Wednesday, December 13, 2017

More Opioids Scheduled in the USA...

The United States Federal government filed a Notice of Intent today to schedule the following seven fentanyl analog compounds:

Cyclopentylfentanyl
Isobutyrylfentanyl
Ocfentanil
Parachloroisobutyrylfentanyl
Parafluorobutyrylfentanyl
Paramethoxybutyrylfentanyl
Valerylfentanyl

Interestingly, Isobutyrylfentanyl was technically already covered as a controlled substance as the government had previously controlled Butyrylfentanyl (and its isomers) in March 2016. Also, Parafluorobutyrylfentanyl was technically covered as the government had previously controlled Parafluoroisobuyrylfentanyl (and its isomers) in March 2017. Maybe this is another sign by the Government that the Analogue Enforcement Act is neither effective nor efficient in its purpose?

Also published was a Final Order to control the opioid research chemical MT-45. It seems that the government skipped filing a Notice of Intent and went directly to Final Order on this one.

 
Heracles vs. the Hydra. Southern entrance to the Hofburg,Vienna, Austria.
Image from: https://www.britannica.com/topic/Hydra-Greek-mythology

This brings the list up to 20 total fentanyl analogs and designer opioids scheduled by the Federal government since 2015.

2015: Acetylfentanyl

2016: AH-7921, Betahydroxythiofentanyl, Butyrylfentanyl, Furanylfentanyl, U47700

2017: Acrylfentanyl, Cyclopentylfentanyl, Cyclopropylfentanyl, Isobutyrylfentanyl, Methoxyacetylfentanyl, MT-45, Ocfentanil, Orthofluorofentanyl, Parachloroisobutyrylfentanyl, Parafluorobutyrylfentanyl, Parafluoroisobutyrylfentanyl, Paramethoxybutyrylfentanyl, Tetrahydrofuranylfentanyl, Valerylfentanyl

It is quite alarming to see that the number of compounds scheduled has rapidly increased each year since the initial scheduling of Acetylfentanyl in 2015. Also, don’t forget that the other major fentanyl derivative that has caused many intoxications and deaths in the USA, Carfentanil, is already Schedule II.

Novel psychoactive substances (NPS) are like the mythological Hydra. Sever one head, and two more sprout from the wound.

 
References

Schedules of Controlled Substances: Temporary Placement of Seven Fentanyl-Related Substances in Schedule I. 21 CFR Part 1308, Docket No. DEA-475, Federal Register Volume 82, Number 238 (December 13, 2017) https://www.deadiversion.usdoj.gov/fed_regs/rules/2017/fr1213_2.htm

Schedules of Controlled Substances: Placement of MT-45 into Schedule I. 21 CFR Part 1308, Docket No. DEA-451, Federal Register Volume 82, Number 238 (December 13, 2017)                          

Sunday, December 10, 2017

Cyanide: A 2 Minute Primer

Slobodan Praljak, formerly a general in the Croatian Army and Croatian Defense Council, was convicted of crimes against humanity and violations of war/Geneva Convention during the Croat-Bosniak War (1992-1995). He received a 20-year prison sentence in 2013. At an appeals hearing in The Hague on November 29, 2017, and upon hearing that his conviction would be upheld, Praljak spoke, “Judges, Slobodan Praljak is not a war criminal. With disdain, I reject your verdict!” He then drank from a small bottle and said, “What I am drinking now is poison.” The judge stopped the hearing and medical professionals were summoned. He died a short while later.

 
Image of Slobodan Praljak in the act of drinking a vial of liquid during his appeals hearing at The Hague on November 29, 2017.
 
