title: Near death from a novel synthetic opioid labeled U-47700: emergence of a new opioid class.
abstract: BACKGROUND
  In the last decade there has been a worldwide surge in the recreational abuse of novel psychoactive substances, particularly amphetamine derivatives and synthetic cannabinoids. Synthetic opioids such as AH-7921, MT-45, and U-47700, with structures distinct from those ever used therapeutically or described recreationally, have also recently emerged.
  
  
  METHODS
  We report a patient who suffered respiratory failure and depressed level of consciousness after recreationally using a novel synthetic opioid labeled U-47700. A single dose of naloxone administered by paramedics completely reversed his opioid poisoning. Comprehensive laboratory analysis confirmed the presence of a novel synthetic opioid and excluded other drugs. The drug used appeared to have caused a false positive benzodiazepine result on the initial urine drugs of abuse panel.
  
  
  CONCLUSIONS
  The case we describe of toxicity from the synthetic opioid labeled U-47700 highlights the emerging trend of novel synthetic opioid abuse.
authors.affiliation: a Division of Medical Toxicology , University of California, San Diego Health System , San Diego , CA , USA.|b Department of Emergency Medicine , University of California, San Diego Health System , San Diego , CA , USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Schneir
authors.affiliation: c Department of Pathology, Center for Advanced Laboratory Medicine , University of California, San Diego Health System , San Diego , CA , USA.
authors.forename: Imir G
authors.initials: IG
authors.lastname: Metushi
authors.affiliation: b Department of Emergency Medicine , University of California, San Diego Health System , San Diego , CA , USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Sloane
authors.affiliation: b Department of Emergency Medicine , University of California, San Diego Health System , San Diego , CA , USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Benaron
authors.affiliation: c Department of Pathology, Center for Advanced Laboratory Medicine , University of California, San Diego Health System , San Diego , CA , USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Fitzgerald
mesh_terms: D000701:Analgesics, Opioid / Q000506:poisoning* / Q000652:urine; D001549:Benzamides / Q000506:poisoning* / Q000652:urine; D015198:Designer Drugs / Q000506:poisoning*; D006801:Humans; D008297:Male; D009270:Naloxone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D012131:Respiratory Insufficiency / Q000139:chemically induced*; D015813:Substance Abuse Detection / Q000379:methods; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D001549:Benzamides; D015198:Designer Drugs; D009292:Narcotic Antagonists; C000614521:U-47700; D009270:Naloxone
keywords: U-47700; novel opioid; novel psychoactive substance; opioid poisoning; synthetic opioid