纽约发生的由合成大麻素 AMB-FUBINACA 引起的“僵尸”疫情。

"Zombie" Outbreak Caused by the Synthetic Cannabinoid AMB-FUBINACA in New York.

机构信息

From the Clinical Toxicology and Environmental Biomonitoring Laboratory (A.J.A., R.G.) and School of Medicine (A.J.A.), University of California, San Francisco, San Francisco, and the Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto (S.D.B.) - both in California; the Department of Emergency Medicine, Wyckoff Heights Medical Center, New York (L.I.); the Office of Diversion Control, Drug and Chemical Evaluation Section, Drug Enforcement Administration, Springfield, VA (J.T.); and the Chemical Defense Program, Office of Health Affairs, Department of Homeland Security, Washington, DC (M.S.).

出版信息

N Engl J Med. 2017 Jan 19;376(3):235-242. doi: 10.1056/NEJMoa1610300. Epub 2016 Dec 14.

DOI:10.1056/NEJMoa1610300

PMID:27973993

Abstract

BACKGROUND

New psychoactive substances constitute a growing and dynamic class of abused drugs in the United States. On July 12, 2016, a synthetic cannabinoid caused mass intoxication of 33 persons in one New York City neighborhood, in an event described in the popular press as a "zombie" outbreak because of the appearance of the intoxicated persons.

METHODS

We obtained and tested serum, whole blood, and urine samples from 8 patients among the 18 who were transported to local hospitals; we also tested a sample of the herbal "incense" product "AK-47 24 Karat Gold," which was implicated in the outbreak. Samples were analyzed by means of liquid chromatography-quadrupole time-of-flight mass spectrometry.

RESULTS

The synthetic cannabinoid methyl 2-(1-(4-fluorobenzyl)-1H-indazole-3-carboxamido)-3-methylbutanoate (AMB-FUBINACA, also known as MMB-FUBINACA or FUB-AMB) was identified in AK-47 24 Karat Gold at a mean (±SD) concentration of 16.0±3.9 mg per gram. The de-esterified acid metabolite was found in the serum or whole blood of all eight patients, with concentrations ranging from 77 to 636 ng per milliliter.

CONCLUSIONS

The potency of the synthetic cannabinoid identified in these analyses is consistent with strong depressant effects that account for the "zombielike" behavior reported in this mass intoxication. AMB-FUBINACA is an example of the emerging class of "ultrapotent" synthetic cannabinoids and poses a public health concern. Collaboration among clinical laboratory staff, health professionals, and law enforcement agencies facilitated the timely identification of the compound and allowed health authorities to take appropriate action.

摘要

背景

新精神活性物质在美国是不断增长和动态变化的滥用药物类别。2016 年 7 月 12 日，一种合成大麻素导致纽约市一个社区的 33 人集体中毒，这一事件在大众媒体中被描述为“僵尸”爆发，因为中毒者的出现。

方法

我们从 18 名被送往当地医院的患者中采集并检测了 8 名患者的血清、全血和尿液样本；我们还对涉案的草药“香料”产品“AK-47 24 克拉金”进行了测试。样品采用液相色谱-四极杆飞行时间质谱法进行分析。

结果

AK-47 24 克拉金中发现了合成大麻素甲基 2-(1-(4-氟苄基)-1H-吲哚-3-甲酰胺基)-3-甲基丁酸酯（AMB-FUBINACA，也称为 MMB-FUBINACA 或 FUB-AMB），平均（±SD）浓度为 16.0±3.9 毫克/克。在所有 8 名患者的血清或全血中均发现了去酯化酸代谢物，浓度范围为 77 至 636 纳克/毫升。