Simultaneous fatal poisoning of two victims with 4F-MDMB-BINACA and ethanol

Simultaneous fatal poisoning of two victims with 4F-MDMB-BINACA and ethanol

Purpose Methyl-2-(1-(4-fluorobutyl)-1H-indazole-3-carboxamido)-3,3-dimethylbutanoate (4F-MDMB-BINACA) is a newly emerging synthetic cannabinoid receptor agonists (SCRA) first described in 2018 in both Europe and the United States. Two fatal cases are reported caused by simultaneous consumption of 4F...

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Bibliographic Details
Published in:Forensic toxicology Vol. 41; no. 1; pp. 151 - 157
Main Authors: Simon, Gábor, Tóth, Dénes, Heckmann, Veronika, Mayer, Mátyás, Kuzma, Mónika
Format: Journal Article
Language:English
Published: Singapore Springer Nature Singapore 01-01-2023
Subjects:
Blood Alcohol Content
Cannabinoid Receptor Agonists - analysis
Cannabinoids - analysis
Case Report
Ethanol - analysis
Forensic Medicine
Forensic Science
Gas Chromatography-Mass Spectrometry
Humans
Illicit Drugs - analysis
Male
Medical Law
Medicinal Chemistry
Medicine
Medicine & Public Health
Pharmacology/Toxicology
Tandem Mass Spectrometry
United States
United States
Synthetic cannabinoid receptor agonist
Overdose
Poisoning
4F-MDMB-BINACA
Ethanol
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Summary:Purpose Methyl-2-(1-(4-fluorobutyl)-1H-indazole-3-carboxamido)-3,3-dimethylbutanoate (4F-MDMB-BINACA) is a newly emerging synthetic cannabinoid receptor agonists (SCRA) first described in 2018 in both Europe and the United States. Two fatal cases are reported caused by simultaneous consumption of 4F-MDMB-BINACA and ethanol. Methods The victims were brothers who were both found deceased after consuming 4F-MDMB-BINACA and ethanol. Post-mortem toxicological analyses of blood and urine were carried out by supercritical fluid chromatography tandem mass spectrometry (SFC–MS/MS) and headspace gas chromatography with flame ionization detection (HS-GC–FID). Results The concentration of 4F-MDMB-BINACA in the postmortem blood was 2.50 and 2.34 ng/mL, and blood alcohol concentration was 2.11 and 2.49 g/L, respectively. Conclusion According to the reported cases and reviews of the scientific literature, concurrent ethanol consumption should amplify the toxicity of SCRAs. The threshold SCRA concentration for fatal overdose can be estimated ng/mL level (0.37–4.1 ng/mL according to the reported cases) in cases in which 1.5–2.5 g/L of ethanol is present in the blood.
ISSN:1860-8965
1860-8973
DOI:10.1007/s11419-022-00632-y