Journal of Analytical Toxicology
July 24, 2019
Isabel Gomila, Maria Ángeles Leciñena, Miguel Ángel Elorza et al.
Methoxetamine (MXE) and two methoxy-substituted analogs of phencyclidine (3-MeO-PCP and 4-MeO-PCP) are sold as legal alternatives to banned dissociative drugs like ketamine and PCP. This study tested whether these new psychoactive substances cross-react with five commercial urine immunoassays designed to detect PCP. 3-MeO-PCP and 4-MeO-PCP showed cross-reactivity ranging from 1% to 143% across all assays, and urine samples from two overdose cases were positive for PCP. MXE showed very weak cross-reactivity (0.04% to 0.25%), and ketamine was not detected in any assay. The assays can rapidly screen for 3-MeO-PCP and 4-MeO-PCP but not for ketamine, and MXE's low reactivity limits its detection.
Journal of Analytical Toxicology
May 1, 2019
Alice Ameline, Hugues Greney, Laurent Monassier et al.
Two fatal overdoses involving the dissociative drug 3-methoxyphencyclidine (3-MeO-PCP) are described. The compound, a new psychoactive substance in the phencyclidine family, has been proposed as a legal alternative to phencyclidine in some countries. Using mass spectrometry, the authors detected 3-MeO-PCP and its metabolites in human urine. In vitro metabolism studies with human liver microsomes identified four metabolites: O-demethyl-3-MeO-PCP, piperidine-hydroxy-3-MeO-PCP, O-demethyl-piperidine-di-hydroxy-3-MeO-PCP, and piperidine-di-hydroxy-3-MeO-PCP. All were found in the urine of both cases. The ratio of each metabolite to parent 3-MeO-PCP was always less than 1, indicating that testing for metabolites does not extend the detection window for the drug.
Journal of Analytical Toxicology
October 26, 2018
Nadine Theofel, P. Möller, Elke Vejmelka et al.
A 52-year-old man died after abusing N-ethyldeschloroketamine and venlafaxine. The highest concentration of N-ethyldeschloroketamine was found in the liver (6,137 ng/g), followed by urine, bile fluid, gastric contents, heart blood, and liquor, with the lowest in femoral blood (375 μg/L). Venlafaxine tablets were found in the duodenum during autopsy. Other substances detected in urine included deschloroketamine, bisoprolol, and ramiprilate. The femoral blood concentration provides a reference point for evaluating future N-ethyldeschloroketamine intoxications, and the other values help assess post-mortem distribution of this research chemical.
Journal of Analytical Toxicology
July 1, 2017
Christie Mitchell-Mata, Brittany Thomas, Brianna L Peterson et al.
Two deaths in Washington State involved the dissociative drug 3-methoxyphencyclidine (3-MeO-PCP), a structural analog of PCP and ketamine. Postmortem blood concentrations were 0.63 mg/L and 3.2 mg/L, higher than previously reported fatal cases. Both decedents had other drugs in their systems—methamphetamine in one, and ethanol, bupropion, delorazepam, paroxetine, and mitragynine in the other—consistent with polysubstance use seen in novel psychoactive substance intoxications. Both individuals were in drug rehabilitation facilities before death. The drug remains accessible online, drawing users for its dissociative effects.
Journal of Analytical Toxicology
May 1, 2017
Monika Židková, Tomáš Hložek, Martin Balik et al.
Two individuals experienced non-fatal intoxication from 3-MeO-PCP, a derivative of the dissociative drug PCP, which is available on the black market in central Europe. Clinical and laboratory data from the analytically confirmed cases are presented, and potential metabolites excreted in urine were assessed using liquid chromatography high-resolution mass spectrometry. Little is known about this new psychoactive substance, despite its availability.
Journal of Analytical Toxicology
October 1, 2015
Justin L. Poklis, Sara K Dempsey, Kai Liu et al.
Fifteen metabolites of the designer hallucinogen 25I-NBOMe were identified in mouse liver microsomal preparations and in urine from two intoxicated patients. One patient's urine contained the parent drug and all fifteen metabolites; the other contained only three O-desmethyl metabolites. Two major urinary metabolites were synthesized. The authors recommend using β-glucuronidase hydrolysis before screening and using the metabolite M5 as the primary biomarker for detecting 25I-NBOMe use.
Journal of Analytical Toxicology
March 1, 2009
Barry K. Logan, Gary Goldfogel, Rebecca Hamilton et al.
Five teenage males in three states died after intentionally ingesting large, recreational doses of dextromethorphan, a common over-the-counter cough suppressant that can cause intoxication, hallucinations, and dissociation at high doses. All obtained the drug from the same internet supplier. Postmortem blood concentrations ranged from 950 to 3230 ng/mL, far above therapeutic levels. Three also had diphenhydramine, one a trace of alprazolam, and two tested positive for cannabinoids. Each death was attributed to dextromethorphan toxicity or combined drug toxicity. The article describes the drug's metabolism, pharmacology, and interaction risks, and notes that the deaths led to prosecution of three individuals involved in selling or distributing the drug.
Journal of Analytical Toxicology
May 1, 2007
Amy Cochems, Patrick Harding, Laura Liddicoat
Dextromethorphan, a common cough-suppressant ingredient in over-the-counter medications, is abused by young adults for psychoactive effects similar to marijuana and, at higher doses, dissociative effects. Analysis of blood samples from suspected impaired drivers in Wisconsin between 1999 and 2004 found 108 samples positive for dextromethorphan. Concentrations ranged from less than 5 to 1800 ng/mL (mean 207 ng/mL), far exceeding the therapeutic range of 0.5-5.9 ng/mL. The highest concentrations occurred in males aged 16-20. Ninety-six percent of specimens also contained other drugs. Dextromethorphan-impaired drivers showed poor performance on field sobriety tests, gaze nystagmus, and signs of central nervous system depression.