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Protonitazene metabolite variability in postmortem casework.

Rebecca Wood¹, Robert Moore¹

¹Department of Toxicology, University Hospitals Sussex NHS Foundation Trust, Royal Sussex County Hospital, Eastern Road, Brighton, BN2 5BE, United Kingdom.

Journal of Analytical Toxicology

|May 12, 2025

Summary

This summary is machine-generated.

Detecting protonitazene, a potent synthetic opioid, is challenging due to varied metabolite profiles in post-mortem samples. Analysis of 14 cases revealed multiple metabolites, but no single marker reliably indicates exposure.

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Area of Science:

Forensic Toxicology
Pharmacology
Analytical Chemistry

Background:

Protonitazene is a potent synthetic opioid increasingly found in illicit drug supplies.
Limited data exists on protonitazene metabolism and metabolite detection in post-mortem specimens.

Purpose of the Study:

To investigate protonitazene metabolite profiles in post-mortem blood and urine.
To identify reliable biomarkers for protonitazene exposure in forensic investigations.

Main Methods:

Retrospective analysis of 14 post-mortem cases.
High-resolution mass spectrometry for metabolite profiling in blood and urine.

Main Results:

Identified metabolites including 5-aminoprotonitazene, N-desethylprotonitazene, 4-hydroxynitazene, and a novel hydroxyprotonitazene.
Observed significant variability in detected metabolites across cases.
No single metabolite consistently indicated protonitazene use.

Conclusions:

Detecting protonitazene exposure is complex due to metabolic and post-mortem factors.
Targeting multiple metabolites is essential for accurate identification of protonitazene use.
Further research is required to confirm metabolite identities, stability, and toxicological significance.