methylone and Drug-Overdose

It is reasonable to expect the presence of multiple drugs to present a complicated picture of toxicity. We report a fatal case involving a young man who purchased illicit drugs and knowingly consumed them. After consuming these drugs and going to sleep in his friend's car, he was found unresponsive the next morning with no signs of physical violence. Drugs found in the peripheral blood at autopsy were oxymorphone, methylone and ethanol at concentrations of 0.106, 0.50 and 130 mg/dL, respectively. The levels of oxymorphone and methylone in peripheral blood were comparable to those observed in other reported fatalities. Cocaine and benzoylecgonine were detected in the urine but not in the blood. Measureable concentrations were also observed for oxymorphone and methylone in urine, liver, kidney and bile. The physical findings at autopsy included pulmonary edema. This is the only reported fatal case involving this combination of drugs encountered in our laboratory.

Topics: Adult; Drug Overdose; Ethanol; Fatal Outcome; Forensic Toxicology; Humans; Male; Methamphetamine; Oxymorphone; Pulmonary Edema

This report presents a fatal case related to the consumption of methylone, a relatively new cathinone type designer drug. A 16-year-old boy suddenly lost his consciousness in a party. Resuscitation had been continued for about 1.5 hours at the intensive care unit, but it was unsuccessful. His previous history included cardiac malformation detected at infancy and bronchial asthma had been diagnosed one year before his death. Signs of sudden cardiac death were observed during autopsy. Methylone intake was proved in blood and liver extract using gas chromatography/mass spectrometry; its concentration was 272 ng/ml in the blood, and 387 ng/g in the liver. Pathohistology revealed microvascular steatosis in the liver, which raised the possibility of chronic use of toxic substances. In addition, striated heart muscle damage was observed, which could be due to the use of an amphetamine-like substance. The authors presume that steatosis of the heart muscle, congenital heart disease and bronchial asthma could be predisposing factors for sudden cardiac death that occurred in the presence of relatively low levels of methylone. Access to various designer drugs is easy, fast and broad. Consequently, the potential abuse or overdose should be taken into consideration in the emergency practice. The use of "non-illicit" drugs does not require formal intervention by the authorities, but the medical service must alarm the stakeholders.

Topics: Adolescent; Amphetamine; Asthma; Autopsy; Causality; Death, Sudden, Cardiac; Designer Drugs; Drug Overdose; Fatal Outcome; Fatty Liver; Heart Defects, Congenital; Humans; Hungary; Male; Methamphetamine; Muscle, Smooth; N-Methyl-3,4-methylenedioxyamphetamine