It has now been reported by Dutch officials that Slobodan Praljak committed suicide by drinking cyanide.
What is cyanide?
Cyanide, also known as hydrocyanic acid, has a molecular formula HCN and its molecular weight is 27.03 g/mol. HCN’s boiling point is 25.6°C (78.1°F). Hydrogen cyanide was first isolated from the pigment Prussian blue; hence another alternative name is prussic acid. In the 1800s, cyanide was given its modern name from the English word cyan, which means a shade of blue.  Hydrogen cyanide and its potassium and sodium salts have been used as fumigants, insecticides, metal polishes, and in gold/silver electroplating solutions. Cyanide vapor can be detected by a characteristic almond odor, but it is estimated that up to approximately 50% of the human population cannot detect this odor due to a recessive genetic trait. Cyanide can be found in trace levels in the human body as a result of normal metabolic processes, as well as from eating a diet high in cyanogenic foodstuffs (e.g. apples, apricots, bitter almonds, and cherries) and smoking cigarettes.

Chemical structure of Hydrogen Cyanide

Structure drawn by Kevin G. Shanks (2017)
 

What does cyanide do to the body?
Cyanide inhibits cellular respiration by binding to the iron atom in the cytochrome c oxidase enzyme, an enzyme involved in the last step of the mitochondrial electron transport chain. Normally, during this step, molecular oxygen is converted into water. This inhibition causes oxidative phosphorylation to halt and the Kreb’s cycle is disrupted. Adenosine triphosphate (ATP) cannot be produced by the mitochondria. Pyruvic acid, formed during glycolysis, accumulates and is modified anaerobically to lactic acid. Lactic acid buildup causes metabolic acidosis. Oxygen also builds up in tissue and alters the gradient for oxygen release from hemoglobin, which produces cellular hypoxia.
The onset of symptoms of cyanide poisoning is dependent on the route of exposure/administration. Hydrogen cyanide vapor is rapidly absorbed through inhalation. Potassium and sodium cyanide salts are more easily absorbed via oral ingestion, but are absorbed at lower rates and if ingested orally, they are converted to hydrogen cyanide via gastric acids. The lethal dose of hydrogen cyanide has been estimated to be 100 mg while sodium/potassium cyanide’s lethal dose has been estimated to be 200-300 mg.
Acute intoxication symptoms of cyanide poisoning are central nervous system stimulation, headache, dizziness, tachycardia, shortness of breath, rapid breathing, and vomiting. Other symptoms that may occur after initial intoxication include seizure, bradycardia, hypotension, coma, and cardiac arrest. Chronic administration of cyanide can lead to abnormalities of vitamin B12, folate, and thyroid function as well as severe longer-term neurological issues.
What does the body do to cyanide?
Cyanide is biotransformed to thiocyanate by the hepatic enzymes rhodanese and beta-mercaptopyruvate-cyanide sulfurtransferase. Thiocyanate is then excreted into the urine. Other metabolic pathways include trapping of cyanide by hydroxocobalamin via formation of vitamin B12, oxidation to formic acid and carbon dioxide, and pulmonary excretion of unchanged substance. The elimination half-life of cyanide in whole blood is reported as 0.7-2.1 hours. Volume of distribution is 0.4 L/kg.
Has it been used as a historical poison?
Because of its ease of use and toxicity, cyanide has appeared throughout history regularly as a poison, in warfare, suicides, and homicides. Some of the most well-known modern cases are:
It is rumored that cyanide played a role in Grigori Rasputin’s assassination in 1916. He was allegedly given cyanide-laced cakes and Madeira wine.
Hydrogen cyanide, as the pesticide Zyklon B, was used in gas chambers to murder people in the Nazi concentration camps during World War II.
In the 1940s, Erwin Rommel, Eva Braun, and Heinrich Himmler all committed suicide by cyanide liquid ingestion. The six children of Joseph Goebbels were murdered by being injected with morphine by Helmut Kunz, an SS dentist, and administered cyanide Ludwig Stumpfegger, Adolf Hitler’s personal doctor.
In 1974, Ronald Clark O’Bryan gave potassium cyanide laced Pixie Stix to his son, daughter, and three other children. The son ate the candy, while none of the other children did. The boy died. During the police investigation it was determined that the boy had a life insurance policy on him worth a very large amount of money. The father was convicted of murder in 1975 and was executed via lethal injection in 1984.
In 1978, in Jonestown, Guyana, 907 people died in a mass suicide event lead by Jim Jones. Cyanide, alongside diazepam, chloral hydrate, and promethazine, was consumed via a grape flavored beverage.
In 1982, seven people died from a series of drug tampering cases in Chicago, Illinois. Tylenol brand acetaminophen had been laced with potassium cyanide by an unknown person. Several more deaths occurred in copycat crimes. No one was ever convicted of these homicides.
In 1988, Stella Nickel was convicted of murdering her husband and another woman with cyanide-laced Excedrin tablets. She received a 90 year prison sentence.
Cyanide has also been used in capital punishment in the United States, with the last gas chamber execution via cyanide occurring in Arizona in 1999. It still remains an option for capital punishment in six states.
In 2012, Wall Street trader Michael Marin consumed a cyanide tablet while in the courtroom shortly after a guilty verdict for arson was rendered.
In 2015, John McLemore committed suicide using potassium cyanide. He was currently recording a narrative for the investigative journalism podcast S-Town.
Conclusion
Cyanide is a rapidly acting substance that causes death via disruption of cellular respiration and results in hypoxia and cardiac arrest. It is found as hydrogen cyanide or as potassium or sodium salts. It has been effectively used throughout history as an agent to murder people and has been implicated in suicides

