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Neukamm MA, Pollak S, Thoma V, Vogt S, Huppertz LM, Auwärter V. A fatal case of aspiration due to consumption of the hallucinogenic tryptamine derivative dipropyltryptamine (DPT). J Pharm Biomed Anal 2024; 240:115959. [PMID: 38183731 DOI: 10.1016/j.jpba.2023.115959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND AND AIM This case involves a 20-year-old man with prior hallucinogen-use experience, who sniffed an unknown amount of dipropyltryptamine in an apartment. Dipropyltryptamine, a hallucinogenic compound belonging to the tryptamine class is recognized for inducing effects similar to dimethyltryptamine (DMT) but with a longer duration. Ten to fifteen minutes later he experienced visual hallucinations, followed by increasing apathy. Two hours post consumption he developed abdominal pain, leading to collapse, seizure, and vomiting. Despite emergency medical resuscitation on site, transport to hospital 2.5 hours post consumption and extracorporeal life support he died 21 hours later. Relevant toxicological and morphological findings are presented. METHODS A serum sample was collected four hours post consumption. Autopsy was performed six days after death. Antemortem serum, as well as postmortem cardiac blood and urine were analyzed for alcohol and psychoactive drugs by systematic toxicological analyses employing gas chromatography-mass spectrometry (Maurer/Pfleger/Weber library among others), liquid chromatography-ion trap mass spectrometry (LC-MSn, Toxtyper™), and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Dipropyltryptamine was quantified by LC-MS/MS after solid-phase extraction. RESULTS Autopsy revealed a state after deep aspiration of gastric contents with consecutive brain edema due to oxygen deprivation. Dipropyltryptamine concentrations were approximately 210 ng/ml, 110 ng/ml and 180 ng/ml in antemortem serum, postmortem cardiac blood and urine, respectively. To the best of our knowledge, these are the first reported concentrations of dipropyltryptamine in a fatal case. CONCLUSION Unlike typical tryptamine overdose reports, this case did not present with agitation, hyperthermia, or tachycardia. Despite the individual's prior experience with tryptamines and the generally low toxicity associated with this class of hallucinogens, death in this case was an indirect consequence of the nasal consumption of a high dose of dipropyltryptamine.
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Affiliation(s)
- Merja A Neukamm
- Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstraße 9, Freiburg 79104, Germany.
| | - Stefan Pollak
- Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstraße 9, Freiburg 79104, Germany
| | - Vanessa Thoma
- Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstraße 9, Freiburg 79104, Germany
| | - Susanne Vogt
- Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstraße 9, Freiburg 79104, Germany
| | - Laura M Huppertz
- Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstraße 9, Freiburg 79104, Germany
| | - Volker Auwärter
- Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstraße 9, Freiburg 79104, Germany
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Franchetti G, Thierauf-Emberger A, Franz A, Thoma V, Auwärter V, Huppertz LM. Detection of methadone and buprenorphine in urine samples from inmates of German prisons. Front Psychiatry 2023; 14:1139370. [PMID: 36926464 PMCID: PMC10011066 DOI: 10.3389/fpsyt.2023.1139370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/02/2023] [Indexed: 03/04/2023] Open
Abstract
The use of non-prescribed opioid substitution drugs is a serious public health problem, involving general population as well as vulnerable populations such as prisoners. The estimation of the prevalence of opioid substitution drug misuse in prisoners is crucial to suggest strategies to contrast this phenomenon and reduce the associated morbidity and mortality. The present study aimed to provide an objective estimation of the prevalence of illicit use of methadone and buprenorphine in two German prisons. Urine samples were collected from inmates of Freiburg and Offenburg prisons at random times and tested for the detection of methadone, buprenorphine and their metabolites. Analyses were performed by a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. In total 678 inmates participated in this study. The participation rate was about 60% of all permanent inmates. Of the 675 samples suitable for the analysis, 70 samples (10.4%) tested positive for methadone, 70 samples (10.4%) for buprenorphine, and 4 samples (0.6%) for both drugs. At least 100 samples (14.8%) were not associated with reported prescribed-opioid substitution treatment (OST). Buprenorphine was the most common illicitly used drug. In one of the prisons, buprenorphine was brought in from the outside. The present cross-sectional experimental study was able to provide reliable information regarding the illicit use of opioid substitution drugs in prisons.
