A Fatality Following Ingestion of the Designer Drug Meta‐Chlorophenylpiperazine (mCPP) in an Asthmatic—HPLC‐MS/MS Detection in Biofluids and Hair

Abstract

A 20-year-old man, a cocaine addict and regular ecstasy user, with a medical history of allergic asthma died after ingesting half a tablet earlier the same day. The white tablet, stamped with a "smiling sun" logo looked very much like an ecstasy tablet and was sold as such. He experienced a severe asthma attack just after ingesting the half tablet and it evolved over the next few hours into fatal cardiorespiratory arrest. Biological samples, taken after embalming, were analyzed by high-performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS). Analysis revealed meta-chlorophenylpiperazine (mCPP) in concentrations of 45.8 mg in a similar tablet obtained later from the drug dealer, 5.1 ng/mL in the bile, 0.3 ng/g in the liver, 15.0 ng/mL in the urine, and its absence in a hair sample (<0.02 ng/mg), which indicated he was not a regular user (whereas strong concentrations of MDMA and cocaine were found in the hair). Interrogated by the police after his arrest, the dealer said that he had sold the victim and for the very first time two tablets with the same "smiling sun" logo. The tablet used for analysis was from the same brand as the one ingested by the victim. The autopsy excluded other causes of death, while the histological analyses showed a large number of polynuclear eosinophils in the bronchial walls, confirming the asthmatic pathology. None of the other organs examined (larynx, liver, heart, adrenal glands, and kidneys) showed any distinctive signs, and in particular no inflammatory infiltrate. The death was the result of an asthma attack in an asthmatic person, violently decompensated following ingestion of approximately 20 mg of mCPP.

Recent Trends in Analytical Methods to Determine New Psychoactive Substances in Hair

“…Whereas GC/MS in the EI mode plays a major role particularly in comprehensive screening procedures because a very large collection of reference spectra is available and the cost of the instrument is not excessive, LC/MS with different mass analyzer types is becoming more and more a standard technique for automated target screening procedures and particularly for high –throughput quantification. In fact LC/MS has shown to be an ideal supplement, especially for detection of more polar, unstable or low-dose drugs [ 48 - 53 ]. This latter evidence is supported by our results; although very few GC-MS methods have been described for the determination of NPS in hair, the vast majority of studies conducted on this regard use LC/MS-MS or UHPLC–MS/MS.…”

Importance of Toxicokinetics to Assess the Utility of Zebrafish Larvae as Model for Psychoactive Drug Screening Using Meta-Chlorophenylpiperazine (mCPP) as Example

“…mCPP is an N-substituted piperazine with a molecular weight of 196.68 g/mol, an octanol-water partition coefficient (logP) of 2.06 and a pKa of 8.87. This chemical met our two selection criteria: Firstly, it is known to bind to melanin, at least in mammalian hair ( Gaillard et al, 2013 ), but with presumably lower affinity than cocaine. The latter characteristic has not yet been directly shown with mCPP, but it is known for fluphenazine, an anti-psychotic therapeutic drug with a piperazine ring ( Baweja et al, 1977 ; Tardy et al, 2014 ).…”

The Variability of Ecstasy Tablets Composition in Brazil

“…Psychoactive substances, which include piperazines such as benzylpiperazine (BZP) or m ‐chlorophenylpiperazine ( m CPP), as well as analogues of methcathinone such as 4‐methylmethcathinone (4‐MMC or mephedrone) or methylenedioxypyrovalerone (MDPV), are now relatively common in ecstasy‐like tablets . Tablets seized in Netherlands presented several active substance, such as methamphetamine, 4‐bromo‐2,5‐dimethoxyphenethylamine (2C‐B), p‐methoxy‐methamphetamine (PMA), m‐chlorophenylpiperazine (mCPP), benzylpiperazine (BZP), atropine, ketamine, lidocaine, procaine, ephedrine, and caffeine .…”