References
Bosnian war criminal dies after swallowing poison in court. CNN. November 30, 2017. http://www.cnn.com/2017/11/29/europe/slobodan-praljak-hague-sentencing/index.html
Slobodan Praljak died after taking cyanide in court. Al Jazeera. December 2, 2017. http://www.aljazeera.com/news/2017/12/slobodan-praljak-died-cyanide-court-171202171937067.html
https://www.om.nl/actueel/nieuwsberichten/@101280/voorlopige/. Translated from Dutch to English via Google Translate. 12/03/2017.
Baselt, R. Cyanide. Disposition of Toxic Drugs and Chemicals in Man. Eleventh Edition. Biomedical Publications: Seal Beach, CA, 536-539 (2017).
Principles of Forensic Toxicology. Fourth Edition. Barry Levine. AACC, Inc. (2017).
Poisoned, shot, and beaten: why cyanide along may have failed to kill Rasputin. The Guardian. January 13, 2017. https://www.theguardian.com/science/blog/2017/jan/13/poisoned-shot-and-beaten-why-cyanide-may-have-failed-to-kill-rasputin
The Holocaust: A Learning Site for Students, United States Holocaust Memorial Museum. https://www.ushmm.org/outreach/en/article.php?ModuleId=10007714
Candy Man’s legacy still haunting today. Chron. October 30, 2003. http://www.chron.com/neighborhood/article/Candy-Man-s-legacy-still-haunting-today-9774087.php
Jones plotted cyanide deaths years before Jonestown. CNN. November 12, 2008. http://www.cnn.com/2008/US/11/12/jonestown.cyanide/index.html
How the Tylenol murders of 1982 changed the way we consume medication. PBS. September 24, 2014. https://www.pbs.org/newshour/health/tylenol-murders-1982
Bitter Pill: A Wife on Trial. CBS News: 48 Hours, 2001. https://www.cbsnews.com/news/bitter-pill-a-wife-on-trial/
Michael Marin, former Wall Street trader, took cyanide after arson conviction, says autopsy. CBS News.  July 27, 2012. https://www.cbsnews.com/news/michael-marin-former-wall-street-trader-took-cyanide-after-arson-conviction-says-autopsy/
Woodstock man at the center  of “S-Town” podcast . Tuscaloosa News. March 28, 2017. http://www.tuscaloosanews.com/news/20170328/woodstock-man-at-center-of-s-town-podcast
Methods of Execution. Death Penalty Information Center. https://deathpenaltyinfo.org/methods-execution

Saturday, November 11, 2017

Running for Charity

The kid and I are running the Drumstick Dash in Indianapolis on 11/23. We are trying to raise money to help provide meals for the homeless in Indianapolis and all money raised goes to Wheeler Mission. We've raised $100 so far and would love to raise more to help. If you can can help, it's much appreciated (hit the link below) or since this is the kid's first race so drop a comment wishing him good luck. 