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Affiliation(s)
- Giorgia Franchetti
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal Medicine and Toxicology, University of Padova, Padova, Italy.,Institute of Forensic Medicine, Forensic Toxicology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Annette Thierauf-Emberger
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Anette Franz
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Vanessa Thoma
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Volker Auwärter
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Laura M Huppertz
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, University of Freiburg, Freiburg, Germany
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Haschimi B, Grafinger KE, Pulver B, Psychou E, Halter S, Huppertz LM, Westphal F, Pütz M, Auwärter V. New synthetic cannabinoids carrying a cyclobutyl methyl side chain: Human Phase I metabolism and data on human cannabinoid receptor 1 binding and activation of Cumyl-CBMICA and Cumyl-CBMINACA. Drug Test Anal 2021; 13:1499-1515. [PMID: 33788409 DOI: 10.1002/dta.3038] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/11/2021] [Accepted: 03/11/2021] [Indexed: 02/01/2023]
Abstract
Synthetic cannabinoids (SCs) represent a large group of new psychoactive substances (NPS), sustaining a high prevalence on the drug market since their first detection in 2008. Cumyl-CBMICA and Cumyl-CBMINACA, the first representatives of a new subclass of SCs characterized by a cyclobutyl methyl (CBM) moiety, were identified in July 2019 and February 2020. This work aimed at evaluating basic pharmacological characteristics and human Phase I metabolism of these compounds. Human Phase I metabolites were tentatively identified by liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QToF-MS) of urine samples and confirmed by a pooled human liver microsome (pHLM) assay. The basic pharmacological evaluation was performed by applying a competitive ligand binding assay and a functional activation assay (GTPγS) using cell membranes carrying the human cannabinoid receptor 1 (hCB1 ). Investigation of the human Phase I metabolism resulted in the identification of specific urinary markers built by monohydroxylation or dihydroxylation. Although Cumyl-CBMICA was primarily hydroxylated at the indole ring, hydroxylation of Cumyl-CBMINACA mainly occurred at the CBM moiety. Both substances acted as agonists at the hCB1 receptor, although substantial differences could be observed. Cumyl-CBMINACA showed higher binding affinity (Ki = 1.32 vs. 29.3 nM), potency (EC50 = 55.4 vs. 497 nM), and efficacy (Emax = 207% vs. 168%) than its indole counterpart Cumyl-CBMICA. This study confirms that substitution of an indole by an indazole core tends to increase in vitro potency, which is potentially reflected by higher in vivo potency. The emergence and disappearance of SCs distributed via online shops carrying a CBM moiety once more demonstrate the "cat-and-mouse" game between manufacturers and legislation.
