JWH-210 CHEMICAL POWDER
Due to the unknown toxicity of newly emerging SCRAs, forensic assessments of cases involving these substances are challenging. According to the reported cases and reviews of the scientific literature, concurrent ethanol consumption should amplify the toxicity of SCRAs. 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. Two fatal cases are reported caused by simultaneous consumption of 4F-MDMB-BINACA and ethanol.
Fig. 2.
The precursor ion m/z 396 (B10, B12/B15) was 32 Da higher than the parent drug, 4F-MDMB-BINACA, suggesting the addition of two hydroxy groups. All the below explanations for transformations into metabolites are based on the data shown in Fig. Metabolites were identified according to their precursor ions, product ions, and fragmentation patterns (Fig. 1). Traditional in-vivo metabolism studies to generate human metabolites of drugs relied heavily on the use of whole animal model systems, which are expensive, limited by drug administration amount, influenced by species variation and faced by many ethical issues. Eight in-vivo metabolites tentatively identified were mainly products of ester hydrolysis with or without additional dehydrogenation, N-dealkylation, monohydroxylation and oxidative defluorination with further oxidation to butanoic acid.
Fig. 1.
Monitoring metabolism of synthetic cannabinoid 4F-MDMB-BINACA via high-resolution mass spectrometry assessed in cultured hepatoma cell line, fungus, adb butinaca liver microsomes and confirmed using urine samples The threshold for fatal overdose of combined use of SCRAs and ethanol can be estimated as a little ng/mL (0.37–4.1 ng/mL according to the reported cases) of SCRA and 1.5–2.5 g/L of ethanol. The reported cases and reviews of the scientific literature suggest a possible synergistic effect between SCRAs and ethanol, because their combined use clearly increases their toxicity. The victim died due to severe necrotizing pancreatitis and acute kidney injury evolving into multi-organ failure 11 days after hospital admission . Studies have found no unequivocal synergistic effect between THC and ethanol at low or moderate ethanol doses [29, 30], but no data on high doses of ethanol are available. Given that THC and ethanol act on the same receptors, data on their simultaneous use may yield important insights in this regard.
Fungus C. elegans
Concentrations of 4F-MDMB-BINACA in the postmortem blood samples were 2.50 and 2.34 ng/mL, which are in line with published data. Although the lethal dose of 4F-MDMB-BINACA is unknown, its concentration in postmortem blood samples was found to range between 0.10 and 2.90 ng/mL . In SCRA-related cases in which the deceased suffered from heart disease, the SCRA concentration in the postmortem blood was less than 1 ng/mL . Concentrations of SCRAs in postmortem cases cover a wide range ; however, some reports of survival have also been published—even at relatively high blood SCRA concentrations [19, 20
Similarly, precursor ion identified at m/z 380 (B19/B21, B23/B25) was 16 Da higher than the 4F-MDMB-BINACA, indicating monohydroxylation at the butyl side chain (B19/B21) and indazole (B23/B25) moieties with product ions m/z 145 and 161, respectively. Metabolites identified at m/z 366 (B8, B9, B13), which was 16 Da higher than the 4F-MDMB-BINACA ester hydrolysis metabolite (B22), confirmed monohydroxylation upon ester hydrolysis. Death involving these drugs have been reported [5,6,7,8,9], and this raises public health and social concerns. Due to their similar physiological effects to the principal psychoactive component of cannabis, Δ9-tetrahydrocannabinol (THC), SCBs are gaining popularity and are often abused as recreational drugs. The fact that similar 4F-MDMB-BINACA and ethanol concentrations were detected in the postmortem blood samples of both victims suggests that both substances played a role in the fatal outcom
In general, the locomotor depressant and discriminative stimulus effects have been observed at doses that do not produce adverse effects, although tremors were observed upon handling in mice that received JWH-210 (Gatch et al., 2016), and 5F-AMB produced sustained vocalization and convulsions in rats (Gatch et al., 2018
The chemical structures of the recent synthetic cannabinoids are unlike that of Δ9-THC, but are largely based on the structure of older synthetic cannabinoids that are known to have substantial abuse liability (Fig. 1
A limitation of this case report is that we did not have a urine sample available for additional NPS testing. Point-of-care DOA tests using urine to screen for misuse of multiple substances, regularly include cannabis, amphetamines, cocaine, opioids, benzodiazepines and methadone. THC, methamphetamine, SRCA, lysergic acid diethylamide (LSD), gamma-hydroxybutyrate (GHB) and ketamine are likely to become volatile under the temperature of current e-cigarettes, while crack cocaine is hard to vaporise. A systematic review including data of 114 patients of which the majority was intoxicated due to SCRA smoking revealed that 45 % of the patients who present at the ER after an intoxication due to SCRA smoking recovered within 24 hours