title: Lethal poisonings with AH-7921 in combination with other substances.
abstract: AH-7921 is a synthetic μ-opioid agonist, approximately equipotent with morphine. We report the death of two young individuals after ingestion of AH-7921 in combination with other psychoactive drugs. In the first case a young man died shortly after ingesting Internet drugs. Toxicological analysis of post mortem peripheral blood revealed AH-7921 (0.43 mg/L), 2-FMA (0.0069 mg/L) and 3-MMC (0.0021 mg/L) as well as codeine (0.42 mg/L), codeine-6-glucuronide (0.77 mg/L) and acetaminophen (18.7 mg/L). The second case involved a young female found dead at home. The only positive finding at medicolegal autopsy was needle marks. Toxicological analysis revealed AH-7921 (0.33 mg/L), methoxetamine (MXE) (0.064 mg/L), etizolam (0.27 mg/L), phenazepam (1.33 mg/L), 7-aminonitrazepam (0.043 mg/L), diazepam (0.046 mg/L), nordiazepam (0.073 mg/L), and oxazepam (0.018 mg/L) in blood. In both cases intoxication with AH-7921 in combination with other psychoactive drugs was considered to be the cause of death.
authors.affiliation: Norwegian Institute of Public Health, Division of Forensic Sciences, Box 4404 Nydalen, 0403 Oslo, Norway. Electronic address: ritva.karinen@fhi.no.
authors.forename: Ritva
authors.initials: R
authors.lastname: Karinen
authors.affiliation: Norwegian Institute of Public Health, Division of Forensic Sciences, Box 4404 Nydalen, 0403 Oslo, Norway.
authors.forename: Silja Skogstad
authors.initials: SS
authors.lastname: Tuv
authors.affiliation: Norwegian Institute of Public Health, Division of Forensic Sciences, Box 4404 Nydalen, 0403 Oslo, Norway; Faculty of Medicine, University of Oslo, Norway.
authors.forename: Sidsel
authors.initials: S
authors.lastname: Rogde
authors.affiliation: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Av do Cafe S/N, Campus USP, BR-14040903 São Paulo, Brazil.
authors.forename: Mariana Dadalto
authors.initials: MD
authors.lastname: Peres
authors.affiliation: Norwegian Institute of Public Health, Division of Forensic Sciences, Box 4404 Nydalen, 0403 Oslo, Norway.
authors.forename: Unni
authors.initials: U
authors.lastname: Johansen
authors.affiliation: Department of Clinical Pharmacology, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway.
authors.forename: Joachim
authors.initials: J
authors.lastname: Frost
authors.affiliation: Norwegian Institute of Public Health, Division of Forensic Sciences, Box 4404 Nydalen, 0403 Oslo, Norway.
authors.forename: Vigdis
authors.initials: V
authors.lastname: Vindenes
authors.affiliation: Norwegian Institute of Public Health, Division of Forensic Sciences, Box 4404 Nydalen, 0403 Oslo, Norway.
authors.forename: Åse Marit Leere
authors.initials: ÅM
authors.lastname: Øiestad
mesh_terms: D000082:Acetaminophen / Q000097:blood; D018712:Analgesics, Non-Narcotic / Q000097:blood; D001549:Benzamides / Q000097:blood / Q000506:poisoning*; D005260:Female; D053593:Forensic Toxicology; D006801:Humans; D008297:Male; D009294:Narcotics / Q000097:blood; D011619:Psychotropic Drugs / Q000097:blood / Q000506:poisoning*; D019966:Substance-Related Disorders / Q000097:blood; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D001549:Benzamides; D009294:Narcotics; D011619:Psychotropic Drugs; D000082:Acetaminophen; C006215:AH 7921
keywords: AH-7921; Designer drugs; Forensic science; UPLC–MS/MS; Whole blood