Krotulski AJ, Mohr AL, Diamond FX, Logan BK
National Library of MedicineNew psychoactive substances (NPS) continue to emerge around the world. APP‐BINACA (or APP‐BUTINACA), a novel synthetic cannabinoid, was first reported in Europe in January 2019 and later in the United States in March 2019. APP‐ BINACA was identified in the United States for the first time in blood sample extracts from forensic casework by liquid chromatography quadrupole time‐of‐flight mass spectrometry (LC‐QTOF‐MS).
To date, APP‐BINACA has been identified in 11 forensic toxicology cases from five states and in both medicolegal death investigations and drug impaired driving investigations. APP‐BINACA was commonly found in combination with 4F‐MDMB‐BINACA. Subsequent to its discovery in biological samples, APP‐BINACA was detected and characterized in seized drug material by gas chromatography mass spectrometry (GC–MS), LC‐QTOF‐MS, and nuclear magnetic resonance (NMR) spectroscopy. Further analysis of biological specimens resulted in the dentification of five metabolites, including 4‐HO‐APP‐BINACA and APP‐BINACA 3‐phenylpropanoic acid. The frequency of APP‐BINACA detection appears to be increasing and this new synthetic cannabinoid has been identified as a possible contributory factor in adverse events, including death.
This is the first literature report regarding the characterization of the new synthetic cannabinoid APP‐BINACA in humans. Since it is not widely tested for, it is not yet known the extent to which APP‐BINACA is contributing to morbidity and mortality, but forensic scientists, public health officials, and others should be aware of its possible presence and impact. Laboratories should incorporate APP‐BINACA into testing workflows for detection and confirmation, where possible.
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