Piotr Adamowicz1, Karolina Nowak2. 1. Institute of Forensic Research, Westerplatte 9, 31-033, Krakow, Poland. padamowicz@ies.gov.pl. 2. Institute of Toxicology Research, Kasztanowa 45, 55-093, Borowa, Poland.
Abstract
PURPOSE: Over the last decade, there has been a significant growth in the market and number of new psychoactive substances (NPS). One of the NPS groups that has grown rapidly in recent years, bringing a new set of problems, consists of new synthetic opioids. The extreme potency of these compounds poses a high risk of acute poisoning, as an overdose can cause respiratory depression. Most of the information regarding human pharmacokinetics of new opioids is based on toxicological case reports and the data on concentrations of new opioids in human blood are scarce. The interpretation of results usually requires a comparison to previously published cases; therefore, a referenced compilation of previously published concentration data would be useful. METHODS: The data were collected by searching the PubMed and Scopus databases and by using the Google search engine. All the available data from articles and reports that measured new opioid concentrations in plasma, serum, or whole blood were included in the data analysis. RESULTS: The presented tables list the observed concentrations in fatal and nonfatal cases involving 37 novel synthetic opioids. CONCLUSIONS: Blood levels of new opioids are extremely difficult to interpret. Low blood concentrations of these substances do not rule out acute poisoning as their high potency creates a risk of respiratory depression even at low doses. Opioid tolerance, frequent presence of other drugs, and additional diseases make it impossible to define concentration ranges, especially the minimum fatal concentrations. This report provides quick access to the source articles quantifying novel synthetic opioids.
PURPOSE: Over the last decade, there has been a significant growth in the market and number of new psychoactive substances (NPS). One of the NPS groups that has grown rapidly in recent years, bringing a new set of problems, consists of new synthetic opioids. The extreme potency of these compounds poses a high risk of acute poisoning, as an overdose can cause respiratory depression. Most of the information regarding human pharmacokinetics of new opioids is based on toxicological case reports and the data on concentrations of new opioids in human blood are scarce. The interpretation of results usually requires a comparison to previously published cases; therefore, a referenced compilation of previously published concentration data would be useful. METHODS: The data were collected by searching the PubMed and Scopus databases and by using the Google search engine. All the available data from articles and reports that measured new opioid concentrations in plasma, serum, or whole blood were included in the data analysis. RESULTS: The presented tables list the observed concentrations in fatal and nonfatal cases involving 37 novel synthetic opioids. CONCLUSIONS: Blood levels of new opioids are extremely difficult to interpret. Low blood concentrations of these substances do not rule out acute poisoning as their high potency creates a risk of respiratory depression even at low doses. Opioid tolerance, frequent presence of other drugs, and additional diseases make it impossible to define concentration ranges, especially the minimum fatal concentrations. This report provides quick access to the source articles quantifying novel synthetic opioids.
Authors: Patil Armenian; Alexander Olson; Andres Anaya; Alicia Kurtz; Rawnica Ruegner; Roy R Gerona Journal: Ann Emerg Med Date: 2016-07-26 Impact factor: 5.721
Authors: Szabolcs Sofalvi; Harold E Schueler; Eric S Lavins; Claire K Kaspar; Ian T Brooker; Carrie D Mazzola; David Dolinak; Thomas P Gilson; Steve Perch Journal: J Anal Toxicol Date: 2017-07-01 Impact factor: 3.367
Authors: Szabolcs Sofalvi; Eric S Lavins; Ian T Brooker; Claire K Kaspar; John Kucmanic; Carrie D Mazzola; Christie L Mitchell-Mata; Cassandra L Clyde; Rindi N Rico; Luigino G Apollonio; Charissa Goggin; Brittany Marshall; Danielle Moore; Thomas P Gilson Journal: J Anal Toxicol Date: 2019-10-17 Impact factor: 3.367
Authors: Arne Helland; Wenche Rødseth Brede; Lisbeth Solem Michelsen; Per Ole M Gundersen; Harald Aarset; Jan Erik Skjølås; Lars Slørdal Journal: J Anal Toxicol Date: 2017-10-01 Impact factor: 3.367