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                            Library & Multimedia
 Proliferation of Novel Synthetic Opioids in Postmortem Investigations After Core-Structure Scheduling for Fentanyl-Related Substances
NCJ Number
              305710
Journal

*American Journal of Forensic Medicine and Pathology* Volume: 43 Issue: 4 Dated: December 2022 Pages: 315-327
Author(s)
          Donna M. Papsun;
                        Alex J. Krotulski;
                        Barry K. Logan
Date Published

December 2022
Length
              13 pages
Annotation
              This study documented the proliferation of novel synthetic opioids in postmortem investigations after core-structure scheduling for fentanyl-related substances.
Abstract
              New generations of novel synthetic opioids (NSOs) have emerged to fill a void in the illicit drug markets left by the decline in popularity of fentanyl analogs subsequent to core-structure scheduling of fentanyl-related substances in the United States and China. These new opioids include members of the 2-benzyl benzimidazole (e.g., isotonitazene, metonitazene, N-pyrrolidino etonitazene, protonitazene, etodesnitazene), benzimidazolone (e.g., brorphine), and cinnamylpiperazine (eg, AP-238, 2-methyl AP-237) subclasses. Novel synthetic opioids continue to be detected in opioid-related fatal overdoses, demonstrating the harms associated with exposure to these drugs. Between January 2020 and December 2021, 384 casework blood samples were reported by our laboratory to contain 1 or more of the prior listed 8 NSOs. Isotonitazene (n = 144), metonitazene (n = 122), and brorphine (n = 91) were the 3 most prevalent substances, with positivity for isotonitazene and brorphine peaking just before the announcement of emergency scheduling. These NSOs have been documented as significant drivers of drug mortality, and this case series described here highlights the challenges medical examiners and coroners face in staying current with emerging drugs. Challenges include regional differences, rapid turnover, short lifecycles, variable toxicology testing, and difficulty in assessing individual drug toxicity in polydrug cases. (Publisher abstract provided)
      
  
          Additional Details
Grant Number(s)
        2020-DQ-BX-0007


  
  
        
  Agencies
        NIJ-Sponsored


  
  
        
  Publication Type
        Research (Applied/Empirical)


  
  
        
  Award
        Real-Time Sample-Mining and Data-Mining Approaches for the Discovery of Novel Psychoactive Substances (NPS)
    
  
  
Date Published: December 1, 2022
    
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      PatentsRelated Topics
        
                Research and Development in Forensic Science for Criminal Justice Purposes
        Drug markets
        Opioids
        Medical examiners



  
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