Synthetic stimulants are the largest class of novel psychoactive substances (NPS) identified each year by forensic laboratories internationally. While hundreds of these drugs appear in drug powders, only a few proliferate in use among forensically relevant populations, eventually emerging in postmortem and clinical investigations. Beta-keto-methylenedioxyamphetamines (i.e., NPS with names ending in “ylone”) are currently the most popular subclass of synthetic stimulants. Leading up to its federal scheduling in 2018, N-ethyl pentylone was the most encountered synthetic stimulant. The popularity of N-ethyl pentylone declined once it was scheduled but it was quickly replaced by eutylone (bk-EBDB), a structurally related analogue from the same family. In cases encountered between January 2019 and April 2020, eutylone was quantitatively confirmed in 83 forensic investigations, including postmortem cases and driving under the influence of drugs (DUID) cases. Matrix types included blood, urine, and tissue. Eutylone was identified in cases submitted from thirteen states, demonstrating proliferation around the United States; Florida accounted for 60% of the positive cases. The mean concentration of eutylone in postmortem blood was 1,020 ng/mL (standard deviation = ±2,242 ng/mL; median = 110 ng/mL, range = 1.2-11,000 ng/mL, n = 67). The mean concentration of eutylone in blood from DUID cases was 942 ng/mL (standard deviation = ±1,407 ng/mL; median = 140 ng/mL, range = 17-3,600 ng/mL, n = 7). This report includes cause and manner of death data for 22 postmortem cases. Further analysis of authentic human specimens revealed the presence of three eutylone metabolites, including one unique biomarker and one metabolite in common with butylone. Laboratories should be aware that eutylone may be present in cases of suspected Ecstasy, “Molly”, and/or MDMA use, causing or contributing to impairment or death.

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Eutylone中毒—法医研究中一种新兴的合成兴奋剂

合成兴奋剂是国际上每年由法医实验室鉴定的最大类别的新型精神活性物质（NPS）。尽管成百上千种这些药物以粉末形式出现，但在法医相关人群中仅少数使用，最终在验尸和临床研究中崭露头角。β-酮-亚甲基二氧基苯丙胺（即名称以“ ylone”结尾的NPS）目前是合成兴奋剂中最流行的子类。N-乙基戊烯酮是2018年最受关注的合成兴奋剂，导致其2018年联邦法规的发布。N的流行-乙基戊烯酮一旦被预定就下降了，但很快被同家族的结构相关类似物eutylone（bk-EBDB）取代。在2019年1月至2020年4月之间遇到的案件中，在83个法医调查中定量确认了eutylone，包括死后案件和受毒品影响的案件（DUID）。基质类型包括血液，尿液和组织。在从13个州提交的病例中鉴定出了Eutylone，这说明了在美国的扩散。佛罗里达州占阳性病例的60％。死后血液中大黄酮的平均浓度为1,020 ng / mL（标准偏差=±2,242 ng / mL；中位数= 110 ng / mL，范围= 1.2-11,000 ng / mL，n = 67）。DUID患者血液中的大黄酮的平均浓度为942 ng / mL（标准偏差=±1,407 ng / mL；中位数= 140 ng / mL，范围= 17-3,600 ng / mL，n = 7）。该报告包括22个死后病例的死因和死亡数据。对真实人类标本的进一步分析显示，存在三种大黄酮代谢物，包括一种独特的生物标志物和一种与丁酮共有的代谢物。实验室应意识到，在怀疑摇头丸，“莫莉”和/或使用摇头丸的情况下，可能存在大黄酮，导致或导致损害或死亡。