Evidence map›Paper›PMID 42212046›Full record

ArticleFrontiers in toxicology2026

Synthetic cannabinoids in human post-mortem samples - ADB-BUTINACA and metabolites in three fatalities.

Annette Zschiesche, Sophia Köpfler, Cora Wunder, Annekathrin M Keiler, Johanna Görg, Cleo P Walz, Barbara Fliss, Tanja Germerott, Volker Auwärter, Laura M Huppertz

Abstract read
In one paragraph

Article in Frontiers in toxicology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Annette Zschiesche *Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Sophia Köpfler *Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Cora WunderInstitute of Legal Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Annekathrin M KeilerFaculty of Biology, Environmental Monitoring and Endocrinology, TU Dresden University of Technology, Dresden, Germany.
Johanna GörgInstitute of Legal Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Cleo P WalzInstitute of Legal Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Barbara FlissInstitute of Legal Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Tanja GermerottInstitute of Legal Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Volker AuwärterInstitute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Laura M HuppertzInstitute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The potent synthetic cannabinoid ADB-BUTINACA (also known as ADB-BINACA) was implicated in three fatal intoxications. Post-mortem samples, including femoral and heart blood, urine, gastric content, bile, vitreous humor, cerebrospinal fluid, and various tissues (brain, kidney, liver, lung, muscle), were analyzed. All cases were mixed intoxications with pregabalin, heroin, ketamine, MDPHP, or ethanol. Methods: Post-mortem examinations were performed in all three fatalities. Blood and urine were screened by immunoassay, gas chromatography-mass spectrometry (GC-MS), and liquid chromatography-tandem mass spectrometry (LC-MS/MS) for drugs. ADB-BUTINACA was quantified by standard addition in all matrices except vitreous humor and cerebrospinal fluid. For assessing the contribution of ADB-BUTINACA, a Toxicological Significance Score (TSS) was assigned to each case. Metabolite profiles received from analysis of post-mortem matrices were compared with HepG2 cell and human liver microsome data. Additionally, compound stability was assessed over 12 weeks in whole blood. Results: Femoral blood concentrations of ADB-BUTINACA ranged from 4.2-8.2 ng/mL, and in heart blood from 5.7-11 ng/mL. Brain tissue contained 1.0-6.2 ng/g, and vitreous humor 0.33-2.1 ng/mL. TSS for ADB-BUTINACA of 1 - 3 were assigned for all cases. Heart-to-femoral blood ratios (1.3-1.8) indicated relatively low post-mortem redistribution. Metabolite profile assessment indicated that detection of metabolic biomarkers such as the dihydrodiol could be relevant in urine and bile. Matrix storage at -20 °C is highly recommended to avoid stability issues. Conclusion: ADB-BUTINACA was detected in all investigated matrices, with the highest concentrations observed in liver, lung, and kidney tissue. The elevated levels in these organs likely reflect their lipophilicity as well as their involvement in absorption (lungs) and metabolism/excretion processes (liver and kidneys). The results of this study may enhance interpretation of toxicological findings in similar cases.

Indexed as

brain tissuecerebrospinal fluidfatal intoxicationsHepG2 cellsnew psychoactive substances (NPS)synthetic cannabinoid receptor agonist (SCRA)toxicological significance score (TSS)vitreous humor

Identifiers

PMID42212046
PMCPMC13215650

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.