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Published on: June 23, 2023
Combined lethal intoxication involving 2-methyl-2-butanol.
Martin Dokter1, Paul Hagen2, Julia Wudtke2
1Institute of Legal Medicine, University Medical Centre of Greifswald, Kuhstraße 30, Greifswald, 17489, Germany. martin.dokter@med.uni-greifswald.de.
International Journal of Legal Medicine
|July 1, 2026
Summary
A fatal drug intoxication was investigated in a 26-year-old male. Combined drug toxicity, including 2-methyl-2-butanol (2m2b), methamphetamine, and venlafaxine, was identified as the cause of death.
Area of Science:
- Forensic Toxicology
- Clinical Chemistry
- Drug Abuse Research
Background:
- A 26-year-old male with a history of drug abuse was found deceased.
- The investigation aimed to determine the cause of death, with initial findings including unspecific signs of intoxication.
Purpose of the Study:
- To clarify the cause of death in a young male found deceased in his apartment.
- To investigate the role of 2-methyl-2-butanol (2m2b) and other substances in the fatality.
Main Methods:
- Autopsy and comprehensive chemical analyses were performed.
- Headspace gas chromatography with flame ionization detection (HS-GC-FID) was utilized.
- Toxicological screening identified multiple drug substances in biological samples.
Main Results:
- High concentrations of 2-methyl-2-butanol (2m2b) were detected in blood (245 mg/L) and urine (225 mg/L).
- Toxic levels of methamphetamine and venlafaxine were identified, alongside evidence of heroin and diazepam use.
- Ethanol was present below quantification limits.
Conclusions:
- A combined drug intoxication involving 2m2b, methamphetamine, venlafaxine, heroin, and diazepam was determined as the cause of death.
- The potential for 2m2b abuse as an ethanol substitute, its potency, and lack of detection by routine methods highlight its forensic significance.
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