Here is a good informational source on homelessness in Marion county, Indiana for 2016 from the Indiana University Public Policy Institute.

 https://www.crowdrise.com/k-and-h-run-the-drumstick-dash/fundraiser/kevinshanks#the-story

Thursday, October 26, 2017

Tales of (Un)Poisoned Halloween Candy

It's Halloween time and stories are starting to emerge (again...groan) about drugs being given out in Halloween candy or candy being poisoned and handed out to the kiddos.

Headlines like this...


Or...

 
Or...

Let me just stop you right there and right now.

Folks are not giving out drugs in Halloween candy. They are not.

Drugs are expensive. No one is giving away that stuff. No one.

It's true that drugs can be made to look like candy. Especially marijuana/THC infused edibles. They can look like this...


 
Cute and tasty looking gummy bears! Though each of those bears contains 10 mg of THC, the main psychoactive substance found in cannabis/marijuana. Let me be quite clear again...no one is giving these out for free. Edibles are damned expensive. And hard to come by in certain locales. No one is giving them out to random children for free.

And of course, Ecstasy tablets look like candy...



But Ecstasy is expensive. Drug dealers are not just going to give up tablets for free. It makes no sense to think this does happen.

These headlines pop up every year just before Halloween, but did you know that there has never been a single documented case where someone was randomly handing out drugs in Halloween candy or poisoned-laced loot.

None. Zero. Nil. Nada. Zilch.

It's an urban legend. A myth.

Now, let's not confuse this with homicide/murder during Halloween times and then blaming it on the "candy was poisoned" myth. 
In 1970, a 5 year old child in Michigan ate some Halloween candy and died a few days later. Toxicology showed the death was from a heroin overdose. The Halloween candy was analyzed by the lab and heroin was found. The police investigation concluded that the child found a family member's drug stash and consumed some of it. To cover up the death and the family member's involvement, family concocted a scheme to contaminate the Halloween candy with heroin after the boy's death.

In 1974, a Texas father gave potassium cyanide laced Pixie Stix to his son and daughter and three other children. The son ate the candy, while none of the other children did. The boy died. During the police investigation it was determined that the boy had a life insurance policy on him worth a very large amount of money. The father used the poisoned Halloween candy myth (the legend was around back then too) as cover for his plot to kill the boy and collect the life insurance. The father was convicted of murder in 1975 and was executed via lethal injection in 1984.

There have been countless other drugs in Halloween candy scares across the USA since the 1970s and upon investigation, each one has proven to be untrue.

So, please, go ahead and eat your Halloween candy loot this year without drug worries.

Happy Halloween!


References

Candy suspected in death of boy, 5 - 1970
http://www.nytimes.com/1970/11/07/archives/candy-suspected-in-death-of-boy-5.html

Candy Man's legacy still haunting today - 2003
http://www.chron.com/neighborhood/article/Candy-Man-s-legacy-still-haunting-today-9774087.php


 

Monday, October 2, 2017

Girl on LSD

It is being reported that Tom Petty is in critical condition on life support after being found in cardiac arrest. Some outlets have reported he has passed. I have grown up listening to Petty's music - through high school and college and into adulthood. His music has been a huge part of my music listening life. So many good songs. So many good associations.

His most beautiful song? Wildflowers.

Best song to drive to? You Wreck Me and Runnin' Down A Dream. Preferably played back to back.

One of the first songs I knew all the words to? Free Fallin

Biggest song memory in junior high/high school? You Don't Know How It Feels

Song that makes me think about life? Learning to Fly

Coolest music video? Don't Come Around Here No More - I'm a sucker for Alice in Wonderland themes.

Song I can't help but sing no matter where I am? Mary Jane's Last Dance, always thought it was neat that it mentioned Indiana, then found out later it was originally titled Indiana Girl and thought that was even more awesome.


But the song I'll never forget is the one song that never made it to an album because it was deemed too controversial at the time by record execs, but was the B side on the 1994 single release of You Don't Know How It Feels...