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Affiliation(s)
- Belal Haschimi
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Herrmann Staudinger Graduate School, University of Freiburg, Freiburg, Germany
| | - Katharina Elisabeth Grafinger
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Benedikt Pulver
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Herrmann Staudinger Graduate School, University of Freiburg, Freiburg, Germany.,State Bureau of Criminal Investigation Schleswig-Holstein, Forensic Science Institute, Kiel, Germany
| | - Evangelia Psychou
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Halter
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Herrmann Staudinger Graduate School, University of Freiburg, Freiburg, Germany
| | - Laura M Huppertz
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Folker Westphal
- State Bureau of Criminal Investigation Schleswig-Holstein, Forensic Science Institute, Kiel, Germany
| | - Michael Pütz
- Federal Criminal Police Office, Forensic Science Institute, Wiesbaden, Germany
| | - Volker Auwärter
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Grumann C, Huppertz LM, Bisel P, Angerer V, Auwärter V. Method validation and preliminary pharmacokinetic studies on the new designer stimulant 3‐fluorophenmetrazine (3‐FPM). Drug Test Anal 2019; 11:1009-1017. [DOI: 10.1002/dta.2577] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/15/2019] [Accepted: 02/17/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Christina Grumann
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
- Hermann Staudinger Graduate SchoolUniversity of Freiburg Freiburg Germany
| | - Laura M. Huppertz
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
| | - Philippe Bisel
- Institute for Pharmaceutical Sciences, University of Freiburg Freiburg Germany
| | - Verena Angerer
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
- Forensic ToxicologyInstitute of Forensic Medicine St. Gallen Switzerland
| | - Volker Auwärter
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
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5
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Mogler L, Franz F, Wilde M, Huppertz LM, Halter S, Angerer V, Moosmann B, Auwärter V. Phase I metabolism of the carbazole-derived synthetic cannabinoids EG-018, EG-2201, and MDMB-CHMCZCA and detection in human urine samples. Drug Test Anal 2018; 10:1417-1429. [PMID: 29726116 DOI: 10.1002/dta.2398] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/17/2018] [Accepted: 04/18/2018] [Indexed: 02/02/2023]
Abstract
Synthetic cannabinoids (SCs) are a structurally diverse class of new psychoactive substances. Most SCs used for recreational purposes are based on indole or indazole core structures. EG-018 (naphthalen-1-yl(9-pentyl-9H-carbazol-3-yl)methanone), EG-2201 ((9-(5-fluoropentyl)-9H-carbazol-3-yl)(naphthalen-1-yl)methanone), and MDMB-CHMCZCA (methyl 2-(9-(cyclohexylmethyl)-9H-carbazole-3-carboxamido)-3,3-dimethylbutanoate) are 3 representatives of a structural subclass of SCs, characterized by a carbazole core system. In vitro and in vivo phase I metabolism studies were conducted to identify the most suitable metabolites for the detection of these substances in urine screening. Detection and characterization of metabolites were performed by liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) and liquid chromatography-electrospray ionization-quadrupole time-of-flight-mass spectrometry (LC-ESI-QToF-MS). Eleven in vivo metabolites were detected in urine samples positive for metabolites of EG-018 (n = 8). A hydroxypentyl metabolite, most probably the 4-hydroxypentyl isomer, and an N-dealkylated metabolite mono-hydroxylated at the carbazole core system were most abundant. In vitro studies of EG-018 and EG-2201 indicated that oxidative defluorination of the 5-fluoropentyl side chain of EG-2201 as well as dealkylation led to common metabolites with EG-018. This has to be taken into account for interpretation of analytical findings. A differentiation between EG-018 and EG-2201 (n = 1) uptake is possible by the detection of compound-specific in vivo phase I metabolites evaluated in this study. Out of 30 metabolites detected in urine samples of MDMB-CHMCZCA users (n = 20), a metabolite mono-hydroxylated at the cyclohexyl methyl tail is considered the most suitable compound-specific consumption marker while a biotransformation product of mono-hydroxylation in combination with hydrolysis of the terminal methyl ester function provides best sensitivity due to its high abundance.
