The synthetic cannabinoid 5F-MDMB-PICA: A case series

• Published in: Forensic science international 2020-09, Vol.314, p.110410, Article 110410
• Main Authors: Kleis, J., Germerott, T., Halter, S., Héroux, V., Roehrich, J., Schwarz, C.S., Hess, C.
• Format: Article
• Language: English
• Subjects: 5F-MDMB-PICA; Adult; Aggression - drug effects; Amphetamines; Autopsy; Biological properties; Biological samples; Blood; Cannabinoids; Cannabinoids - adverse effects; Cannabinoids - analysis; Cannabinoids - chemistry; Cannabis; Chromatography; Chromatography, Liquid; Confusion - chemically induced; Conjunctiva - pathology; Consumption; Crime; Disorientation; Driving ability; Driving Under the Influence; Drug abuse; Drugs; DUID; Eye (anatomy); Fatalities; Female; Forensic medicine; Forensic sciences; Gas flow; High resolution mass spectrometry; Humans; Illicit Drugs - adverse effects; Illicit Drugs - analysis; Illicit Drugs - chemistry; Intoxication; Ions; Legal medicine; Limit of Detection; Male; Mass Spectrometry; Metabolites; Middle Aged; Molecular Structure; Mood Disorders - chemically induced; Moods; Particle size; Post mortem; Postural Balance - drug effects; Pupil Disorders - chemically induced; Scientific imaging; Sensation Disorders - chemically induced; Side effects; Solid Phase Extraction; Substance-Related Disorders - complications; Synthetic cannabinoids; Urine
• ISSN: 0379-0738; 1872-6283
• DOI: 10.1016/j.forsciint.2020.110410

•5F-MDMB-PICA is associated with serious adverse health and behavioral effects.•Serum concentrations from 0.1–16ng/mL, largely combined drug abuse.•Hydrolysis metabolites of synthetic cannabinoids can be found in serum samples.•Developing a comprehensive screening approach for synthetic cannabinoids.•Quadrupole time-of-flight mass spectrometry after solid phase extraction. 5F-MDMB-PICA has been detected in products sold on the internet as well as in biological samples since 2016. It is associated with serious adverse health and behavioral effects and even death. Herein we report on twelve cases with proven 5F-MDMB-PICA consumption, including three fatalities, four cases of driving under the influence of drugs and five other criminal acts. In these cases, 5F-MDMB-PICA was detected in postmortem blood or serum. Concentrations ranged from 0.1–16ng/mL. In some blood (serum) and urine samples, the hydrolysis metabolite of 5F-MDMB-PICA (M12) could also be detected. In this case series, co-consumption with other drugs occurred in 9 of 12 cases, most commonly alcohol, cannabis and other contemporary SCs. In five cases, 4F-MDMB-BINACA was also detected. The described cases demonstrate various adverse effects that might be associated with 5F-MDMB-PICA. Observed physical adverse effects were mainly balance deficiencies and ocular effects such as reddened conjunctivae, glassy eyes and delayed or unresponsive pupil light reactions. Observed mental and behavioral effects were mainly changing moods, aggression, confusion, erratic behavior, mental leaps, disorientation, slowed reaction, logorrhea and slurred speech. Due to the fast changing market of synthetic cannabinoids, data on such new appearing substances are basically scarce. Because of the limited number of studies on pharmacological properties of synthetic cannabinoids, reports of findings in human samples along with corresponding case history descriptions can be valuable for the interpretation of upcoming routine cases.