PRIMARY STUDY

Fatal intoxication with new synthetic cannabinoids 5F-MDMB-PICA and 4F-MDMB-BINACA—parent compounds and metabolite identification in blood, urine and cerebrospinal fluid

Key Findings:  This case study is of a 33-year-old man who lost consciousness and died following the suspected consumption of a synthetic cannabinoid (SC). Lab analysis found 5F-MDMB-PICA and 4F-MDMB-BINACA, both significantly more potent than tetrahydrocannabinol (THC), on the glass pipe at the scene, and thier metabolites in much higher levels in the cerebrospinal fluid (CSF) compared to serum levels, leading to further suspicion that the synthetic cannabinoids played a role in the individual's death. Due to the rapid metabolism of both substances, current lab analysis capabilities are more difficult in suspected cases involving SC, and CSF analysis should be included.