Trends of novel psychoactive substances (NPSs) and their fatal cases

Abstract

The abuse of novel psychoactive substances (NPSs) has been increasing dramatically since the late 2000s worldwide. Furthermore, variations of synthetic cannabinoids and other NPSs have been appearing in the market recently. The number of newly identified NPSs in 2013 was 42 in Singapore, 37 in Korea, and 23 in Indonesia. Even though the kinds and amounts of NPSs are increasing sharply, toxicological information regarding NPSs is not available and hard to obtain. When compared to classical controlled drugs, there are only a few fatal cases and a limited number of data in terms of metabolism and toxicity of NPSs. However there have been fatal cases of NPSs reported continuously in the USA, Europe, Japan and other countries, but not in Korea. Therefore, in this study, the fatal concentrations of NPSs have been reviewed through papers to predict the unexpected side effects or toxicological effects of NPSs. The blood concentrations of synthetic cannabinoids, synthetic cathinones and others in fatal cases are presented. JWH-018, JWH-073, MAM-2201, NNEI, MDPV, mephedrone, methylone, a-PVP, PV9, 25I-NBOMe, PMMA and methoxetamine were substances targeted. The fatal NPS cases will be of great help for forensic toxicologists in the research of the metabolism and toxicity of NPSs, and will also aid in establishing analytical methods for detecting NPSs in biological fluids.

Fatal intoxication by 5F–ADB and diphenidine: Detection, quantification, and investigation of their main metabolic pathways in humans by LC/MS/MS and LC/Q‐TOFMS

“…Acute poisoning cases by overdosing on NPS have been reported, driving forensic toxicologists to develop rapid and sensitive detection methods for these drugs in biological specimens . Among the encountered acute intoxication and even lethal cases involving NPS, designer products containing synthetic cannabinoids (SCs) and cathinones, along with other NPS that are synthetic offspring of classical narcotics are heavily involved . These abused products commonly contain multiple kinds of NPS, giving rise to co‐administration of multiple drugs of abuse that results in adverse outcomes.…”

“…[2][3][4] Among the encountered acute intoxication and even lethal cases involving NPS, designer products containing synthetic cannabinoids (SCs) and cathinones, along with other NPS that are synthetic offspring of classical narcotics are heavily involved. [5][6][7][8][9][10] These abused products commonly contain multiple kinds of NPS, giving rise to co-administration of multiple drugs of abuse that results in adverse outcomes. Forensic toxicologists are thus continuously compelled to develop sensitive methods of detecting such ever-evolving drugs of abuse.…”

Molecularly imprinted polymer solid‐phase extraction of synthetic cathinones from urine and whole blood samples

“…As mentioned earlier, SCs can have significant toxicological effects in humans. In fatal cases, the concentrations of 4-MMC in urine and blood were reported to be 144-198 and 0.04-22 μg/mL, respectively [30][31][32][33][34], and those of methylone were 0.22-38 and 0.06-6.6 μg/mL, respectively [32, 35]. In nonfatal therapeutic cases, the blood concentrations of 4-MMC and 4-FMC were reported to be 0.013-0.412 and 0.136 μg/mL, respectively [34,36,37].…”

Targeted and non‐targeted metabolite identification of MAM‐2201 in human, mouse, and rat hepatocytes

“…MAM‐2201, [1‐(5‐fluoropentyl)‐1 H ‐indol‐3‐yl](4‐methyl‐1‐naphthalenyl)‐methanone, is a fluorinated naphthoylindole synthetic cannabinoid with potent psychoactive properties that has been detected as an active ingredient in herbal incense blends . Cases of intoxication and fatalities due to MAM‐2201 abuse have been reported …”

“…1 Cases of intoxication and fatalities due to MAM-2201 abuse have been reported. [2][3][4] Detection and quantification of abused drug substances in biological samples are key steps in the diagnosis and treatment of emergency cases. However, most synthetic cannabinoids are extensively metabolized, and it is therefore difficult to identify such synthetic cannabinoids in biological samples.…”