Girl on LSD.



Such a great song from a drug and toxicology perspective.

Marijuana.
Cocaine.
Beer.
Crystal meth.
Glue.
Ecstasy.
Pills.
China White (aka heroin).
Caffeine.

Give it a listen. And while you're at it, smile and throw some good thoughts out there. The world needs some positivity these days.

Peace.

Update: Tom Petty has passed on. The Rock Band In The Sky added one more member.

Saturday, September 23, 2017

Toxicology of Designer Drugs (Lecture 3, Fentanyl, Fentanyl Analogs, and Designer Opioids)

The third installment of Toxicology of Designer Drugs focused on the emergence of fentanyl, fentanyl analogs, and other designer opioids in modern street heroin.

The outline of topics for this lecture included:

Fentanyl, Fentanyl Analogs, and Designer Opioids

    • Sliding scale of harm
      • Water
      • SSRI antidepressants
      • Benzodiazepines
      • Tricyclic antidepressants
      • Barbiturates
      • Opiates / Opioids
    • Opioid Deaths in the USA (Pre-2014/2015)
      • 2000 - 2014 data
      • Opioid analgesic deaths continue to rise
      • Surge in deaths, two trends
      • Double trouble: heroin and fentanyl
    • Heroin
      • History
      • Chemistry
      • Pharmacology
      • Metabolism
      • Forms of the product
      • NFLIS data, 2001 - 2016
    • Fentanyl
      • History
      • Chemistry
      • Pharmacology
      • Metabolism
      • Forms of the product (licit vs. illicit)
      • Death of Prince
      • NFLIS data, 2001 - 2015
      • NFLIS data, 2013 - 2015
      • NFLIS data, 2016
      • NY Times report on trends in US overdose deaths, 2017
    • Fentanyl Analogs
      • What are they? Where do they come from?
      • How many compounds exist?
      • DEA scheduling actions, 2015 - 2017
      • DEA Emerging Threats Reports, 2017
      • Overdoses, hospitalizations, and reported deaths in media
      • Analyte Specific Looks
        1. 3-methylfentanyl (cis/trans)
        2. Acetylfentanyl
        3. Furanylfentanyl
        4. Acrylfentanyl
        5. Carfentanil
    • Designer Opioids
      • Opioid research chemicals
        1. U47700
          • Death of Prince
        2. AH7921
        3. MT-45
    • Analytical Methods
      • Method development
      • Method validation
      • Organic extraction
      • Instrumental analysis via LC-MS/MS
    • Prevalence
      • What drugs have been detected?
      • How prevalent are they?
      • What locations are they found?
      • Special look at Carfentanil detections
    • Postmortem Case Studies
      • Case 1 (Information Withheld)
      • Case 2 (Information Withheld)
      • Case 3 (Information Withheld)
      • Case 4 (Information Withheld)
      • Case 5 (Information Withheld)
      • Case 6 (Information Withheld)
      • Case 7 (Information Withheld)
      • Case 8 (Information Withheld)
    • Testing for Fentanyl Analogs and Designer Opioids vs. A Fishing Expedition
    • Conclusions

Toxicology of Designer Drugs (Lecture 2, A Brief History of Designer Drugs)

Here is the next installment of my Toxicology of Designer Drugs class - this lecture focused on a high level look at the timeline of designer drugs in the USA.

A Brief History of Designer Drugs
    • 1960s and 1970s
      • LSD
      • Mescaline
      • DOM (STP)
      • PCP / TCP / PCE
    • 1980s
      • Fentanyl derivatives (China White)
      • MDMA
      • MPPP / MPTP
      • Methamphetamine / Methcathinone / 4-methylaminorex
    • 1990s
      • Anabolic steroids
      • Research chemicals
      • The 2C family and PiHKAL / TiHKAL
    • 2000s and 2010s
      • Cathinones and designer stimulants
      • Synthetic cannabinoids
      • Analogs of sildenafil / herbal supplements
      • Designer opioids / fentanyl analogs
      • Benzodiazepine derivatives
      • NBOMes
      • Methoxetamine
      • Nootropics

Toxicology of Designer Drugs (Lecture 1, Introduction to Forensic Toxicology)

I'm teaching a toxicology of designer drugs course at IUPUI this fall via the Forensic and Investigative Sciences Program.

