Acetylfentanyl

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Acetylfentanyl
Clinical data
Routes of
administration		oral, iv, im, insuflation
ATC code
  • none
Legal status
Legal status
  • AU: Illegal
  • BR: Class F1 (Prohibited narcotics)
  • CA: Schedule I[1]
  • DE: Anlage II (Authorized trade only, not prescriptible)
  • UK: Class A
  • US: Schedule I[2]
  • Illegal in China, Cyprus, Estonia, Finland, Ireland, Latvia, Lithuania, Norway, Poland, Sweden and Switzerland[3]
Identifiers
  • N-(1-Phenethylpiperidin-4-yl)-N-phenylacetamide
JSmol)
  • CC(N(C1=CC=CC=C1)C2CCN(CCC3=CC=CC=C3)CC2)=O
  • InChI=1S/C21H26N2O/c1-18(24)23(20-10-6-3-7-11-20)21-13-16-22(17-14-21)15-12-19-8-4-2-5-9-19/h2-11,21H,12-17H2,1H3
  • Key:FYIUUQUPOKIKNI-UHFFFAOYSA-N

Acetylfentanyl (acetyl fentanyl) is an

respiratory depression. Fentanyl analogs have killed hundreds of people throughout Europe and the former Soviet republics since the most recent resurgence in use began in Estonia in the early 2000s, and novel derivatives continue to appear.[8][9][10]

Deaths

Europe

Acetylfentanyl has been analytically confirmed in 32 fatalities in four European member states between 2013 and August 2015, Germany (2), Poland (1), Sweden (27) and the United Kingdom (2).[3]

Russia

Twelve deaths have been associated with acetylfentanyl in Russia since 2012.[3][11]

United States

The Centers for Disease Control and Prevention (CDC) issued a health alert to report that between March 2013 and May 2013, 14 overdose deaths related to injected acetylfentanyl had occurred among intravenous drug users (ages between 19 and 57 years) in Rhode Island. After confirming five overdoses in one county, including a fatality, Pennsylvania asked coroners and medical examiners across the state to screen for acetylfentanyl. As a result of this investigation, Pennsylvania confirmed at least one acetylfentanyl overdose death and attributed at least 50 fatalities to either fentanyl or acetylfentanyl during the first half of 2013.[12][13] In July 2015, the DEA informed about 52 confirmed fatalities involving acetylfentanyl in the United States between 2013 and 2015.[14]

Japan

One fatal poisoning caused by intravenous injection of a "bath salt" product containing acetylfentanyl mixed with 4'-Methoxy-α-pyrrolidinopentiophenone (a substituted cathinone) has been reported in 2016.[15]

Legal status

Canada

As an analog of fentanyl, acetylfentanyl is a Schedule I controlled drug.[1]

China

As of October 2015 acetylfentanyl is a controlled substance in China.[16]

United States

Acetylfentanyl is a Schedule I controlled substance as of May 2015.[17]

Switzerland

As of March 2023, acetylfentanyl is a controlled substance in Switzerland.[18]

United Kingdom

Acetylfentanyl was made a class A drug as an analogue of fentanyl in 1986.[19]

Overdose

Acetylfentanyl overdosage has been reported to closely resemble heroin overdosage clinically. Additionally, while naloxone (Narcan) is effective in treating acetylfentanyl overdose, larger than normal doses of the antidote may be required.[5]

Detection in body fluids

Acetylfentanyl may be quantitated in blood, plasma or urine by

liquid chromatography-mass spectrometry to confirm a diagnosis of poisoning in hospitalized patients or to provide evidence in a medicolegal death investigation. Postmortem peripheral blood acetylfentanyl concentrations have been in a range of 89–945 μg/L in victims of acute overdosage.[20][21]

See also

References

  1. ^ a b "Controlled Drugs and Substances Act". IsomerDesign.
  2. ^ "Two Charged With Witness Tampering in Joint Woonsocket Police, DEA Investigation". The United States Attorney's Office: District of Rhode Island. US Department of Justice. 6 June 2013.
  3. ^
    ISBN 9789291689163
    .
  4. S2CID 41668288
    .
  5. ^
    S2CID 22092512
    .
  6. PMID 2641054. Archived from the original
    (PDF) on 2016-12-22. Retrieved 2016-08-26.
  7. ^ "Extremely potent painkiller hits Montreal black market". CBS News. 13 May 2013.
  8. PMID 25976511
    .
  9. PMID 2374405
    .
  10. ^ Kroll D (29 August 2013). "CDC Issues Alert On Deadly New Designer Drug, Acetyl Fentanyl". Forbes.
  11. S2CID 95218072
    .
  12. PMID 23985500
    .
  13. PMID 25934111
    .
  14. ^ Drug Enforcement Administration (July 2015). "Acetyl fentanyl" (PDF). Drug Enforcement Administration Office of Diversion Control.
  15. PMID 27591912
    .
  16. ^ 关于印发《非药用类麻醉药品和精神药品列管办法》的通知 [Notice on Printing and Distributing the "Measures for the Scheduling of Non-Pharmaceutical Narcotic Drugs and Psychotropic Substances"]. sfda.gov.cn (in Chinese). 29 September 2015. Archived from the original on 1 October 2015. Retrieved 1 October 2015.
  17. ^ "80 FR 29227 - Schedules of Controlled Substances: Temporary Placement of Acetyl Fentanyl into Schedule I". U.S. Government Publishing Office (GPO). 21 May 2015. Retrieved 30 June 2015.
  18. ^ "Verordnung des EDI über die Verzeichnisse der Betäubungsmittel, psychotropen Stoffe, Vorläuferstoffe und Hilfschemikalien" [EDI ordinance on the lists of narcotics, psychotropic substances, precursors and auxiliary chemicals]. fedlex.admin.ch (in German). 30 May 2011.
  19. ^ "The Misuse of Drugs Act 1971 (Modification) Order 1986". UK Home Office. 16 December 1986.
  20. PMID 24354295
    .
  21. ISBN 978-0-692-77499-1
    .

Further reading
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