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Acetyl Fentanyl: Trends and Concentrations in Metro Detroit
Author(s) -
Avedschmidt Sarah,
Schmidt Carl,
Isenschmid Daniel,
Kesha Kilak,
Moons David,
Gupta Avneesh
Publication year - 2019
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/1556-4029.13840
Subject(s) - fentanyl , medical examiner , medicine , forensic toxicology , anesthesia , analgesic , opioid , cohort , pharmacology , emergency medicine , poison control , injury prevention , chemistry , receptor , chromatography
Acetyl fentanyl (N‐[1‐phenethylpiperidin‐4‐yl]‐N‐phenylacetamide) is a potent opioid analgesic with no medicinal uses. We report deaths between 2016 and 2017 at the Medical Examiner's Office in Detroit, MI where acetyl fentanyl was found in the decedent's blood and compare them to previously published deaths between 2015 and 2016. The recent cases (cohort B) had a mean acetyl fentanyl concentration of 0.9 ng/ mL (range: 0.1–5.3 ng/ mL ) and an associated higher concentration of fentanyl along with multiple other drugs present. The older cases (cohort A) had higher concentrations of acetyl fentanyl (mean: 8.9 ng/ mL ; range: 0.28–37 ng/ mL ) with lower, yet still toxic, concentrations of fentanyl. We conclude that the cause of death in these recent cases was likely multiple drug toxicity with fentanyl and that the consistently observed lower peripheral blood concentrations of acetyl fentanyl are most likely an artifact in the manufacture of the consumed illicit fentanyl.