Deadly confusion of novel psychoactive substances: fatal outcome of ADB-BUTINACA mislabeled as 3',4'-methylenedioxy-α-pyrrolidinohexiophenone
- Annette Zschiesche 1,2, Nadine Theofel 3, Stefan Braukmüller 4, Edwin Ehrlich 3, Martin Jasyk 3, Maximilian Methling 3, Michael Tsokos 3, Stefan Scholtis 3, Laura M Huppertz 1, Volker Auwärter 5
- 1Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstr. 9, 79104, Freiburg, Germany.
- 2Hermann Staudinger Graduate School, University of Freiburg, Hebelstr. 27, 79104, Freiburg, Germany.
- 3Department of Forensic Toxicology, Governmental Institute of Legal Medicine and Forensic Sciences, Turmstraße 21, Berlin, Germany.
- 4Institute of Organic Chemistry, University of Freiburg, 79104, Freiburg, Germany.
- 5Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstr. 9, 79104, Freiburg, Germany. volker.auwaerter@uniklinik-freiburg.de.
- 0Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstr. 9, 79104, Freiburg, Germany.
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View abstract on PubMed
Summary
This summary is machine-generated.A fatality was linked to mislabeled synthetic cannabinoid ADB-BUTINACA, found in high purity. This case highlights the dangers of potent novel psychoactive substances (NPS) and the need for drug checking services.
Area Of Science
- Forensic Toxicology
- Analytical Chemistry
- Pharmacology
Background
- Novel psychoactive substances (NPS) pose significant public health risks due to their unpredictable potency and potential for mislabeling.
- Synthetic cannabinoids, such as ADB-BUTINACA, are increasingly prevalent in illicit drug markets.
- Mislabeled NPS can lead to severe poisoning and fatalities, especially when purchased online.
Purpose Of The Study
- To identify and quantify a substance found at a fatality scene, initially labeled as a synthetic cathinone (MDPHP).
- To determine the toxicological profile and concentrations of the identified substance in post-mortem samples.
- To assess the risks associated with mislabeled potent novel psychoactive substances.
Main Methods
- Liquid chromatography-high resolution mass spectrometry (LC-HRMS), liquid chromatography-tandem mass spectrometry (LC-MS/MS), and nuclear magnetic resonance (NMR) spectroscopy were used for substance identification.
- Comprehensive toxicological screening of blood, urine, and tissues was performed.
- ADB-BUTINACA was quantified using standard addition in various post-mortem matrices, and scalp hair was analyzed for long-term exposure.
Main Results
- The powder was identified as highly pure ADB-BUTINACA (> >98%), a potent synthetic cannabinoid, not MDPHP.
- High concentrations of ADB-BUTINACA were found in post-mortem blood (34.5 ng/mL femoral, 101 ng/mL heart) and urine (3.1 ng/mL).
- Traces of MDPHP were detected, suggesting prior use, but ADB-BUTINACA was the primary cause of fatality with a toxicological significance score of 3.
Conclusions
- Fatal poisoning resulted from extremely high ADB-BUTINACA concentrations in post-mortem samples.
- This case underscores the severe dangers of mislabeled and highly potent novel psychoactive substances.
- Drug checking services are crucial for preventing poisonings and overdoses related to NPS.
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