Citation

Avedschmidt S, Schmidt C, Isenschmid D, Kesha K, Moons D, Gupta A. J. Forensic Sci. 2019; 64(1): 149-153.

Affiliation

Michigan Medicine Department of Pathology/Wayne County Medical Examiner's Office, 1300 E Warren Ave, Detroit, MI, 48207.

Copyright

(Copyright © 2019, American Society for Testing and Materials, Publisher John Wiley and Sons)

DOI

10.1111/1556-4029.13840

PMID

29940698

Abstract

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.

© 2018 American Academy of Forensic Sciences.

Language: en

Keywords

acetyl fentanyl; fentanyl; forensic pathology; forensic science; forensic toxicology; opioid abuse; overdose; synthetic opioids