The detection of fentanyl (FEN) and FEN analogs has been widely communicated throughout the scientific community. While most of the reporting has been in relation to overdose deaths, these drugs are commonly detected in impaired driving cases. A retrospective study of impaired driving cases analyzed between 2017 and 2019 produced 270 cases positive for FEN, carfentanil (CFEN) and/or acetylfentanyl (AFEN). FEN was the predominant drug found in these 270 cases (65.5%) with concentrations ranging from less than 1.0 to 64 ng/mL. CFEN was found alone in 6.6% cases with three concentrations above 1.0 ng/mL. AFEN was always found when FEN was positive with concentrations ranging from <1.0 to 9.2 ng/mL. Detailed case histories are provided with corresponding toxicology results. Toxicology results show impaired drivers using multiple drugs with a wide range of observed behaviors. The inclusion of these drugs in routine impaired driver toxicology testing is extremely important when attempting to determine their overall prevalence.

中文翻译：

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芬太尼、乙酰芬太尼和卡芬太尼在受损驾驶案例中的应用：270 例回顾

芬太尼 (FEN) 和 FEN 类似物的检测已在整个科学界广泛传播。虽然大多数报告都与过量死亡有关，但这些药物通常在驾驶受损的情况下被发现。一项对 2017 年至 2019 年间分析的受损驾驶案例的回顾性研究产生了 270 例 FEN、卡芬太尼 (CFEN) 和/或乙酰芬太尼 (AFEN) 阳性的案例。FEN 是在这 270 例 (65.5%) 中发现的主要药物，浓度范围从小于 1.0 到 64 ng/mL。在 6.6% 的病例中单独发现 CFEN，三个浓度高于 1.0 ng/mL。当 FEN 呈阳性且浓度范围为＜1.0 至 9.2 ng/mL 时，总是会发现 AFEN。详细的病史与相应的毒理学结果一起提供。毒理学结果显示，驾驶员使用多种药物并观察到多种行为。在试图确定它们的总体患病率时，将这些药物纳入常规受损驾驶员毒理学测试非常重要。