En versting blant opioider

Vevelstad, Merete; Drange, Elisabeth

doi:10.4045/tidsskr.17.0419

Cited by 1 publication

(3 citation statements)

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“…Remarkably, during routine monitoring of new psychoactive substances (NPSs) present on darknet websites by the Belgian Early Warning System on Drugs, a carfentanil sample was obtained with strikingly similar packaging and handwriting as the packaging found on the scene of death in this toxicological case ( Figure 1B ). A similar bag with identical labeling in similar handwriting has also been reported in the context of a fatality in Norway ( Figure 1C ), where the powder was apparently ordered from a German darknet shop ( Vevelstad and Drange, 2017 ). Based on this information, the vendor (or primary source) is most probably the same vendor as mentioned in other publications ( Marlin and Hoyte, 2017 ; Vevelstad and Drange, 2017 ).…”

Section: Case Presentationsupporting

confidence: 68%

“…A similar bag with identical labeling in similar handwriting has also been reported in the context of a fatality in Norway ( Figure 1C ), where the powder was apparently ordered from a German darknet shop ( Vevelstad and Drange, 2017 ). Based on this information, the vendor (or primary source) is most probably the same vendor as mentioned in other publications ( Marlin and Hoyte, 2017 ; Vevelstad and Drange, 2017 ).…”

Section: Case Presentationsupporting

confidence: 68%

“…(B) Foil bag obtained by the Belgian Early Warning System on Drugs. (C) Foil bag and plastic bag found in a fatality in Norway [image used with kind permission of the National Criminal Investigation Service/Photo (Norway)] ( Vevelstad and Drange, 2017 ).…”

Section: Case Presentationmentioning

confidence: 99%

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Activity-Based Detection and Bioanalytical Confirmation of a Fatal Carfentanil Intoxication

et al. 2018

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Carfentanil, one of the most potent opioids known, has recently been reported as a contaminant in street heroin in the United States and Europe, and is associated with an increased number of life-threatening emergency department admissions and deaths. Here, we report on the application of a novel in vitro opioid activity reporter assay and a sensitive bioanalytical assay in the context of a fatal carfentanil intoxication, revealing the highest carfentanil concentrations reported until now. A 21-year-old male was found dead at home with a note stating that he had taken carfentanil with suicidal intentions. A foil bag and plastic bag labeled “C.50” were found at the scene. These bags were similar to a sample obtained by the Belgian Early Warning System on Drugs from a German darknet shop and to those found in the context of a fatality in Norway. Blood, urine and vitreous, obtained during autopsy, were screened with a newly developed in vitro opioid activity reporter assay able to detect compounds based on their μ-opioid receptor activity rather than their chemical structure. All extracts showed strong opioid activity. Results were confirmed by a bioanalytical assay, which revealed extremely high concentrations for carfentanil and norcarfentanil. It should be noted that carfentanil concentrations are typically in pg/mL, but here they were 92 ng/mL in blood, 2.8 ng/mL in urine, and 23 ng/mL in vitreous. The blood and vitreous contained 0.532 and 0.300 ng/mL norcarfentanil, respectively. No norcarfentanil was detected in urine. This is the first report where a novel activity-based opioid screening assay was successfully deployed in a forensic case. Confirmation and quantification using a validated bioanalytical procedure revealed the, to our knowledge, highest carfentanil concentrations reported in humans so far.

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Section: Case Presentationsupporting

confidence: 68%