Seither Joshua, Reidy Lisa
Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Rosenstiel Medical Science Building (RMSB), 1600 NW 10th Avenue, 7th Floor Suite 7020 (R-5), Miami, FL 33136, USA.
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J Anal Toxicol. 2017 Jul 1;41(6):493-497. doi: 10.1093/jat/bkx049.
Recently, it has been documented that there has been a rise in synthetic opioid abuse. Synthetic opioids are compounds that were created to act as agonists for the opioid receptors. Like synthetic cannabinoids, most of these compounds were created by research groups or pharmaceutical companies in an attempt to find compounds that have medicinal use. Synthetic opioids have severe health implications when abused that can include hospitalization and death. Due to the high potency and the low dose required to produce the desired effects for these compounds, it was hypothesized that they may not be detectable in human performance case samples. However, this report documents a male driver who was involved in a single-vehicle incident. First responders treated the subject with naloxone as opioid drug impairment was suspected and he was transported to the local emergency room. The subject consented to a blood draw for a driving under the influence (DUI) investigation. Initial routine testing identified alprazolam at 55 ng/mL and fentanyl at less than 0.5 ng/mL. Further testing using a validated liquid chromatography-tandem mass spectrometry (LC-MS-MS) assay, confirmed the presence of carfentanil, furanyl fentanyl, para-fluoroisobutyryl fentanyl, U-47700 and its metabolite. To the author's knowledge, this is the first report of a DUI cases where carfentanil, U-47700 and other synthetic opioids were confirmed and described in a human performance blood sample. This case demonstrates the need to supplement routine toxicological analyses with a sensitive methodology that can detect synthetic opioids in human performance cases where opioid use may be implicated.
最近，有文献记载合成阿片类药物滥用情况有所增加。合成阿片类药物是一类被制造出来作为阿片受体激动剂的化合物。与合成大麻素一样，这些化合物大多是由研究团队或制药公司制造出来，试图找到具有药用价值的化合物。合成阿片类药物滥用会对健康造成严重影响，包括住院和死亡。由于这些化合物效力高且产生预期效果所需剂量低，据推测它们可能无法在人体性能案件样本中被检测到。然而，本报告记录了一起涉及一名男性司机的单车事故。急救人员怀疑该男子因阿片类药物受损，用纳洛酮对其进行了治疗，并将他送往当地急诊室。该男子同意抽取血液用于酒驾调查。初步常规检测发现阿普唑仑含量为55纳克/毫升，芬太尼含量低于0.5纳克/毫升。使用经过验证的液相色谱-串联质谱（LC-MS-MS）分析法进行的进一步检测，证实了卡芬太尼、呋喃基芬太尼、对氟异丁酰芬太尼、U-47700及其代谢物的存在。据作者所知，这是第一份在人体性能血液样本中确认并描述卡芬太尼、U-47700和其他合成阿片类药物的酒驾案件报告。该案例表明，有必要用一种敏感的方法来补充常规毒理学分析，这种方法能够在可能涉及阿片类药物使用的人体性能案件中检测出合成阿片类药物。