The outline of topics for the first lecture included:

Introduction to Forensic Toxicology

    • The Realms of Forensic Toxicology
      • Human Performance
      • Postmortem
      • Drug Facilitated Crimes
      • Urine Drug Testing
    • The Role of the Forensic Toxicologist
      • Analyze specimens
      • Analytical instrumentation
      • Develop and validate testing methods
      • Case review and release
      • Results interpretation
      • Education
      • Expert and fact witness courtroom testimony
      • Research, publish, and present
    • Autopsy and Toxicology Specimens
      • Blood
      • Urine
      • Vitreous Humor
      • Tissues
      • Bile
      • Gastric contents
      • Alternative matrices
    • Toxicological Terms
      • Pharmacokinetics
        1. Dose
        2. Dosing interval
        3. CMax
        4. TMax
        5. CMin
        6. Volume of distribution
        7. Concentration
        8. Elimination half life
        9. Elimination rate constant
        10. Bioavailability
      • Pharmacodynamics
        1. Onset vs. Duration of action
        2. Receptor agonism
        3. Receptor antagonism
        4. Receptor inverse agonism
        5. Catecholamines / Neurotransmitters
          • Serotonin
          • Norepinephrine
          • Dopamine
          • Histamine
          • Acetylcholine
          • GABA

Forensic and Investigative Sciences (FIS) Program Seminar Series - 2017

I'm thrilled to be giving a talk today in the Indiana University-Purdue University Indianapolis (IUPUI) Forensic and Investigative Sciences (FIS) Program Seminar Series at 3:30 pm.

The title of the talk is:

"Not Your Father's Heroin: Forensic Toxicology in the Age of Fentanyl and Fentalogs"

While you're reading this, why not pop into IUPUI's FIS Program website and have a look around? They've got some really cool things happening.

Tuesday, September 19, 2017

Visited Purdue University Today

I visited Dr. Susie Swithers' Drugs and Behavior class at Purdue University today and introduced the students to forensic toxicology. Had some good interactions with the students. I have fun with things like this - love outreach and education.

While you're reading this, why not peruse Purdue's Psychological Sciences website and learn something new?

Forensic Toxicology Job Listings

Some good job opportunities are out there for forensic toxicology!

The following are good references and sites for job postings:

Society of Forensic Toxicologists - Job Listings

American Academy of Forensic Sciences - Job Postings

Midwestern Association of Forensic Scientists - Employment

Southwestern Association of Forensic Scientists - Employment

Northeastern Association of Forensic Scientists - Employment

Tuesday, September 12, 2017

Three more fentanyl analogs to be placed into Schedule I

The DEA announced today a notice of intent to place three more fentanyl analogs into Schedule I of the Controlled Substances Act. These compounds are Methoxyacetylfentanyl, Ortho-Fluorofentanyl, and Tetrahydrofuranfentanyl. 

According to the Federal Register, the first detection of Ortho-Fluorofentanyl in drug seizure evidence was in April 2016 and the first detection of Tetrahydrofuranfentanyl was in March 2017. Methoxyacetylfentanyl was first identified in solid dose evidence in April 2017. There have been multiple confirmed fatalities associated with each of these substances.

These three compounds make a total of nine (9) fentanyl analogs controlled by the DEA since 2015. Others controlled in this time period are Acetylfentanyl (2015), Betahydroxthiofentanyl and Butyrylfentanyl, and Furanylfentanyl (2016), and 4-Fluorisobutyrylfentanyl and Acrylfentanyl(2017).


