3-Methoxyphencyclidine (3-MeO-PCP), a phencyclidine analogue with anesthetic, analgesic, and hallucinogenic properties, appeared on the illicit drug market in 2011. This paper reports a non-fatal intoxication and seven deaths involving 3-MeO-PCP in Sweden from March 2014 to June 2016. The non-fatal case involved a 19-year-old male with drug problems and depression who presented awake but tachycardic, hypertensive, tachypnoeic, and catatonic, later developing fever, lactic acidosis, psychomotor agitation, and hallucinations; he fully recovered after 22 hours of intensive care. Blood concentrations of 3-MeO-PCP at admission were 0.14 μg/g, declining to 0.04 μg/g after 17 hours, with an estimated half-life of 11 hours.
The hallucinogenic drugs 25C-NBOMe and 25I-NBOMe are primarily broken down in the body by O-demethylation, followed by O-di-demethylation and hydroxylation. All methoxy groups could be demethylated; hydroxylation occurred mainly on the NBOMe ring. Phase I metabolites were extensively conjugated with glucuronic acid and sulfate in human urine. Specific and abundant urine targets for detecting 25C-NBOMe are 5'-desmethyl 25C-NBOMe, 25C-NBOMe, and 5-hydroxy 25C-NBOMe; for 25I-NBOMe, they are 2' and 5'-desmethyl 25I-NBOMe and hydroxy 25I-NBOMe. These findings can aid clinical and forensic laboratories in developing analytical methods and interpreting results.