Confirmation of Carfentanil, U-47700 and Other Synthetic Opioids in a Human Performance Case by LC–MS-MS

Abstract

Recently, it has been documented that there has been a rise in synthetic opioid abuse. Synthetic opioids are compounds that were created to act as agonists for the opioid receptors. Like synthetic cannabinoids, most of these compounds were created by research groups or pharmaceutical companies in an attempt to find compounds that have medicinal use. Synthetic opioids have severe health implications when abused that can include hospitalization and death. Due to the high potency and the low dose required to produce the desired effects for these compounds, it was hypothesized that they may not be detectable in human performance case samples. However, this report documents a male driver who was involved in a single-vehicle incident. First responders treated the subject with naloxone as opioid drug impairment was suspected and he was transported to the local emergency room. The subject consented to a blood draw for a driving under the influence (DUI) investigation. Initial routine testing identified alprazolam at 55 ng/mL and fentanyl at less than 0.5 ng/mL. Further testing using a validated liquid chromatography-tandem mass spectrometry (LC-MS-MS) assay, confirmed the presence of carfentanil, furanyl fentanyl, para-fluoroisobutyryl fentanyl, U-47700 and its metabolite. To the author's knowledge, this is the first report of a DUI cases where carfentanil, U-47700 and other synthetic opioids were confirmed and described in a human performance blood sample. This case demonstrates the need to supplement routine toxicological analyses with a sensitive methodology that can detect synthetic opioids in human performance cases where opioid use may be implicated.

Ten Years of Fentanyl-like Drugs: a Technical-analytical Review

“…Moreover, the absorbent of cartridges can be either reverse-phase, 26 cation exchange, 27,28 polymeric 29 or mixed-mode. 30,31 In specific cases, further steps were implemented prior SPE, namely solvent protein precipitation 27 or enzymatic hydrolysis on urine samples. 1,28,32 According to Eckart et al 26 serum, blood and tissue samples were purified for the detection of different opioids using a Bakerbond SPE C18.…”

Pharmacotoxicology of Non-fentanyl Derived New Synthetic Opioids

“…A number of fatalities and non-fatal intoxications from U-47700 have occurred in United States and Europe ( Coopman et al, 2016 ; Elliott et al, 2016 ; Mohr et al, 2016 ; Armenian et al, 2017b ; Domanski et al, 2017 ; Ellefsen et al, 2017 ; Jones et al, 2017 ; McIntyre et al, 2017 ; Rao and Nelson, 2017 ; Rambaran et al, 2017 ; Schneir et al, 2017 ; Seither and Reidy, 2017 ; Shoff et al, 2017 ), with concentrations varying widely, ranging from 7.6 to 1,460 ng/mL; while in other 16 confirmed fatalities across United States, blood concentrations ranged from 17 to 490 ng/mL ( Mohr et al, 2016 ; Logan et al, 2017 ; World Health Organization [WHO], 2017 ). In 2016, U-47700 was identified for the first time in East and South-East Asia ( United Nations Office on Drugs and Crime [UNODC], 2017a ).…”

Analysis of fentanyl derivatives by ultra high performance liquid chromatography with diode array ultraviolet and single quadrupole mass spectrometric detection

“…Separation techniques are excellent complements to detection techniques such as MS. GC-MS [10,11,[14][15][16][17][18][19], and LC-MS [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]are the most commonly employed techniques in the analysis of fentanyls. CE-MS [35] has also been used to separate and analyze fentanyl derivatives and analogues.…”

“…LC‐MS using ESI has been gaining popularity because it provides protonated molecular ion information and complementary retention time data to GC. Previous studies on the separation of fentanyl related compounds have been performed on a variety of columns, including reverse phase cyano , Phenyl‐Hexyl , Biphenyl , vancomycin , C8 , and C18 . Analogues such as fentanyl, sufentanil, and alfentanil separate with a resolution greater than one .…”