References

United States DEA (2017) Notice of Intent. Schedules of Controlled Substances: Temporary Placement of Orthofluorofentanyl, Tetrahydrofuranylfentanyl, and Methoxyacetylfentanyl
 into Schedule I. Federal Register. Volume 82, Number 175.
https://www.gpo.gov/fdsys/pkg/FR-2017-09-12/pdf/2017-19283.pdf

Monday, September 11, 2017

Synthetic cannabinoid FUB-AMB to be placed into Schedule I

The DEA announced today a notice of intent to place the synthetic cannabinoid FUB-AMB into Schedule I of the Controlled Substances Act.

The chemical formula of FUB-AMB is C21H22FN3O3 and molecular weight is 383.42 g/mol. Alternative alphabet soup names for this substances include AMB-FUBINACA and MMB-FUBINACA. FUB-AMB emerged as a substance in herbal incense and smokable potpourri blends in the USA sometime between 2014-2016. FUB-AMB is structurally related to the Pfizer developed synthetic cannabinoid AB-FUBINACA. In 2016, Banister et al. reported on the pharmacology of FUB-AMB and structurally related compounds. They determined FUB-AMB to be a potent synthetic cannabinoid receptor agonist. In the study, FUB-AMB's half maximal effective concentration or EC50 at CB1 equaled 2.0 nM and 18 nM at CB2.

Image taken by Kevin G. Shanks (2017)


A "mass casualty event" in Brooklyn, New York occurred on July 12, 2016, when thirty three (33) people reported adverse effects after smoking an herbal incense product. Eighteen (18) of the 33 people were hospitalized. Adams et al. reported on this outbreak of illnesses in The New England Journal of Medicine on January 2017. Common reported effects included blank stares, slow responses, "zombielike" groaning, slow mechanical movements of the arms and legs, and lethargy. Blood, serum, and urine specimens were obtained from eight (8) of the people who were admitted to the hospital. The authors also analyzed a package of the product purported to be at the center of the mass illnesses - AK-47 24 Karat Gold. FUB-AMB was detected in the product. An FUB-AMB metabolite was detected in the blood or serum of all patients tested.

This act makes 33 synthetic cannabinoids scheduled at the federal level since 2011.

One more synthetic cannabinoid scheduled, one more to take its place.

The beat goes on...


References

United States DEA (2017) Notice of Intent. Schedules of Controlled Substances: Temporary Placement of FUB-AMB into Schedule I. Federal Register. Volume 82, Number 174.
https://www.deadiversion.usdoj.gov/fed_regs/rules/2017/fr0911.htm

S.D. Banister et al. (2016) Pharmacology of Valinate and tert-Leucinate Synthetic Cannabinoids 5F-AMBICA, 5F-AMB, 5F-ADB, AMB-FUBINACA, MDMB-FUBINACA, MDMB-CHMICA, and Their Analogues. ACS Chemical Neuroscience. 7: 1241-1254.
http://pubs.acs.org/doi/abs/10.1021/acschemneuro.6b00137

A.J. Adams et al. (2017) Zombie Outbreak Caused by the Synthetic Cannabinoid AMB-FUBINACA in New York. The New England Journal of Medicine. 376: 235-242.
http://www.nejm.org/doi/10.1056/NEJMoa1610300

Tuesday, September 5, 2017

DEA Emerging Threat Report - Mid-Year 2017

The DEA has released their emerging threat report for mid-year 2017. It is located here via the National Drug Early Warning System (NDEWS).

In summary...

No new synthetic cannabinoids have been identified US drug seizures in 2017. FUB-AMB remains the most commonly identified synthetic cannabinoid with 5F-MDMB-PINACA and ADB-FUBINACA running second and third.

Fentanyl remained the most prevalent opioid detected with furanylfentanyl and U47700 running second and third. Fentanyl analogs methoxyacetylfentanyl and tetrahydrofuranfentanyl were identified for the first time in drug evidence in the US during this time period. Interestingly, with as much coverage as carfentanil has gotten from media reports, it was only fifth in the overall number of detections. Maybe that's a good thing?

The top two cathinones detected were N-ethylpentylone and dibutylone. N-ethylpentylone made up approximately 50% of all cathinone drug detections. Alpha-PVP has fallen to fourth in the list, but it is still out there.

