Recommended Methods for The Identification and Analysis of Fentanyl and Its Analogues in Biological Specimens

Manual for Use by National Drug Analysis Laboratories

image of Recommended Methods for The Identification and Analysis of Fentanyl and Its Analogues in Biological Specimens

The present manual is one in a series of similar publications by the United Nations Office on Drugs and Crime (UNODC), dealing with the identification and analysis of various types of drugs under international control. In line with the overall objective of this series of UNODC publications, the present manual suggests approaches that may assist drug analysts in the selection of methods appropraiate to the sample under examination and provide data suitable for the purpose at hand, leaving room also for adaptation to the level of sophistication of different laboratories and the various legal need.



Reference data for the interpretation of toxicological findings of fentanyl and selected analogues

Numerous incidents of fentanyl-related fatalities have been reported, with blood fentanyl concentrations ranging from 3.0-28 ng/mL; in comparison, recommended serum concentrations range from 1-2 ng/mL for analgesia and 10-20 ng/mL for anaesthesia [26,56]. Case series of reported fentanyl concentrations in adults who died from transdermal, intravenous, and oral abuse of fentanyl patches were 18 ng/mL (range 4-54), 59 (3-383) and 28 (7-97), respectively [29,72]. In fentanyl-only related deaths, average blood concentrations have been increasing, with a 2003 case series reporting an average result of 9 ng/mL, and a 2014 case series reporting an average of 30 ng/mL. A cluster of 9 fentanyl-laced heroin deaths were reported in Australia with reported average and median femoral blood concentrations of 18 and 29 ng/mL (range <1-45) accompanied by morphine, 140 and 80 ng/mL (range 20-400 ng/mL). The combination of heroin and fentanyl has become a routine toxicological finding in suspected opioid overdose death investigations, but even fentanyl by itself is posing an increased risk of overdose and death to recreational users.


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