Morbidity Involving the Hallucinogenic Designer Amines MDA and 2C‐I

• Published in: Journal of forensic sciences Vol. 54; no. 6; pp. 1485 - 1487
• Main Authors: Drees, Julia C., Stone, Judy A., Wu, Alan H. B.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.11.2009; Wiley Subscription Services, Inc
• Subjects: 2C‐I; 3,4-Methylenedioxyamphetamine - adverse effects; 3,4-Methylenedioxyamphetamine - analysis; Adult; Chromatography; Chromatography, Gas; Designer Drugs - adverse effects; Designer Drugs - analysis; Dimethoxyphenylethylamine - adverse effects; Dimethoxyphenylethylamine - analogs & derivatives; Dimethoxyphenylethylamine - analysis; Drug abuse; Female; forensic science; Forensic sciences; Forensic Toxicology; Gas Chromatography-Mass Spectrometry; Hallucinogens - adverse effects; Hallucinogens - analysis; hemorrhagic stroke; Humans; Intracranial Hemorrhages - etiology; liquid chromatography–tandem mass spectrometry; Mass spectrometry; MDA; Morbidity; Moyamoya; Moyamoya Disease - complications; Moyamoya Disease - diagnosis; Quadriplegia - etiology; Stroke; Stroke - etiology; Substance Abuse Detection - methods; Substance-Related Disorders - complications; Toxicity
• DOI: 10.1111/j.1556-4029.2009.01199.x
• ISSN: 0022-1198

:  A case is presented of a 39‐year‐old woman who suffered severe debilitation because of a hemorrhagic stroke in the context of substance abuse. The patient presented to the emergency room with rapidly diminishing mental status, hypertension, and vasoconstriction; her friends provided a history of ingestion of cocaine, 3,4‐methylenedioxymethamphetamine (MDMA), and 2C‐I, a novel designer amine. A multi‐targeted LC‐MS/MS method for sympathomimetic amines and related drugs in urine detected and quantified 2C‐I and MDA, while ruling out MDMA. The cause of the stroke was determined to be an underlying cerebrovascular abnormality called Moyamoya, secondary to substance abuse. In clinical laboratories, gas chromatography–mass spectrometry or liquid chromatography–tandem mass spectrometry (LC‐MS/MS) confirmation of a positive amphetamine immunoassay is usually directed only towards amphetamine, methamphetamine, MDMA and MDA. This report demonstrates the utility of testing for a wider menu of compounds using LC‐MS/MS in order to better characterize the prevalence and toxicities of novel amines such as 2C‐I.