An epidemic of fatal 3-methylfentanyl poisoning in Estonia

  title={An epidemic of fatal 3-methylfentanyl poisoning in Estonia},
  author={Ilkka Ojanper{\"a} and Merja Gergov and Milana Liiv and A Riikoja and Erkki Vuori},
  journal={International Journal of Legal Medicine},
An exceptional epidemic of poisonings due to the highly potent opioid designer drug 3-methylfentanyl (TMF) was revealed among Estonian drug users in 2005–2006 by post-mortem forensic toxicology. [] Key Method Quantitative analysis of cis-TMF, trans-TMF, and fentanyl was performed by liquid chromatography–tandem mass spectrometry. Comprehensive toxicological analysis was performed using a multi-technique approach. The number of TMF-related fatal accidental poisonings identified was 46 and 71 for 2005 and 2006…

Postmortem and Toxicological Findings in a Series of Furanylfentanyl-Related Deaths.

It is difficult to establish a specific lethal concentration of furanylfentanyl, due to incompletely known effects of possible pharmacokinetic and pharmacodynamic interactions with other drugs, as well as to the unknown degree of tolerance to opioids.

Analysis of cis and trans 3-methylfentanyl by liquid chromatography-high resolution mass spectrometry and findings in forensic toxicology casework.

Quantitation of 3-MF with separation of (±)-cis and (±-trans-3-MF provides additional detail for more specific toxicological interpretation and is necessary for forensic toxicology laboratories to obtain instruments sensitive enough to detect these substances in driving under the influence of drugs and postmortem cases.

Postmortem Toxicology Findings of Acetyl Fentanyl, Fentanyl, and Morphine in Heroin Fatalities in Tampa, Florida

Based on case circumstances, autopsy results, and toxicology results, it is evident that fentanyl and/or acetyl fentanyl, when present, contributed to the cause of death.

Intoxications involving the fentanyl analogs acetylfentanyl, 4-methoxybutyrfentanyl and furanylfentanyl: results from the Swedish STRIDA project

Potentially life-threatening opioid toxicity was seen in acute intoxications involving acetylfentanyl, 4-methoxybutyrfentanyl, and furanylfentanyl between April and November 2015.

Opioid intoxications involving butyrfentanyl, 4-fluorobutyrfentanyl, and fentanyl from the Swedish STRIDA project

Analysis of two “butyrfentanyl” NPS products brought to hospital by patients showed that the 10-fold more potent fentanyl was the main active ingredient in both, alarming, given the narrow range between a safe and a lethal dose for opioids.

Gas Chromatography-Mass Spectrometry Analysis of Synthetic Opioids Belonging to the Fentanyl Class: A Review

  • C. A. Valdez
  • Biology
    Critical reviews in analytical chemistry
  • 2021
The following review will cover the literature dealing with the detection and identification of synthetic opioids belonging to the fentanyl class by GC-MS means and hyphenated versions of the technique.

Quantitative Analysis of Fentanyl and Six Fentanyl Analogs in Postmortem Specimens by UHPLC-MS-MS.

The ability to distinguish the isomer pairs isobutyryl/butyry l fentanyl and p-fluoroisobutyyl/p-fluorsports-tandem mass spectrometry fentanyl is achieved by the UHPLC-MS-MS method.

Distinguishing between cyclopropylfentanyl and crotonylfentanyl by methods commonly available in the forensic laboratory.

The usefulness of the two approaches is demonstrated by unambiguously identifying cyclopropylfentanyl, as well as its metabolites, in two authentic post mortem blood samples.



Blood Levels of 3-Methylfentanyl in 3 Fatal Poisoning Cases

The blood concentrations of cis-3-methylfentanyl, measured here for the first time by a specific tandem mass spectrometric method, ranged from 0.3 to 0.9 μg/L (mean 0.5 μg/ L).

Fatal outcome in a child after ingestion of a transdermal fentanyl patch

The case history and toxicological findings of a fatal fentanyl intoxication due to ingestion of a transdermal patch are presented. A 1-year-old otherwise healthy girl was put to bed and 2 h later

Deaths after intravenous misuse of transdermal fentanyl.

The present cases demonstrate the possibility of intravenous misuse of transdermal patches and the risk of fatal outcome, and identify two male drug addicts, found dead within a one week interval in the same apartment.

Carisoprodol intoxications: a retrospective study of forensic autopsy material from 1992–2003

It is concluded that carisoprodol can be fatal in concentrations below those indicated in some of the previously published literature.

Fentanyl use, misuse, and abuse: a summary of 23 postmortem cases.

The rapid rise in the number of fentanyl cases over the past three years, the increasing availability of fentanyl patches, and the large number of case histories indicating misuse or abuse suggest that fentanyl is rapidly becoming an additional desired opioid similar to oxycodone and methadone.

Fentanyl-related deaths in Ontario, Canada: toxicological findings and circumstances of death in 112 cases (2002-2004).

A retrospective study of all cases in which fentanyl was quantitated in blood was conducted for the time period between 2002 and 2004 and provided additional insight into the use of this drug for both therapeutic and illicit means.

An outbreak of designer drug--related deaths in Pennsylvania.

Drug abusers in the northeastern United States should be considered at risk for more "designer drug" overdose outbreaks in the future after 3-methylfentanyl was identified in 16 fatal overdose cases in Allegheny County, Pennsylvania, contributing to a fourfold rise in overdose mortality during October of that year.

Fentanyl-related deaths: demographics, circumstances, and toxicology of 112 cases.

Although most of the fentanyl victims had a prior history of intravenous drug use, morphine or codeine were not commonly found, which suggests that the victims had little or no opiate tolerance.

Frequency of different anti-depressants associated with suicides and drug deaths

From each case of suicide and drug-related death autopsied in the Institute of Forensic Medicine, Munich during the years 2001–2005, a toxicological investigation on anti-depressants (AD) was performed, there were serious differences in the frequency of different ADs regarding to the manner of suicide.

Fatal intravenous fentanyl abuse: four cases involving extraction of fentanyl from transdermal patches.

The transdermal fentanyl system delivers a specific dose at a constant rate. Even after the prescribed application time has elapsed, enough fentanyl remains within a patch to provide a potentially