Synthetic cannabinoid receptor agonists (SCRAs) are one of the largest groups of new psychoactive substances (NPS). Yet, another novel analog started spreading on the NPS market around 2021. Soon after, the substance could be analytically characterized in herbal material as ADB-HEXINACA, an SCRA containing a hexyl-substituted tail on the indazole core. Here, we present suitable urinary markers to prove the consumption of this analog, a case report of acute polydrug intoxication and data on its prevalence in Germany. Anticipated phase I metabolites were detected in 12 authentic urine samples that were collected for abstinence control and analyzed by ultra-performance liquid chromatography coupled to a time-of-flight mass spectrometer (UPLC-qToF-MS). The results of in vivo samples were confirmed by analysis of in vitro incubates with pooled human liver microsomes (pHLMs). Forensic samples were used to assess the prevalence of ADB-HEXINACA. Thirty-two phase I metabolites were detected in the authentic urine samples. The main metabolites resulted from amide hydrolysis in combination with either monohydroxylation or ketone formation at the hexyl moiety (M15 and M26), the monitoring of which is recommended as a proof of consumption. ADB-HEXINACA was detected in 3.5% of SCRA positive urine samples collected for abstinence control in Freiburg up to December 2022 and in 5.5% of the SCRA positive blood/serum samples. The hexyl substituent of ADB-HEXINACA allows for the detection of specific urinary biomarkers suggested as analytical targets to confirm its prior intake. ADB-HEXINACA had a rather low prevalence in Germany, alternating months of higher prevalence with periods of total absence.

中文翻译：

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ADB-HEXINACA——一种带有己基取代基的新型合成大麻素：真实尿样中的 I 相代谢、病例报告和德国市场上的流行情况

合成大麻素受体激动剂（SCRA）是最大的一组新型精神活性物质（NPS）之一。然而，另一种新型类似物于 2021 年左右开始在 NPS 市场上传播。不久之后，该物质可以在草药材料中进行分析表征，称为 ADB-HEXINACA，这是一种在吲唑核心上含有己基取代尾部的 SCRA。在这里，我们提供了合适的尿液标记物来证明这种类似物的消耗，一份急性多种药物中毒的病例报告及其在德国的流行率数据。在 12 个真实尿样中检测到了预期的 I 期代谢物，这些尿样是为禁欲控制而收集的，并通过超高效液相色谱与飞行时间质谱仪 (UPLC-qToF-MS) 联用进行分析。通过对混合人肝微粒体 (pHLM) 的体外培养物进行分析，证实了体内样品的结果。法医样本用于评估 ADB-HEXINACA 的患病率。在真实的尿液样本中检测到 32 种 I 相代谢物。主要代谢物是由酰胺水解与己基部分（M15 和 M26）处的单羟基化或酮形成结合产生的，建议对其进行监测作为消耗证据。截至 2022 年 12 月，在弗莱堡为戒酒控制而收集的 SCRA 阳性尿样中，有 3.5% 检测到了 ADB-HEXINACA；在 SCRA 阳性血液/血清样本中，有 5.5% 检测到了 ADB-HEXINACA。 ADB-HEXINACA 的己基取代基可以检测建议作为分析目标的特定尿液生物标志物，以确认其先前摄入量。 ADB-HEXINACA 在德国的患病率相当低，患病率较高的几个月与完全不存在的时期交替出现。