“Zombie” Outbreak Caused by the Synthetic Cannabinoid AMB-FUBINACA in New York

Adams, Axel; Banister, Samuel D.; Irizarry, Lisandro; Trecki, Jordan; Schwartz, Michael D.; Gerona, Roy

doi:10.1056/nejmoa1610300

Cited by 273 publications

(241 citation statements)

References 20 publications

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“…A similar phenomenon was observed for synthetic cannabinoids, where the first generation (JWH-018, etc.) were prone to seizures, causing dependence, and other complications, but the latest generation, the result of several waves of prohibition, are more potent, more prone to causing complications, and have been involved in a striking amount of deaths 41–43 .…”

Section: Discussionmentioning

confidence: 99%

Updating the list of known opioids through identification and characterization of the new opioid derivative 3,4-dichloro-N-(2-(diethylamino)cyclohexyl)-N-methylbenzamide (U-49900)

Fabregat‐Safont

Carbón

Ventura

et al. 2017

Sci Rep

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New psychoactive substances have been rapidly growing in popularity in the drug market as non-illegal drugs. In the last few years, an increment has been reported on the use of synthetic alternatives to heroin, the synthetic opioids. Based on the information provided by the European Monitoring Centre for Drug and Drug Addiction, these synthetic opioids have been related to overdoses and deaths in Europe and North America. One of these opioids is the U-47700. A few months ago, U-47700 was scheduled in the U.S. and other countries, and other opioid derivatives have been appearing in order to replace it. One of these compounds is U-49900, an analog of U-47700. A white powder sample was obtained from an anonymous user in Spain. After an accurate characterization by gas chromatography-mass spectrometry, ultra-high performance liquid chromatography-high resolution mass spectrometry, nuclear magnetic resonance and single-crystal X-ray diffraction; and complemented by Fourier-transformed infrared spectroscopy, ultraviolet and circular dichroism spectrophotometry, the drug sample was unequivocally identified as U-49900. The information provided will be useful for the Early Warning System and forensic laboratories for future identifications of the U-49900, as well as in tentative identifications of other related opioids.

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Section: Discussionmentioning

confidence: 99%

Updating the list of known opioids through identification and characterization of the new opioid derivative 3,4-dichloro-N-(2-(diethylamino)cyclohexyl)-N-methylbenzamide (U-49900)

Fabregat‐Safont

Carbón

Ventura

et al. 2017

Sci Rep

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“…However, to circumvent drug legislation, manufacturers of these substances continue to develop new compounds with slightly modified chemical structures. These modifications enable manufacturers to legally distribute the substances until they are registered and banned by law [12,13,14,15]. …”

Section: Introductionmentioning

confidence: 99%

Synthetic Cannabinoid Use in a Psychiatric Patient Population: A Pilot Study

Welter¹,

Lücke

Lam³

et al. 2017

Eur Addict Res

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Background: Consumption of natural cannabis (NC) and synthetic cannabinoids (SCs) has been associated with psychotic disorders. We compared the prevalence of use, consumer profiles, and psychosis-inducing potential of NC and SCs in a specific high-risk population. Methods: This prospective pilot study included 332 patients (18-64 years, mean 36.83, SD 13.33). Patients' sociodemographics and medical histories as well as illicit substance use and psychiatric symptom histories were collected using a drug consumption survey that assessed the use of new psychoactive substances and the Psychotic Symptoms Interview. Results: In total, 7.2% of all patients, 10.6% of psychotic patients, and 4.5% of nonpsychotic patients reported SC consumption. Compared with SCs, NC was consumed much more frequently by its users (mean 222.73, SD 498.27). NC and SC use induced persistent psychosis. Psychotic symptoms were first experienced by patients with a history of NC or SC use during intoxication and persisted after cessation (>1 year) of drug use. Positive and negative symptoms tended to be more severe in SC and NC users, respectively. Conclusions: NC and SCs may cause different symptom clusters. These relationships should be further evaluated.

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“…New psychoactive substances (NPS) are the fastest growing class of illicit drugs in the United States [1]. Their potency and molecular variability have contributed to numerous outbreaks of severe clinical illness [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…Their potency and molecular variability have contributed to numerous outbreaks of severe clinical illness [1,2]. Synthetic cannabinoid (SC) use, a subclass of NPS, has increased dramatically over the last decade [1,3–5].…”

Section: Introductionmentioning

confidence: 99%

Synthetic cannabinoid “Black Mamba” infidelity in patients presenting for emergency stabilization in Colorado: a P SCAN Cohort

Brandehoff

Adams

McDaniel

et al. 2017

Clinical Toxicology

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Background Use of new psychoactive substances (NPS) has increased over the last decade. During this period, variability of both clinical presentations and chemical compositions of these compounds has increased. Synthetic cannabinoids (SCs) are the most commonly used NPS and there are more than 100 documented unique molecules in this class. “Black Mamba”, often associated to ADB-FUBINACA, is the most commonly used SC in Colorado. It has been linked to kidney injury, myocardial toxicity, seizures, and death. Objectives We aim to identify the chemical constituents and quantification of eight cases of reported “Black Mamba” use in order to further understand the clinical variability in patients presenting for emergency stabilization. Methods We report data from eight cases of reported “Black Mamba” use prospectively captured through the Colorado site of the Psychoactive Surveilance Consortium and Analysis Network (P SCAN). P SCAN is a geographically representative group of academic hospitals that capture clinical presentation, outcome, and biologic samples from patients that present for emergency stabilization following NPS use. Serum and urine samples were analyzed and quantified by liquid chromatography-quadrupole time-of-flight mass spectrometry after a qualitative screen for over 600 unique NPS compounds. Results In the reported eight cases, the median age was 28 years old. There were four male and four females. Four patients had agitation/delirium and four patients had chest pain. Normal saline, benzodiazepines and ondansetron were the common treatment provided in the emergency department (ED). Two patients were discharged from the ED and six patients being admitted for emergency observation with a median length of stay (LOS) of six hours. No deaths were reported. Confirmatory testing revealed that only five patients (62.5%) had SCs found in blood or urine samples. Cocaine, NRG-3, 3-methoxyphencyclidine hydrochloride (MeO-PCP), and methamfetamine were identified in other presentations. Conclusions The wide range of clinical presentations from “Black Mamba” use may be explained by the wide variability of chemical constituents found by laboratory analysis.

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“Zombie” Outbreak Caused by the Synthetic Cannabinoid AMB-FUBINACA in New York

Cited by 273 publications

References 20 publications

Updating the list of known opioids through identification and characterization of the new opioid derivative 3,4-dichloro-N-(2-(diethylamino)cyclohexyl)-N-methylbenzamide (U-49900)

Updating the list of known opioids through identification and characterization of the new opioid derivative 3,4-dichloro-N-(2-(diethylamino)cyclohexyl)-N-methylbenzamide (U-49900)

Synthetic Cannabinoid Use in a Psychiatric Patient Population: A Pilot Study

Synthetic cannabinoid “Black Mamba” infidelity in patients presenting for emergency stabilization in Colorado: a P SCAN Cohort

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