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Affiliation(s)
- Lukas Mogler
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.,Hermann Staudinger Graduate School, University of Freiburg, Germany
| | - Florian Franz
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.,Hermann Staudinger Graduate School, University of Freiburg, Germany
| | - Maurice Wilde
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.,Hermann Staudinger Graduate School, University of Freiburg, Germany
| | - Laura M Huppertz
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Sebastian Halter
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Verena Angerer
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Bjoern Moosmann
- Institute of Forensic Medicine, Forensic Toxicology, Kantonsspital St Gallen, Switzerland
| | - Volker Auwärter
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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Mogler L, Wilde M, Huppertz LM, Weinfurtner G, Franz F, Auwärter V. Phase I metabolism of the recently emerged synthetic cannabinoid CUMYL-PEGACLONE and detection in human urine samples. Drug Test Anal 2018; 10:886-891. [DOI: 10.1002/dta.2352] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 12/17/2017] [Accepted: 12/17/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Lukas Mogler
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine; University of Freiburg; Germany
- Hermann Staudinger Graduate School; University of Freiburg; Germany
| | - Maurice Wilde
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine; University of Freiburg; Germany
- Hermann Staudinger Graduate School; University of Freiburg; Germany
| | - Laura M. Huppertz
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine; University of Freiburg; Germany
| | - Georg Weinfurtner
- Clinical Chemistry Laboratory, medbo®; District Hospital for Mental Health; Regensburg Germany
| | - Florian Franz
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine; University of Freiburg; Germany
- Hermann Staudinger Graduate School; University of Freiburg; Germany
| | - Volker Auwärter
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine; University of Freiburg; Germany
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Angerer V, Mogler L, Steitz JP, Bisel P, Hess C, Schoeder CT, Müller CE, Huppertz LM, Westphal F, Schäper J, Auwärter V. Structural characterization and pharmacological evaluation of the new synthetic cannabinoid CUMYL-PEGACLONE. Drug Test Anal 2017; 10:597-603. [DOI: 10.1002/dta.2237] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 06/21/2017] [Accepted: 06/21/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Verena Angerer
- Institute of Forensic Medicine, Forensic Toxicology; Medical Center - University of Freiburg; Germany
- Hermann Staudinger Graduate School; University of Freiburg; Germany
| | - Lukas Mogler
- Institute of Forensic Medicine, Forensic Toxicology; Medical Center - University of Freiburg; Germany
- Hermann Staudinger Graduate School; University of Freiburg; Germany
| | | | - Philippe Bisel
- Institute for Pharmaceutical Sciences; University of Freiburg; Germany
| | - Cornelius Hess
- Institute of Forensic Medicine, Forensic Toxicology; University of Bonn; Germany
| | - Clara T. Schoeder
- PharmaCenter Bonn, Pharmaceutical Institute, Pharmaceutical Chemistry I; University of Bonn; Germany
| | - Christa E. Müller
- PharmaCenter Bonn, Pharmaceutical Institute, Pharmaceutical Chemistry I; University of Bonn; Germany
| | - Laura M. Huppertz
- Institute of Forensic Medicine, Forensic Toxicology; Medical Center - University of Freiburg; Germany
| | - Folker Westphal
- State Bureau of Criminal Investigation Schleswig-Holstein; Kiel Germany
| | - Jan Schäper
- State Bureau of Criminal Investigation Bavaria; München Germany
| | - Volker Auwärter
- Institute of Forensic Medicine, Forensic Toxicology; Medical Center - University of Freiburg; Germany
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Huppertz LM, Moosmann B, Auwärter V. Flubromazolam - Basic pharmacokinetic evaluation of a highly potent designer benzodiazepine. Drug Test Anal 2017; 10:206-211. [DOI: 10.1002/dta.2203] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/03/2017] [Accepted: 04/03/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Laura M. Huppertz
- Institute of Forensic Medicine, Forensic Toxicology Department; Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg; Germany
| | - Bjoern Moosmann
- Institute of Forensic Medicine, Forensic Toxicology Department; Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg; Germany
| | - Volker Auwärter
- Institute of Forensic Medicine, Forensic Toxicology Department; Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg; Germany
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Krais S, Klima M, Huppertz LM, Auwärter V, Altenburger MJ, Neukamm MA. Betel Nut Chewing in Iron Age Vietnam? Detection of Areca catechu Alkaloids in Dental Enamel. J Psychoactive Drugs 2016; 49:11-17. [PMID: 27997280 DOI: 10.1080/02791072.2016.1264647] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The betel quid is one of the most commonly consumed psychoactive substances in the world. By archaeological evidence like the occurrence of areca nuts in archaeological sites, the typical overall reddish-brown staining on prehistoric human teeth or specific artifacts linked with the habit, it is assumed that this tradition reaches back to prehistoric times. Since this kind of evidence is indirect, it is frequently doubted. The present study provides the earliest direct analytical indication of betel nut chewing in human history. A typical stained tooth from an Iron Age skeleton (site Gò Ô Chùa in Southern Vietnam, 400-100 BC) was analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and liquid chromatography-high-resolution mass spectrometry (LC-HR-ToF-MS) and the alkaloid arecoline which is specific for Areca catechu L. (Arecaceae) was detected.
