title: Two cases of intoxication with new synthetic opioid, U-47700.
abstract: BACKGROUND
  Novel substances often referred to as "designer drugs" have emerged as drugs of abuse, and recognition of these is difficult as routine blood and urine screening tests do not detect these agents. U-47700 is a synthetic selective μ-opioid agonist that can be bought online for as little as $40 per gram. We report two patients presenting after insufflation of U-47700, with subsequent confirmation of this substance in urine samples.
  
  
  METHODS
  A 26-year-old man and 24-year-old woman insufflated a substance they believed to be "synthetic cocaine." The man was found down with cyanosis and agonal respirations. He was intubated and taken to hospital where he recovered well with supportive care. The woman presented with anxiety, tremors and drowsiness and was admitted for observation. Urine samples from both patients were analyzed using GC/MS/MS and LC/QToF, and U-47700 was isolated in both cases. No other opioids were detected.
  
  
  CONCLUSIONS
  These cases are concerning because U-47700 is a relatively new agent that is easy to obtain over the internet and has the potential to cause significant morbidity and mortality.
authors.affiliation: a North Texas Poison Control Center, Parkland Health and Hospital System , Dallas , TX , USA.
authors.forename: K
authors.initials: K
authors.lastname: Domanski
authors.affiliation: a North Texas Poison Control Center, Parkland Health and Hospital System , Dallas , TX , USA.|b UT Southwestern Medical Center , Dallas , TX , USA.
authors.forename: K C
authors.initials: KC
authors.lastname: Kleinschmidt
authors.affiliation: a North Texas Poison Control Center, Parkland Health and Hospital System , Dallas , TX , USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Schulte
authors.affiliation: c Gulfstream Diagnostics , Dallas , TX , USA.
authors.forename: S
authors.initials: S
authors.lastname: Fleming
authors.affiliation: d Children's Mercy Hospital , Kansas City , MO , USA.
authors.forename: C
authors.initials: C
authors.lastname: Frazee
authors.affiliation: a North Texas Poison Control Center, Parkland Health and Hospital System , Dallas , TX , USA.
authors.forename: A
authors.initials: A
authors.lastname: Menendez
authors.affiliation: a North Texas Poison Control Center, Parkland Health and Hospital System , Dallas , TX , USA.
authors.forename: K
authors.initials: K
authors.lastname: Tavakoli
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000506:poisoning* / Q000652:urine; D001549:Benzamides / Q000506:poisoning* / Q000652:urine; D015198:Designer Drugs / Q000506:poisoning*; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods; D006801:Humans; D008297:Male; D015813:Substance Abuse Detection / Q000379:methods*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D001549:Benzamides; D015198:Designer Drugs; C000614521:U-47700
keywords: New psychoactive substances; drugs of abuse; research chemical