Cannabinoid-like Effects Of Five Novel Carboxamide Synthetic Cannabinoids

Due to the unknown toxicity of newly emerging SCRAs, forensic assessments of cases involving these substances are challenging. According to the reported cases and reviews of the scientific literature, concurrent ethanol consumption should amplify the toxicity of SCRAs. The concentration of 4F-MDMB-BINACA in the postmortem blood was 2.50 and 2.34 ng/mL, and blood alcohol concentration was 2.11 and 2.49 g/L, respectively. Two fatal cases are reported caused by simultaneous consumption of 4F-MDMB-BINACA and ethanol.
Fig. 2.
The precursor ion m/z 396 (B10, B12/B15) was 32 Da higher than the parent drug, 4F-MDMB-BINACA, suggesting the addition of two hydroxy groups. All the below explanations for transformations into metabolites are based on the data shown in Fig. Metabolites were identified according to their precursor ions, product ions, and fragmentation patterns (Fig. 1). Traditional in-vivo metabolism studies to generate human metabolites of drugs relied heavily on the use of whole animal model systems, which are expensive, limited by drug administration amount, influenced by species variation and faced by many ethical issues. Eight in-vivo metabolites tentatively identified were mainly products of ester hydrolysis with or without additional dehydrogenation, N-dealkylation, monohydroxylation and oxidative defluorination with further oxidation to butanoic acid.
Fig. 1.
Monitoring metabolism of synthetic cannabinoid 4F-MDMB-BINACA via high-resolution mass spectrometry assessed in cultured hepatoma cell line, fungus, adb butinaca liver microsomes and confirmed using urine samples The threshold for fatal overdose of combined use of SCRAs and ethanol can be estimated as a little ng/mL (0.37–4.1 ng/mL according to the reported cases) of SCRA and 1.5–2.5 g/L of ethanol. The reported cases and reviews of the scientific literature suggest a possible synergistic effect between SCRAs and ethanol, because their combined use clearly increases their toxicity. The victim died due to severe necrotizing pancreatitis and acute kidney injury evolving into multi-organ failure 11 days after hospital admission . Studies have found no unequivocal synergistic effect between THC and ethanol at low or moderate ethanol doses [29, 30], but no data on high doses of ethanol are available. Given that THC and ethanol act on the same receptors, data on their simultaneous use may yield important insights in this regard.
Fungus C. elegans
Methyl (2S)-2-([1-(4-fluorobutyl)-1H-indazole-3-carbonyl]amino)-3,3-dimethylbutanoate (4F-MDMB-BINACA, 4F-MDMB-BUTINACA or 4F-ADB), found in numerous SCB product seizures, has been reported by various law enforcement since 2018 . However, most of the SCBs are full agonists at CB1 and CB2 receptors, having a higher risk of undesirable side effects when compared to THC which is a partial agonist . Synthetic cannabinoids (SCBs) are agonists at cannabinoid receptor type 1 (CB1) and type 2 (CB2), where they elicit their main effect

Fig. 2.
Separation of compounds was performed on a 2.1 mm×100 mm, 1.7 adb butinaca μm particle size ACQUITY Torus™ DIOL analytical column (Waters) with guard cartridge. Measurements were performed by an ACQUITY UPC2 supercritical fluid chromatography system (Waters) coupled with a Xevo TQ-S Triple Quadrupole Mass Spectrometer (Waters). During the death scene examination, multiple cigarette butts without filters were found in an ashtray; also found were alcohol bottles, an unopened box of nebivolol-containing drug, and 18 g of unrecognizable herbal residue in a cigarette box.
Data concerning the combined effects of SCRAs and other substances are highly limited, which renders forensic evaluation of possible overdose cases difficult . The threshold SCRA concentration for fatal overdose can be estimated ng/mL level (0.37–4.1 ng/mL according to the reported cases) in cases in which 1.5–2.5 g/L of ethanol is present in the blood. The victims were brothers who were both found deceased after consuming 4F-MDMB-BINACA and ethanol. These confusing shorter names were not scientifically adopted but were used by websites selling the drugs to the public. Monitoring metabolism of synthetic cannabinoid 4F-MDMB-BINACA via high-resolution mass spectrometry assessed in cultured hepatoma cell line, fungus, liver microsomes and confirmed using urine samples. This article does not contain any studies with human participants or animals performed by any of the author


Similarly, precursor ion identified at m/z 380 (B19/B21, B23/B25) was 16 Da higher than the 4F-MDMB-BINACA, indicating monohydroxylation at the butyl side chain (B19/B21) and indazole (B23/B25) moieties with product ions m/z 145 and 161, respectively. Metabolites identified at m/z 366 (B8, B9, B13), which was 16 Da higher than the 4F-MDMB-BINACA ester hydrolysis metabolite (B22), confirmed monohydroxylation upon ester hydrolysis. Death involving these drugs have been reported [5,6,7,8,9], and this raises public health and social concerns. Due to their similar physiological effects to the principal psychoactive component of cannabis, Δ9-tetrahydrocannabinol (THC), SCBs are gaining popularity and are often abused as recreational drugs. The fact that similar 4F-MDMB-BINACA and ethanol concentrations were detected in the postmortem blood samples of both victims suggests that both substances played a role in the fatal outcom