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Affiliation(s)
- Simone Krais
- a Doctoral Candidate, Physical Anthropology, Faculty of Medicine , University of Freiburg , Freiburg , Germany
| | - Miriam Klima
- b Doctoral Candidate, Institute for Forensic Medicine, Medical Center-University of Freiburg, Faculty of Medicine, Hermann Staudinger Graduate School , University of Freiburg , Freiburg , Germany
| | - Laura M Huppertz
- c Research Associate, Institute for Forensic Medicine, Medical Center-University of Freiburg, Faculty of Medicine , University of Freiburg , Freiburg , Germany
| | - Volker Auwärter
- d Professor, Institute for Forensic Medicine, Medical Center-University of Freiburg, Faculty of Medicine , University of Freiburg , Freiburg , Germany
| | - Markus J Altenburger
- e Professor, Department of Operative Dentistry and Periodontology , University Medical Center , Freiburg , Germany
| | - Merja A Neukamm
- f Assistant Professor, Institute for Forensic Medicine, Medical Center-University of Freiburg, Faculty of Medicine , University of Freiburg , Freiburg , Germany
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Moosmann B, Bisel P, Franz F, Huppertz LM, Auwärter V. Characterization and in vitro phase I microsomal metabolism of designer benzodiazepines - an update comprising adinazolam, cloniprazepam, fonazepam, 3-hydroxyphenazepam, metizolam and nitrazolam. J Mass Spectrom 2016; 51:1080-1089. [PMID: 27535017 DOI: 10.1002/jms.3840] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/26/2016] [Accepted: 08/16/2016] [Indexed: 06/06/2023]
Abstract
Designer benzodiazepines represent an emerging class of new psychoactive substances. While other classes of new psychoactive substances such as cannabinoid receptor agonists and designer stimulants are mainly consumed for hedonistic reasons, designer benzodiazepines may also be consumed as 'self-medication' by persons suffering from anxiety or other psychiatric disorders or as stand-by 'antidote' by users of stimulant and hallucinogenic drugs. In the present study, five benzodiazepines (adinazolam, cloniprazepam, fonazepam, 3-hydroxyphenazepam and nitrazolam) and one thienodiazepine (metizolam) offered as 'research chemicals' on the Internet were characterized and their main in vitro phase I metabolites tentatively identified after incubation with pooled human liver microsomes. For all compounds, the structural formula declared by the vendor was confirmed by nuclear magnetic resonance spectroscopy, gas chromatography-mass spectrometry (MS), liquid chromatography MS/MS and liquid chromatography quadrupole time-of-flight MS analysis. The detected in vitro phase I metabolites of adinazolam were N-desmethyladinazolam and N-didesmethyladinazolam. Metizolam showed a similar metabolism to other thienodiazepines comprising monohydroxylations and dihydroxylation. Cloniprazepam was metabolized to numerous metabolites with the main metabolic steps being N-dealkylation, hydroxylation and reduction of the nitro function. It has to be noted that clonazepam is a metabolite of cloniprazepam, which may lead to difficulties when interpreting analytical findings. Nitrazolam and fonazepam both underwent monohydroxylation and reduction of the nitro function. In the case of 3-OH-phenazepam, no in vitro phase I metabolites were detected. Formation of licensed benzodiazepines (clonazepam after uptake of cloniprazepam) and the sale of metabolites of prescribed benzodiazepines (fonazepam, identical to norflunitrazepam, and 3-hydroxyphenazepam) present the risk of incorrect interpretation of analytical findings. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Bjoern Moosmann
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstr. 9, 79104, Freiburg, Germany.
