title: Ocfentanil overdose fatality in the recreational drug scene.
abstract: This paper describes the first reported death involving ocfentanil, a potent synthetic opioid and structure analogue of fentanyl abused as a new psychoactive substance in the recreational drug scene. A 17-year-old man with a history of illegal substance abuse was found dead in his home after snorting a brown powder purchased over the internet with bitcoins. Acetaminophen, caffeine and ocfentanil were identified in the powder by gas chromatography mass spectrometry and reversed-phase liquid chromatography with diode array detector. Quantitation of ocfentanil in biological samples was performed using a target analysis based on liquid-liquid extraction and ultra performance liquid chromatography tandem mass spectrometry. In the femoral blood taken at the external body examination, the following concentrations were measured: ocfentanil 15.3μg/L, acetaminophen 45mg/L and caffeine 0.23mg/L. Tissues sampled at autopsy were analyzed to study the distribution of ocfentanil. The comprehensive systematic toxicological analysis on the post-mortem blood and tissue samples was negative for other compounds. Based on circumstantial evidence, autopsy findings and the results of the toxicological analysis, the medical examiner concluded that the cause of death was an acute intoxication with ocfentanil. The manner of death was assumed to be accidental after snorting the powder.
authors.affiliation: Eurofins Forensics Belgium, Lieven Bauwensstraat 6, 8200 Brugge, Belgium.
authors.forename: Vera
authors.initials: V
authors.lastname: Coopman
authors.affiliation: Eurofins Forensics Belgium, Lieven Bauwensstraat 6, 8200 Brugge, Belgium. Electronic address: jancordonnier@eurofins.be.
authors.forename: Jan
authors.initials: J
authors.lastname: Cordonnier
authors.affiliation: Emergency Department, Algemeen Stedelijk Ziekenhuis, Merestraat 80, 9300 Aalst, Belgium; Department of Forensic Medicine, Ghent University, Campus UZ , De Pintelaan 185, 9000 Gent, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: De Leeuw
authors.affiliation: ChemTox, Rue Grüninger 3, 67405 Illkirch, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Cirimele
mesh_terms: D000082:Acetaminophen / Q000633:toxicity; D000293:Adolescent; D002110:Caffeine / Q000633:toxicity; D002853:Chromatography, Liquid; D062787:Drug Overdose / Q000175:diagnosis / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D013287:Illicit Drugs / Q000633:toxicity*; D008297:Male; D013058:Mass Spectrometry; D010880:Piperidines / Q000633:toxicity*; D011180:Postmortem Changes
chemical_list: D013287:Illicit Drugs; D010880:Piperidines; D000082:Acetaminophen; D002110:Caffeine; C071395:ocfentanil
keywords: Fentanyl analogue; New psychoactive substances (NPS); Ocfentanil; Tissue distribution; Ultra performance liquid chromatography mass spectrometry (UPLC-MS)