Abstract
PurposeWe present a case of fatal intoxication with U-47700 in combination with other NPS (N-ethylhexedrone, adinazolam, 4-chloro-N-isopropylcathinone (4-CIC), 4-chloromethcathinone (4-CMC) and sertraline) confirmed by identification and quantification in biological materials and evidences found at the scene in 2017 in Poland.MethodsBlood and urine samples were extracted with ethyl acetate from alkaline medium (pH 9); powders/crystals were diluted with methanol. The analysis was carried out using ultra-high-performance liquid chromatography–tandem mass spectrometry. Validation criteria were evaluated for blood and urine at the concentrations of 10 and 100 ng/mL.ResultsThe validation parameters of the method were within acceptable ranges. In the presented case, the determined concentrations of drugs were as follows, in blood: U-47700, 1470 ng/mL; N-ethylhexedrone, 58 ng/mL; adinazolam, 18 ng/mL; 4-CIC, 8.0 ng/mL; 4-CMC, 1.7 ng/mL; in urine: U-47700, 3940 ng/mL; N-ethylhexedrone, 147 ng/mL; adinazolam, 82 ng/mL; 4-CIC, 130 ng/mL; 4-CMC, 417 ng/mL. Sertraline (blood, 89 ng/mL; urine, 32 ng/mL) was also determined in both materials. The same substances were also found in 5 powders/crystals: U-47700 (12% by weight), N-ethylhexedrone (54%), adinazolam (14%), 4-CIC (23%), 4-CMC (26%). After 775 days of storage, biological samples at + 4 °C, the most stable substance was sertraline and the less, synthetic cathinones, especially 4-CIC and 4-CMC.ConclusionsThe described case of fatal intoxication with NPS presented postmortem concentrations of U-47700, 4-CMC, N-ethylhexedrone, adinazolam and 4-CIC for the first time in the literature. The paper also showed stability study of these substances stored at + 4 °C for 775 days.
Highlights
According to the EMCDDA [1], in 2017, opioids were involved in between 8 and 9 of every 10 druginduced deaths reported in European countries
Nikolau et al [12] paid attention to scientific papers describing cases of intoxication or deaths related to U-47700 alone, or in combination with alcohol, medicinal, controlled drugs, new psychoactive substances (NPS; especially fentanyl or its analogues)
Wa t e r ( Chromasolv ® L C – M S ), acetonitrile (Chromasolv® LC–MS), methanol (Chromasolv® LC–MS) ethyl acetate, and formic acid were purchased from SigmaAldrich (Steinheim, Germany); ammonium formate from Sigma-Aldrich (Bangalore, India); ammonium carbonate from Fluka (Buchs, Switzerland); 4-CMC, U-47700, N-ethylhexedrone, sertraline, fentanyl-d5, quetiapine-d8 and diazepam-d5 from Cerilliant (Round Rock, TX, USA); adinazolam, 4-methylmethcathinone- d3 (4-MMC-d3), 4-CIC from LGC Standards (Dziekanów Leśny, Poland)
Summary
According to the EMCDDA [1], in 2017, opioids (often heroin) were involved in between 8 and 9 of every 10 druginduced deaths reported in European countries. Among new synthetic opioids (NSOs), we classify prescription opioid analgesics (e.g., oxycodone), legal and illegal fentanyl analogs (e.g., acetyl fentanyl), and opioid drug candidates (e.g., benzamide derivates). Substances from this group pose a threat to public health in many countries, especially in Europe and the USA [2]. ‘Gray Death’ is a random combination (depending on each mixture) of U-47700 with fentanyl, carfentanil, furanyl fentanyl, heroin, or other illicit opiates [11]. Nikolau et al [12] paid attention to scientific papers describing cases of intoxication or deaths related to U-47700 alone, or in combination with alcohol, medicinal, controlled drugs, new psychoactive substances (NPS; especially fentanyl or its analogues). According to users’ reports, U-47700 may induce tolerance and dependence [13]
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