| | - Philippe Bisel
- Institute of Pharmaceutical Sciences, University of Freiburg, Albertstr. 25, 79104, Freiburg, Germany
| | - Florian Franz
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstr. 9, 79104, Freiburg, Germany
- Hermann Staudinger Graduate School, University of Freiburg, Hebelstr. 27, 79104, Freiburg, Germany
| | - Laura M Huppertz
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstr. 9, 79104, Freiburg, Germany
| | - Volker Auwärter
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Albertstr. 9, 79104, Freiburg, Germany
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Thierauf-Emberger A, Franz A, Auwärter V, Huppertz LM. Detection of the ethanol consumption markers ethyl glucuronide and ethyl sulfate in urine samples from inmates of two German prisons. Int J Legal Med 2015; 130:387-91. [PMID: 26160754 DOI: 10.1007/s00414-015-1222-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 06/22/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Abstinence from ethanol is necessary in various situations. Among these are jail terms. Nevertheless, it is a matter of fact that ethanol is illegally produced and ingested in prisons. So far, data regarding drug prevalence in jail have mainly been collected by questionnaires. To get an objective database for the prevalence of ethanol consumption in jail, a cross-sectional study was performed. METHODS Inmates of two German prisons (Offenburg and Freiburg) were asked to give a urine sample at an unknown and random point of time. Participation was voluntary and did lead to neither negative consequences nor benefits. All samples were anonymized. Using the consumption markers ethyl glucuronide (EtG) and ethyl sulfate (EtS), the urine samples were tested for previous ethanol consumption. Analyses were performed by a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. RESULTS In total 676 male inmates participated in this study. The participation rate was 70-75% of all permanent inmates in Offenburg and 30.6% in Freiburg. Ten of the 555 (1.8%) samples from Offenburg and 1 of the 121 (0.8%) samples from Freiburg were positive for ethanol consumption markers with concentrations ranging from trace amounts to 1400 ng/mL for EtG and up to 510 ng/mL for EtS, respectively. CONCLUSIONS The number of participants in this study was rather high, so that the results represent a good cross section, at least for Offenburg, the jail with the higher number of positive samples.
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Affiliation(s)
- Annette Thierauf-Emberger
- Medical Center - University of Freiburg, Institute of Forensic Medicine, Albertstraße 9, 79104, Freiburg, Germany.
| | - Anette Franz
- Medical Center - University of Freiburg, Institute of Forensic Medicine, Albertstraße 9, 79104, Freiburg, Germany
| | - Volker Auwärter
- Medical Center - University of Freiburg, Institute of Forensic Medicine, Albertstraße 9, 79104, Freiburg, Germany
| | - Laura M Huppertz
- Medical Center - University of Freiburg, Institute of Forensic Medicine, Albertstraße 9, 79104, Freiburg, Germany
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12
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Geisenberger D, Wuest F, Bielefeld L, Große Perdekamp M, Pircher R, Pollak S, Thierauf-Emberger A, Huppertz LM. Fat from contused adipose tissue may cause yellow discoloration of clothes in blunt trauma victims. Forensic Sci Int 2014; 245:72-6. [PMID: 25447178 DOI: 10.1016/j.forsciint.2014.10.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 10/10/2014] [Indexed: 11/26/2022]
Abstract
In some fatalities from intense blunt trauma, the victims' clothes show strikingly yellow discoloration being in topographic correspondence with lacerated skin and crush damage to the underlying fatty tissue. This phenomenon is especially pronounced in light-colored textiles such as underwear made of cotton and in the absence of concomitant blood-staining. The constellation of findings seems to indicate that the fabric has been soaked with liquid body fat deriving from the contused adipose tissue. To check this hypothesis, textiles suspected to be contaminated with fat were investigated in 6 relevant cases. GC-MS-analysis proved the presence of 11 fatty acids. The fatty acid composition was similar to that of human adipose tissue with a high proportion of oleic acid (18:1). In total, the morphological and chemical findings demonstrated that the yellow discoloration of the victims' clothes was caused by fat from traumatized adipose tissue.
