indicating their continued relevance.
• The mere presence of SCRAs, rather than concentration, appeared significant in determining cause of death.
• Further research is needed to understand the full impact of SCRAs on mortality and public health.