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First evidence in an oversea French department of the deadly risk of protonitazene use: about 5 post mortem cases

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Abstract

Protonitazene is a synthetic benzoimidazole opioid of the nitazenes class, developed in the 1950s as an effective analgesic, but never released in the market due to severe side effects and major risk of dependence. The laboratory was involved in the determination of the cause of death for 5 subjects deceased in a French department of the Indian Ocean. The 5 victims were male, aged between 20 and 35 years. The first 2 victims were found dead in their prison cell and the 3 other victims were found dead in a squat. Therefore, we have developed and validated a specific procedure to identify and quantify the drug in post mortem specimens using LC-MS/MS. The procedure involves extraction of 0.5 mL fluid at pH 9.5 with a mixture of organic solvents in presence of 20 ng fentanyl-d5 used as internal standard. Linearity of the method was verified from 0.1 to 20 ng/mL in both whole blood and urine (r2 = 0.9983 and 0.9993, respectively). The limit of detection was estimated at 0.05 ng/mL in each matrix. Protonitazene was identified at < LOQ to 0.8 ng/mL, 0.4 to 2.9 ng/mL and 3.0 to 8.0 ng/mL in femoral blood, urine and bile, respectively. Post mortem concentrations were very low, which is consistent with reported high toxicity of protonitazene. As nitazenes represent a growing threat to public health in various parts of the world, this method seems to be a good response to the challenges posed by the identification of this class of substances.

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The data underlying this article will be shared upon reason- able request to the corresponding author.

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Funding

The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Laboratoire SYNLAB Réunion, 19 ter rue Balbolia, Saint-Paul, 97460, France

    Christophe Maruejouls, Cédric Mazoyer, Kati Teston & Frédéric Aknouche

  2. Institut de médecine légale, 11 rue Humann, Strasbourg, 67000, France

    Alice Ameline, Laurie Gheddar & Pascal Kintz

  3. X-Pertise Consulting, 42 rue Principale, Mittelhausbergen, 67206, France

    Pascal Kintz

Authors
  1. Christophe Maruejouls
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  2. Alice Ameline
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  3. Laurie Gheddar
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  4. Cédric Mazoyer
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  5. Kati Teston
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  6. Frédéric Aknouche
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  7. Pascal Kintz
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Contributions

Christophe Maruejouls: resources, project administration. Alice Ameline: methodology, investigation, formal analysis. Laurie Gheddar: methodology, investigation. Cédric Mazoyer: investigation, conceptualization. Kati Teston: investigation. Frédéric Aknouche: validation. Pascal Kintz: writing, review, editing.

Corresponding author

Correspondence to Pascal Kintz.

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None declared (forensic expertise requested by the Prosecutor).

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Maruejouls, C., Ameline, A., Gheddar, L. et al. First evidence in an oversea French department of the deadly risk of protonitazene use: about 5 post mortem cases. Int J Legal Med 139, 87–93 (2025). https://doi.org/10.1007/s00414-024-03309-w

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