ArticleInternational journal of legal medicine2026
Prevalence and toxicological significance of 3-CMC and 4-CMC: A Retrospective study of over 250 forensic cases (2015-2025).
Article in International journal of legal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Synthetic cathinones remain a highly dynamic class of New Psychoactive Substances (NPS) across the global drug market. In Europe, chlorinated derivatives such as 3-chloromethcathinone (3-CMC) and 4-chloromethcathinone (4-CMC) have gained substantial popularity, posing significant public health and traffic safety risks. This study analyzes the occurrence and blood concentrations of 3-CMC and 4-CMC in Polish forensic cases over an 11-year period (2015-2025). Analytes were extracted from biological material via liquid-liquid extraction and quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The study identified 81 cases of 3-CMC and 199 cases of 4-CMC, with 15 cases involving both substances, predominantly related to driving under the influence of drugs (DUID), traffic accidents, and fatalities. Although polydrug use was common, mono-intoxication occurred in 26 (3-CMC) and 56 (4-CMC) cases. Blood concentrations ranged from < 1 to 2680 ng/mL (mean: 68 ng/mL) for 3-CMC, and from < 1 to 2084 ng/mL (mean: 51 ng/mL) for 4-CMC. Fatal intoxications showed the highest mean concentrations (668 ng/mL for 3-CMC; 198 ng/mL for 4-CMC). To evaluate psychomotor impact, mono-substance DUID cases were analyzed, revealing mean concentrations of 15 ng/mL (3-CMC) and 42 ng/mL (4-CMC). Notably, traffic accidents involving only 4-CMC exhibited a mean concentration of 165 ng/mL. The findings document a significant shift in the illicit drug market, with chloromethcathinones replacing traditional stimulants like amphetamine. The established concentration profiles provide a vital epidemiological baseline and crucial reference data to aid forensic toxicologists and law enforcement in evaluating public health risks and drug-impaired driving.
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