China white epidemic: An Eastern United States emergency department experience

Acetyl Fentanyl, a Novel Fentanyl Analog, Causes 14 Overdose Deaths in Rhode Island, March–May 2013

“…Fentanyl and α-methylfentanyl are roughly 50 times more potent than morphine, and 3-methylfentanyl is between 50 and 500 times more potent than morphine [8]. Acetyl fentanyl may have been sold alone due to its relatively low potency, while in past outbreaks, fentanyl, 3-methylfentanyl, and α-methylfentanyl have mostly been found mixed with heroin, likely due to their higher potency [7][8][9][11][12][13][14][15].…”

“…The first epidemic was identified in California in 1978 and was associated with a compound later identified as the fentanyl analog 3-methylfentanyl, branded by the street name BChina White.T his drug is several hundred times more potent than morphine and accounted for more than 100 deaths in California [7][8][9]11]. This same drug resurfaced in 1988 in Pennsylvania, where it was implicated in the deaths of 16 persons [12,13]. In 1991, covertly manufactured fentanyl was sold as heroin on the streets of New York City in small envelopes labeled BTango and Cash.^Because of difficulties in cutting the drug, these samples contained highly variable amounts of fentanyl and their use resulted in 12 deaths [14].…”

Metabolism of designer drugs. The fentanyl derivatives

“…В литера-туре [9][10][11][12][13][14][15] описаны многочисленные случаи интоксика-ции веществами данной группы. Отдельные обзоры [4,16] посвящены главным образом аспектам использования и токсическому действию производных фентанила и содер-жат минимальную информацию о их биотрансформации.…”

“…[18]. В 80-х годах прошлого столетия в США зафиксировано более 100 случаев его передозировки [9]. В последние несколько лет широко распространен в не-легальном обороте на северо-западе РФ и в странах Бал-тии [10][11][12].…”

“…-N-деалкилирование (норметаболиты 2, 3, 4); -ароматическое гидроксилирование фенилэтильно-го фрагмента (метаболиты 6, 8, 9); -окисление по алкильной цепи (метаболиты 3, 5, 7, 8); -конъюгация с глюкуроновой кислотой (метаболи-ты 4,6,8,9).…”