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Affiliation(s)
- D Geisenberger
- Institute of Forensic Medicine, Freiburg University Medical Centre, Freiburg, Germany.
| | - F Wuest
- Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - L Bielefeld
- Institute of Forensic Medicine, Freiburg University Medical Centre, Freiburg, Germany
| | - M Große Perdekamp
- Institute of Forensic Medicine, Freiburg University Medical Centre, Freiburg, Germany
| | - R Pircher
- Institute of Forensic Medicine, Freiburg University Medical Centre, Freiburg, Germany
| | - S Pollak
- Institute of Forensic Medicine, Freiburg University Medical Centre, Freiburg, Germany
| | - A Thierauf-Emberger
- Institute of Forensic Medicine, Freiburg University Medical Centre, Freiburg, Germany
| | - L M Huppertz
- Institute of Forensic Medicine, Freiburg University Medical Centre, Freiburg, Germany
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13
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Spinner J, Klima M, Kempf J, Huppertz LM, Auwärter V, Altenburger MJ, Neukamm MA. Determination of drugs of abuse in bovine dentin using liquid chromatography-electrospray ionization tandem mass spectrometry. J Mass Spectrom 2014; 49:1306-1313. [PMID: 25476949 DOI: 10.1002/jms.3464] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 07/21/2014] [Accepted: 08/07/2014] [Indexed: 06/04/2023]
Abstract
Drugs deposited in human teeth are well preserved; the spectrum of toxicological investigations may therefore be supplemented by an analysis method for drugs in teeth. A liquid chromatography-electrospray ionization tandem mass spectrometry assay for the detection and quantification of basic drugs of abuse in bovine dentin samples was developed and validated. The drugs and metabolites amphetamine, methamphetamine, methylenedioxymethylamphetamine, methylenedioxyethylamphetamine, codeine, morphine, cocaine and benzoylecgonine were extracted from 50 mg ground dentin powder by ultrasonication for 60 min in methanol 3 times. The extracts were analyzed on a triple-quadrupole mass-spectrometer in multiple reaction monitoring mode. The method was validated and proved to be accurate, precise, selective, specific and stable with good linearity within the calibration range and a lower limit of quantification of 10 to 20 pg/mg. To artificially load bovine dentin samples with drugs, the natural process of de- and remineralization in the oral cavity was mimicked by a pH-cycling experiment. The artificially drug-loaded dentin samples showed drug concentrations of 20 to 80 pg/mg. The method can be applied in further in vitro experiments as well as in post-mortem cases, especially where limited sample tissue is available.
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Affiliation(s)
- J Spinner
- Institute of Forensic Medicine, University Medical Center Freiburg, Freiburg, Germany; Institute of Forensic Medicine, University of Bern, Bern, Switzerland
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14
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Kempf J, Traber J, Auwärter V, Huppertz LM. ‘Psychotropics caught in a trap’ – Adopting a screening approach to specific needs. Forensic Sci Int 2014; 243:84-9. [DOI: 10.1016/j.forsciint.2014.04.035] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 04/08/2014] [Accepted: 04/24/2014] [Indexed: 02/02/2023]
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15
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Huppertz LM, Kneisel S, Auwärter V, Kempf J. A comprehensive library-based, automated screening procedure for 46 synthetic cannabinoids in serum employing liquid chromatography-quadrupole ion trap mass spectrometry with high-temperature electrospray ionization. J Mass Spectrom 2014; 49:117-127. [PMID: 24677304 DOI: 10.1002/jms.3328] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 12/09/2013] [Accepted: 12/13/2013] [Indexed: 06/03/2023]
Abstract
Considering the vast variety of synthetic cannabinoids and herbal mixtures - commonly known as 'Spice' or 'K2' - on the market and the resulting increase of severe intoxications related to their consumption, there is a need in clinical and forensic toxicology for comprehensive up-to-date screening methods. The focus of this project aimed at developing and implementing an automated screening procedure for the detection of synthetic cannabinoids in serum using a liquid chromatography-ion trap-MS (LC-MS(n)) system and a spectra library-based approach, currently including 46 synthetic cannabinoids and 8 isotope labelled analogues. In the process of method development, a high-temperature ESI source (IonBooster(TM), Bruker Daltonik) and its effects on the ionization efficiency of the investigated synthetic cannabinoids were evaluated and compared to a conventional ESI source. Despite their structural diversity, all investigated synthetic cannabinoids benefitted from high-temperature ionization by showing remarkably higher MS intensities compared to conventional ESI. The employed search algorithm matches retention time, MS and MS(2)/MS(3) spectra. With the utilization of the ionBooster source, limits for the automated detection comparable to cut-off values of routine MRM methods were achieved for the majority of analytes. Even compounds not identified when using a conventional ESI source were detected using the ionBooster-source. LODs in serum range from 0.1 ng/ml to 0.5 ng/ml. The use of parent compounds as analytical targets offers the possibility of instantly adding new emerging compounds to the library and immediately applying the updated method to serum samples, allowing the rapid adaptation of the screening method to ongoing forensic or clinical requirements. The presented approach can also be applied to other specimens, such as oral fluid or hair, and herbal mixtures and was successfully applied to authentic serum samples. Quantitative MRM results of samples with analyte concentrations above the determined LOD were confirmed as positive findings by the presented method.
