Side effects of fentanyl analogs are similar to those of fentanyl itself, which include itching, nausea and potentially serious respiratory depression, which can be life-threatening. Fentanyl analogs have killed hundreds of people throughout Europe and the former Soviet republics since the most recent resurgence in use began in Estonia in the early 2000s, and novel derivatives continue to appear.[6]
Life-threatening adverse reactions caused by furanylfentanyl use have been observed in Sweden[7] and Canada.[8] At least seven deaths in Cook County, Illinois, have been linked to furanylfentanyl in 2016, with additional deaths in suburban Chicago in 2017.[9][10][11]
Detection in biological fluids
Furanylfentanyl may be measured in blood or urine to monitor for use, confirm a diagnosis of poisoning, or assist in a medicolegal death investigation. Commercially available immunoassays are often used as initial screening tests, but chromatographic techniques are generally used for confirmation and quantitation. Blood furanylfentanyl concentrations are expected to be in a range of 1-45 μg/L in victims of fatal overdosage.[12][13][14]
Legal status
Furanylfentanyl is illegal in Sweden as of January 2016.[15]
The United States Drug Enforcement Administration (DEA) proposed a temporary placement of furanylfentanyl into Schedule I of the Controlled Substances Act on 27 September 2016.[16] On November 29, 2016, the DEA issued its final rule, making furanylfentanyl Schedule I.[17][18]
^Bagley JR, Wynn RL, Rudo FG, Doorley BM, Spencer HK, Spaulding T (March 1989). "New 4-(heteroanilido)piperidines, structurally related to the pure opioid agonist fentanyl, with agonist and/or antagonist properties". Journal of Medicinal Chemistry. 32 (3): 663–671. doi:10.1021/jm00123a028. PMID2563773.
^Chen Q, Shang Y, Xu Y, Li P, Li P, Liu GL (February 2016). "Analgesic effect and pharmacological mechanism of fentanyl and butorphanol in a rat model of incisional pain". Journal of Clinical Anesthesia. 28: 67–73. doi:10.1016/j.jclinane.2015.08.010. PMID26440441.
^Mounteney J, Giraudon I, Denissov G, Griffiths P (July 2015). "Fentanyls: Are we missing the signs? Highly potent and on the rise in Europe". The International Journal on Drug Policy. 26 (7): 626–631. doi:10.1016/j.drugpo.2015.04.003. PMID25976511.
^Helander A, Bäckberg M, Beck O (20 April 2016). "Intoxications involving the fentanyl analogs acetylfentanyl, 4-methoxybutyrfentanyl and furanylfentanyl: results from the Swedish STRIDA project". Clinical Toxicology. 54 (4): 324–332. doi:10.3109/15563650.2016.1139715. PMID26850293. S2CID41668288.
^Dybowski MP, Dawidowicz AL (January 2020). "Furanylfentanyl in whole blood measured by GC–MS/MS after QuEChERS extraction in a fatal case". Forensic Toxicology. 38 (2): 496–504. doi:10.1007/s11419-019-00515-9. ISSN1860-8973. S2CID209897483.