ArticleForensic toxicology2023
Simultaneous fatal poisoning of two victims with 4F-MDMB-BINACA and ethanol.
Article in Forensic toxicology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Interpol review of forensic drug chemistry, 2022-2025.Forensic science international. Synergy · 2026Review
- How structural variations in synthetic cannabinoids affect their metabolism: A pilot study on the in vivo metabolism of 8 synthetic cannabinoid receptor agonists.Archives of toxicology · 2026Article
- 4F-MDMB-BICA toxicity: a fatal case and literature review of synthetic cannabinoid fatalities.Forensic science, medicine, and pathology · 2026Review
- Evaluation of the unregulated online kratom market in two east-central European countries: test purchase and analysis of potential toxicological consequences.Harm reduction journal · 2025Article
- Exacerbated cardiac dysfunction from combined alcohol binge and synthetic cannabinoid use.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2025Article
- Article
- Psychomotor performances relevant for driving under the combined effect of ethanol and synthetic cannabinoids: A systematic review.Frontiers in psychiatry · 2023Review
- Synthesis and pharmacological evaluation of newly detected synthetic cannabinoid receptor agonists AB-4CN-BUTICA, MMB-4CN-BUTINACA, MDMB-4F-BUTICA, MDMB-4F-BUTINACA and their analogs.Frontiers in psychiatry · 2022Article
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Authors and funding
5 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeMethyl-2-(1-(4-fluorobutyl)-1H-indazole-3-carboxamido)-3,3-dimethylbutanoate (4F-MDMB-BINACA) is a newly emerging synthetic cannabinoid receptor agonists (SCRA) first described in 2018 in both Europe and the United States. Two fatal cases are reported caused by simultaneous consumption of 4F-MDMB-BINACA and ethanol.
methodsThe victims were brothers who were both found deceased after consuming 4F-MDMB-BINACA and ethanol. Post-mortem toxicological analyses of blood and urine were carried out by supercritical fluid chromatography tandem mass spectrometry (SFC-MS/MS) and headspace gas chromatography with flame ionization detection (HS-GC-FID).
resultsThe 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.
conclusionAccording to the reported cases and reviews of the scientific literature, concurrent ethanol consumption should amplify the toxicity of SCRAs. 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.
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