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Affiliation(s)
- Laura M Huppertz
- Institute of Forensic Medicine, Forensic Toxicology Department, University Medical Center Freiburg, Albertstr. 9, D-79104 Freiburg, Germany
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16
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Moosmann B, Huppertz LM, Hutter M, Buchwald A, Ferlaino S, Auwärter V. Detection and identification of the designer benzodiazepine flubromazepam and preliminary data on its metabolism and pharmacokinetics. J Mass Spectrom 2013; 48:1150-1159. [PMID: 24259203 DOI: 10.1002/jms.3279] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 08/27/2013] [Accepted: 08/28/2013] [Indexed: 06/02/2023]
Abstract
The appearance of pyrazolam in Internet shops selling 'research chemicals' in 2012 marked the beginning of designer benzodiazepines being sold as recreational drugs or 'self medication'. With recent changes in national narcotics laws in many countries, where two uncontrolled benzodiazepines (phenazepam and etizolam), which were marketed by pharmaceutical companies in some countries, were scheduled, clandestine laboratories seem to turn to poorly characterized research drug candidates as legal substitutes. Following the appearance of pyrazolam, it comes with no surprise that recently, flubromazepam (7-bromo-5-(2-fluorophenyl)-1,3-dihydro-2H-1,4-benzodiazepin-2-one), a second designer benzodiazepine, was offered on the market. In this article, this new compound was characterized using nuclear magnetic resonance, gas chromatography-mass spectrometry (GC-MS), liquid chromatography-mass spectrometry (LC-MS/MS) and liquid chromatography quadrupole time-of-flight MS (LC-Q-ToF-MS). Additionally, a study was carried out, in which one of the authors consumed 4 mg of flubromazepam to gain preliminary data on the pharmacokinetic properties and the metabolism of this compound. For this purpose, serum as well as urine samples were collected for up to 31 days post-ingestion and analyzed applying LC-MS/MS and LC-Q-ToF-MS techniques. On the basis of this study, flubromazepam appears to have an extremely long elimination half-life of more than 100 h. One monohydroxylated compound and the debrominated compound could be identified as the predominant metabolites, the first allowing a detection of a consumption for up to 28 days post-ingestion when analyzing urine samples in our case. Additionally, various immunochemical assays were evaluated, showing that the cross-reactivity of the used assay seems not to be sufficient for safe detection of the applied dose in urine samples, bearing the risk that it could be misused in drug-withdrawal settings or in other circumstances requiring regular drug testing. Furthermore, it may be used in drug-facilitated crimes without being detected.
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Affiliation(s)
- Bjoern Moosmann
- Institute of Forensic Medicine, Forensic Toxicology Department, University Medical Center Freiburg, Albertstr. 9, 79104, Freiburg, Germany; Hermann Staudinger Graduate School, University of Freiburg, Hebelstr. 27, 79104, Freiburg, Germany
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