Analytical findings in a non-fatal intoxication with the synthetic cannabinoid 5F-ADB (5F-MDMB-PINACA): a case report

Abstract

The case report centres on analytical findings from a spice sample (mixed with tobacco (as a cigarette) for consumption), and its corresponding plasma sample, smoked by a 31-year-old man who was attended by emergency services following collapse. The man was fully conscious and cooperative during initial medical treatment. Suddenly, he suffered a complete loss of self-control, whereupon the police was notified. The man encountered the police officers when exiting the apartment, at which point he threatened them with clenched fists and reached for a plant bucket in order to strike out in the direction of the officers. At the trial, he described himself as confused and as being completely overwhelmed, having lost self-control, suffered a panic attack and “just wanted to get out the situation”. Furthermore, he stated that he had no recollection of the incident. He feared death due to palpitations, heart pain, dizziness and repetitive anxiety states. Routine systematic as well as extended toxicological analysis of the plasma sample, taken approximately 2 h after the incident, confirmed the use of cannabis and spice. Plasma concentrations of THC, OH-THC and THC-COOH were 8.0 μg/L, 4.0 μg/L and 147 μg/L, respectively. Furthermore, analysis confirmed uptake of 5F-ADB (5F-MDMB-PINACA) via detection of both 5F-ADB and the 5F-ADB N-(5-OH-pentyl) metabolite. The spice sample additionally contained 5F-MDMB-PICA, which was not detected in the plasma sample. A differentiation between a possible co-use and a recent use of cannabis was not possible. In summary, this case once more underlines the health risks of spice use.

“Spice”-related deaths in and around Munich, Germany: A retrospective look at the role of synthetic cannabinoid receptor agonists in our post-mortem cases over a seven-year period (2014–2020)

“…It was also one of the most frequently detected synthetic cannabinoids in a review of eight case series and 26 case reports on “Spice”-related fatalities by Giorgetti et al [ 16 ] . Likewise, 5F-MDMB-PICA is also described as a highly potent cannabinoid receptor agonist in literature, which is associated with several cases of serious adverse health effects and deaths [ 37 , 38 ]. The detection of the less potent substances like Cumyl-PEGACLONE in our post-mortem cases was thus mostly incidental, considering that an alternative cause of death could almost always be identified.…”

Death after smoking of fentanyl, 5F-ADB, 5F-MDMB-P7AICA and other synthetic cannabinoids with a bucket bong

“…Synthetic cannabinoids have been linked to arrhythmia, acute kidney injury, seizures and psychiatric complications, as well as to respiratory depression [1,2]. For 5F-ADB (methyl 2-{1-(5-fluoropentyl)-1H-indazole-3-carbonyl] amino} 3,3-dimethylbutanoate) in particular psychomotor agitation, impaired consciousness, anxiety, seizures, tachycardia and acute circulatory failure after drug inhalation were described as symptoms of intoxication or causes of death [2][3][4][5]. As for other compounds, tolerance to synthetic cannabinoids can be induced by frequent use [6,7].…”