Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Jul;40(2):383-392.
doi: 10.1007/s11419-022-00628-8. Epub 2022 May 17.

Difficulties interpreting concentrations in fatal cases: example of 2,5-dimethoxy-4-chloroamphetamine

Benedicte Lelievre  1 , Vincent Dupont  2   3 , Celine Buchaillet  2   4 , Nathalie Jousset  2 , Marie Deguigne  5 , Vincent Cirimele  6
Affiliations
Free article
Case Reports

Difficulties interpreting concentrations in fatal cases: example of 2,5-dimethoxy-4-chloroamphetamine

Benedicte Lelievre et al. Forensic Toxicol. 2022 Jul.
Free article

Erratum in

Abstract

Purpose: Death related to the use of drugs is evident when drugs are detected in biological matrices within toxic levels, but sometimes it can be less obvious. Intoxications after 2,5-dimethoxy-4-chloroamphetamine (DOC) use are occurring but up to date, only one fatality has been reported. Here we present the case of a young woman admitted to hospital as she presented vomiting, convulsions and cardiorespiratory arrest.

Methods: Blood ethanol concentration was determined using gas chromatography with flame ionization detection and toxicological screenings (blood, gastric content and hair samples) were performed using liquid chromatography with diode array detection, gas chromatography or liquid chromatography with mass spectrometry detection.

Results: Her health state declined with cardiac troubles, organs failure and cerebral edema till death occurring 4 days later. The autopsy revealed the presence of hemorrhagic infiltration inside the left ventricle, pulmonary edema and hemorrhagic infiltration of the terminal ileum. The analysis of biological fluids confirmed the presence of DOC (< 10 ng/mL in cardiac blood sample), buprenorphine, cocaine and cannabis metabolites. The analysis of hair highlighted a history of drugs abuse.

Conclusion: In the absence of evident identified cause, the hypothesis of a death due to acute drugs use within a history of chronic consumption of drugs has been put forward. The concentration of some substances such as new psychoactive substances can be low in biological matrices but the toxic effects can be additive and lead to death even within young people, hence the importance of the knowledge of consumption history.

Keywords: 2,5-dimethoxy-4-chloroamphetamine; Fatal; New psychoactive substances.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Giorgetti A, Busardò FP, Tittarelli R, Auwärter V, Giorgetti R (2020) Post-mortem toxicology: a systematic review of death cases involving synthetic cannabinoid receptor agonists. Front Psychiat 11:464. https://doi.org/10.3389/fpsyt.2020.00464 - DOI
    1. Logan BK, Mohr ALA, Friscia M, Krotulski AJ, Papsun DM, Kacinko SL, Ropero-Miller JD, Huestis MA (2017) Reports of adverse events associated with use of novel psychoactive substances, 2013–2016: a review. J Anal Toxicol 41(7):573–610 - DOI
    1. UNODC (2020) Early warning advisory on new psychoactive substances, www.unodc.org/LSS/Page/NPS/pharmacology . Consulted 15 December 2020.
    1. European Monitoring Centre for Drugs and Drug Addiction (2018) European drug report 2018: trends and developments. Publications Office of the European Union, Luxembourg
    1. European Monitoring Centre for Drugs and Drug Addiction (2021) European drug report 2021: trends and developments. Publications Office of the European Union, Luxembourg

Publication types

Substances

LinkOut - more resources