A new synthetic opioid threat: A comprehensive review on MT-45

MT-45 is an analgesic belonging to the class of new synthetic opioids (NSOs) found on the illicit drug market, with pharmacological effects similar to morphine. This substance, which can be administered by a variety of routes including oral, nasal, inhalation, and injection, poses a serious threat to public health, particularly through recreational use. MT-45, which is readily available to users, is commonly used to experience its opioid-like effects, which has led to its increasing popularity. It has also been reported to be used by mixing it with other psychoactive substances to obtain more potent effects. The use of MT-45 has been associated with many side effects such as alopecia, hair depigmentation, folliculitis, dermatitis, elevated liver enzymes, transverse white mees lines on fingernails and toenails, and cataracts. In addition, the addictive properties of MT-45 and cases of poisoning and death demonstrate the seriousness of its use and clearly show the negative effects of the substance on health. The aim of this review is to provide a comprehensive resource on the chemical and physical properties, exposure patterns, adverse effects, pharmacology, cases, and detection methods of MT-45 and its control. In this context, it is expected that the review study will draw attention to the abuse of MT-45 and contribute to clinical and judicial practice. In cases where skin, hair, and eye symptoms are observed, caution should be exercised against the possible use of MT-45. In this context, it is important to discourage non-medical use and to carry out studies to raise awareness of the potential risks of this substance in order to protect public health.