Acetyl fentanyl, N-N-phenylacetamide, is an analog of the potent opioid analgesic fentanyl. It is also referred to as nonpharmaceutical fentanyl. Some common street names for acetyl fentanyl include China-White, Apache, China-girl, dance-fever, friend, goodfella, jackpot, murder 8, TNT, and Tango, The chemical structure of acetyl fentanyl is similar to fentanyl. Substances are also referred to as desmethyl fentanyl due to the missing methyl group in its structure compared to that of fentanyl. Acetyl-fentanyl be manufactured, distributed, and sold illicitly, it may be mixed with heroin or agents. It may be marketed as heroin, or oxycodone (OxyContin), to unsuspecting buyers. Acetylfentanyl
Evolution of Acetyl Fentanyl
The 34-year’s-old male was reported to be snorting a white powder that was believed to contain heroin. Toxicological analysis revealed morphine (356 μg/L), fentanyl (34.7 μg/L), alprazolam (64.9 μg/L), and acetyl fentanyl (32.9 μg/L) in femoral blood and 6-monoacetylmorphine (6-MAM, <10.0 μg/L) in vitreous fluid. Norfentanyl was only detected in stomach contents (<1.00 μg/total). Heroin, fentanyl, and acetyl fentanyl were also detected in solid dose evidence submitted by law enforcement. The fentanyl and alprazolam concentrations might normally be associated with a fatal outcome and are supported by the distribution of fentanyl and alprazolam being consistent with acute intoxication.
In addition, the presence of 6-MAM and a free versus total morphine ratio of 67.9% provide supporting evidence of a rapid death following intranasal (IN) administration. However, the presence of illicit ac-etyl fentanyl complicates toxicologic interpretation due to overlapping recreational and fatal concentrations of this compound reported in the literature as well as a potential for postmortem redistribution (PMR). Reported acetyl fe-ntanyl concentrations have also varied when presented with significant fentanyl concentrations and underscore the need to consider a wide range of illicit opioid compounds when investigating drug-related deaths. Based on our comprehensive toxicologic analysis, the results suggest an acute intoxication primarily by IN administration of acetyl fent-anyl and fentanyl. In addition, we suggest the presence of alprazolam, 6-MAM, and a percentage free morphine is also consistent with rapid death. The cause of death was officially attributed to an acute combined intoxication of acetyl fentanyl, fentanyl, alprazolam, and heroin, with the manner of death as accidental.
Acetyl fentanyl, like fentanyl, binds to mu-opioid receptors, causing agonist effects.1 Studies suggest that its potency is 5 to 15 times that of heroin. Clinical effects are similar to those of other opioid agents, including analgesia, as well as euphoria, altered mood, miosis, drowsiness, cough suppression, decreased gastrointestinal motility, and respiratory depression. Adverse effects of fentanyl may include nausea, itching, dizziness, or altered mental status, and may progress to more severe toxicity.
Tolerance and Dependence
Similar to other opioid agents, repeated use can lead to tolerance, with escalating doses required for an effect. Acetyl fent-anyl may also serve as a substitute for heroin or other opioids in opioid-dependent persons, because of agonism of the same mu-opioid receptors. Additionally, individuals may believe they are using heroin and inadvertently become tolerant to or dependent on the more potent opioid, such that a return to unadulterated heroin no longer provides the expected effects. While withdrawal has not been specifically described, given its affinity for opioid receptors, an opioid withdrawal pattern would be expected, with anxiety, sweating, abdominal discomfort, nausea/vomiting, diarrhea, shivering, and piloerection.
Clinical studies evaluating the pharmacologic effects of acetyl fenta-nyl specifically in humans are lacking. Its toxicity is similar to that of other opioids, with lethargy progressing to coma, respiratory depression leading to apnea, bradycardia, and hypotension. Death is usually due to respiratory arrest. Users may be at greater risk of severe effects if they believe they are using heroin but have actually purchased the more potent acetyl fen-tanyl or a mixture of the two. Visit Now
There are no reviews yet.