Only two pieces of evidence were identified as NBOMe hallucinogens (25C-NBOMe and 25I-NBOME).

Tryptamines remain inconsequential in drug seizure evidence.


Other DEA emerging trend reports for 2016 and 2017 can be found here.


Reference

Drug Enforcement Administration. Emerging Threat Report. Midyear 2017.
https://ndews.umd.edu/sites/ndews.umd.edu/files/dea-emerging-threat-report-2017-mid-year.pdf

Saturday, September 2, 2017

Fentanyl and analogs are now the leading drug-related cause of death

This report from the New York Times shows that fentanyl and analogs have overtaken heroin as the leading drug-related cause of death in the USA, which is not at all surprising if you've been paying attention to these over the last few years.
 
But it is frightening, and as the article points out, the numbers from 2016 are not even final and will more than likely go -up-. Another terrifying aspect to this is that fentanyl analog related deaths are most likely underreported as testing for said analogs is really in its infancy and not every known analog can be (or is) accounted for in toxicological testing. Not every postmortem toxicology case includes fentanyl analogs in the scope of testing, whereas heroin (detected in blood and urine as 6-acetylmorphine and morphine) and fentanyl are routinely covered in even the most basic postmortem toxicology testing panels.
 
To make matters even more dire, all signs point to increasing fentanyl/analog death numbers in 2017.

As I've said for a while now, this ain't your father's heroin. At what point do we stop calling it heroin and refer to the standard "heroin" product on the street as fentanyl?
 
It is also interesting to note that cocaine is making a comeback. Or the better realization may be that it never really went away. Cocaine related deaths have continued to rise over the last few years and have more than doubled since about 2010-2011. From this data set beginning in the year 2000, cocaine related deaths peaked in 2005-2006 and then trended downward until 2010 when they began to increase again. Cocaine deaths reached an all time high (topping the peak set in 2005-2006) in 2015-2016.
 
 
Reference

Josh Katz. New York Times. Fentanyl Overtakes Heroin as Leading Cause of US Drug Deaths. 09/02/2017.
https://www.nytimes.com/interactive/2017/09/02/upshot/fentanyl-drug-overdose-deaths.html?smid=tw-share

Wednesday, August 30, 2017

Counterfeit Oxycodone Tablets in Indiana: Fentanyl and Carfentanil (May 2017)

In May 2017, the Indianapolis Metro Police Department (IMPD) seized 970 "oxycodone" tablets that were colored light and dark blue. The laboratory analyzed the "oxycodone" tablets and identified them as counterfeit / illicitly manufactured. The lighter blue tablets were presumptively positive for fentanyl and the darker blue tablets were presumptively positive for carfentanil. Confirmatory analyses were not completed.

 
 
Chemical structures drawn by KGS (2017)



The detailed account of the seizure as well as pictures of the tablets can be found in the following web link to the DEA's website.

Fake RX in Indiana: Carfentanil and Fentanyl Found in Purported Oxycodone Pills

Tuesday, August 29, 2017

Reddit AMA - American Chemical Society, October 2016

Hi folks. Here's a link to a Reddit AMA I did via the American Chemical Society in October 2016. Some interesting questions were asked. Some I could answer and some I couldn't answer. And even some I wouldn't answer. Give it a look.

Reddit AMA - Kevin Shanks, 10/2016


Also, give the AMA by Dr. Matt Hartings of American University a read as well. He covered kitchen chemistry and cooking. It's quite good.

Reddit AMA - Matt Hartings, 11/2016


Cheers,

Kevin

Saturday, August 26, 2017

Under Construction

Hi folks.

This website/blog is under construction. Please bear with me as I update information and begin to use this as a non-pseudonym site as a way to promote chemistry and toxicology education. In the meantime, to the left you can check out some things I have written in the past.

If you'd like to speak about independent case review and consultation, court testimony, or educational opportunities, please see my bio, curriculum vitae, and my contact information to the side of this page as well.

Thanks,

Kevin