October 15, 2020
Prevalence of Synthetic Cannabinoid MDMB-4en-PINACA Continues to Increase in the United States and Internationally
MDMB-4en-PINACA was first identified in toxicology casework in the United States in September 2019; however, its emergence dates back earlier to seized drug testing from Europe in June 2018. MDMB-4en-PINACA is structurally similar to the popular synthetic cannabinoid 5F-ADB (5F-MDMB-PINACA), differing by the removal of the fluorine atom and replacement with a terminal alkene. MDMB-4en-PINACA is a potent activator of the cannabinoid receptor system and its toxicity has been demonstrated through medicolegal death investigations paired with comprehensive toxicology findings. In the United States, MDMB-4en-PINACA has been identified in at least 51 toxicology specimens associated with post-mortem (PM) death investigations, driving under the influence of drugs (DUID) investigations, and clinical investigations. Internationally, MDMB-4en-PINACA has been identified on several continents including North America, Europe, Asia, and Oceania.
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