Following series of synthetic cannabinoid and cathinone derivatives, the illicit drug market has begun to see increased incidence opioids including fentanyl its other chemically unrelated opioid agonists AH-7921 MT-45. Among most frequently encountered compounds in postmortem casework have been furanyl (N-(1-(2-phenylethyl)-4-piperidinyl)-N-phenylfuran-2-carboxamide, Fu-F) U-47700 (trans-3,4-dichloro-N-(2-(dimethylamino)cyclohexyl)-N-methylbenzamide). Both drugs reported be present heroin...

Abstract The synthetic opioid landscape continues to change as non-fentanyl-related substances appear in forensic toxicology casework. Among the newest opioids emerge is isotonitazene, an analogue of a benzimidazole class analgesic compounds. Isotonitazene active and potent opioid, but extent which this compound causing toxicity among drug users was previously unknown. This report describes confirmation quantitation isotonitazene blood, urine vitreous fluid through standard addition, well...

Xylazine, an alpha-2 receptor agonist used in veterinary medicine for its sedative and muscle-relaxant effects, has been reported forensic toxicology casework since the 1980s. It is not approved human use, but it as adulterant heroin illicit fentanyl. The prevalence concentrations of xylazine 2.5 years (January 2019-June 2021) driving under influence drugs (DUID) medico-legal death investigation (MDI) cases was investigated, including other detected combination with xylazine. Of over 170,000...

A sensitive and specific method for the quantification of JWH-018, JWH-073, JWH-250 qualitative identification JWH-019 in whole blood was developed validated. Samples fortified with JWH-018-d9 JWH-073-d9 underwent liquid-liquid extraction were analyzed by liquid chromatography-positive ion electrospray ionization-tandem mass spectrometry. Two transitions monitored all analytes except JWH-250, which there only one available transition. did not meet stringent requirements quantitative...

Synthetic cannabinoid use has risen at alarming rates. This case series describes 11 patients exposed to the synthetic cannabinoid, MAB-CHMINACA who presented an emergency department with life-threatening toxicity including obtundation, severe agitation, seizures and death. All required sedatives for nine endotracheal intubation, three experienced seizures, one developed hyperthermia. One anoxic brain injury, rhabdomyolysis died. A significant number were pediatric patients. The mainstay of...

This is the first report regarding characterization of new synthetic cannabinoid 4F-MDMB-BINACA. 4F-MDMB-BINACA was analytically confirmed in seized drug material using gas chromatography-mass spectrometry (GC-MS), liquid chromatography-quadrupole time-of-flight mass (LC-QTOF), and nuclear magnetic resonance (NMR) spectroscopy. Subsequent to this characterization, detected biological specimens collected as part forensically relevant casework, including medicolegal death investigations...

Sweat testing is a noninvasive technique for monitoring drug exposure in treatment, criminal justice, and employment settings.We evaluated cocaine excretion 9 participants' sweat after they received 3 low doses (75 mg/70 kg) of HCl subcutaneously within 1 week and, weeks later, high (150 kg). Six additional participants completed portions the study. PharmChek patches (n = 1390) were collected throughout 3-week washout period, reflecting previously self-administered drugs, during controlled...

Abstract New synthetic opioids continue to appear as novel psychoactive substances (NPS) on illicit drug markets. Isotonitazene emerged in mid‐2019, becoming the most prevalent NPS opioid United States within a few months. Notification by Drug Enforcement Administration of its intent schedule isotonitazene mid‐2020 led decline popularity and replacement with new opioid: brorphine. Brorphine is potent opioid, but little information was previously available regarding toxicity or involvement...

We describe the development and validation of a method for screening confirmation range chemically diverse synthetic cannabinoid drugs in human whole blood. The targets better known arylindole compounds as well emerging aminocarbonyl/ carboxamide (NACA) compounds. approach consists two separate extraction procedures designed to optimize recovery each these classes, followed by analysis liquid chromatography-tandem mass spectrometry (LC-MS/MS). most significant novel added were AB-FUBINACA,...

Abstract Background: Understanding methamphetamine (MAMP) and amphetamine (AMP) excretion in sweat is important for interpreting hair testing results judicial, workplace, drug treatment settings. Methods: Participants (n = 8) received 4 10-mg (low) oral doses of sustained-release S-(+)-MAMP HCl (d-MAMP HCl) within 1 week a double-blind, institutional review board–approved study. Five participants also 20-mg (high) 3 weeks later. PharmChek patches 682) were worn periods 2 h to during up after...

Characterization of opioid excretion in sweat is important for accurate interpretation tests drug treatment, criminal justice, and workplace testing programs.Participants (n=20) received placebo, 3 low (60 mg/70 kg) or high (120 codeine sulfate doses (used as a model excretion) within 1 week. Codeine metabolites were collected with PharmChek Sweat Patches; hourly patches applied to 15 h (n=775) weekly 7 days (n=118). Patches analyzed by solid-phase extraction gas chromatography-mass...

Buprenorphine (BUP) is under investigation as a medication therapy for opioid-dependent pregnant women. We investigated BUP and metabolite disposition in urine from women maintained on during the second third trimesters of pregnancy postpartum.

A novel liquid chromatography tandem mass spectrometry method for quantification of buprenorphine, norbuprenorphine, and glucuronidated conjugates was developed validated. Analytes were extracted from meconium using buffer, concentrated by solid-phase extraction quantified within 13.5 min. In order to determine free total concentrations, specimens analyzed with without enzyme hydrolysis. Calibration achieved linear regression a 1/x weighting factor deuterated internal standards. All analytes...

To the Editor: Toxicological analysis is an important component of medicolegal death investigations (MDIs). For example, in case involving criminal or civil litigation where recent cannabis use sobriety decedent may be issue. Interpretation these results dependent upon multiple factors, including assumption that postmortem (PM) concentration drugs cannabinoids and their metabolites accurately reflects amount drug circulating proximate to time death. Another factor for interpretation whether...