When: This event originally occurred on April 29th, 2022.

Presenter: Dr. Mark Koponen, Forensic Pathologist, at UNDSMHS, Grand Forks, ND

This Webinar describes multiple, acute drug intoxications with 25I-NBOMe, a synthetic designer drug which resulted in two fatalities with negative initial toxicology screening, occurring over a two-week period in the summer of 2012 in Grand Forks, North Dakota and East Grand Forks, Minnesota. The presentation describes the circumstances surrounding the deaths and intoxications with autopsy results of the decedents and medical record review of survivors along with toxicology results. This webinar discusses the law enforcement and local hospital collaborations necessary to investigate sudden, suspected drug deaths due to novel synthetic drugs which inexplicably occur in the background of the multiple other drug deaths which inundate every hospital emergency department and medical examiner’s office.

Detailed Learning Objectives:

1. NBOMe compounds are synthetic phenethylamine derivatives which are potent serotonin receptor agonists. NBOMe drugs are sold as powders for insufflation, a solution to use as a nasal spray or more commonly in blotters and sold as LSD. Intoxication with these drugs can result in seizures, hyperthermia, tachycardia and cardiac arrest.

2. Novel synthetic drugs may not be identified in biological samples (blood, urine, etc.) on routine drug testing. A high index of suspicion is necessary to identify these deaths as drug related, when initial drug screens are negative by the routine panel of screened drugs.

3. Policy and procedures may be developed with law enforcement and hospital staff to ensure that adequate blood specimens are obtained for toxicological analysis in patients with suspected drug toxicities who are admitted to the hospital.

*Funding for this training was made possible by a cooperative agreement between the National Network of Public Health Institutes and the Centers for Disease Control and Prevention [6 NU38OT000303-03-02]. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Centers for Disease Control and Prevention nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

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