2-Fluorodeschloroketamine consumption: About two deaths and a case of self-mutilation.

2-Fluorodeschloroketamine (2-FDCK), a new psychoactive substance similar to ketamine, was detected and quantified in three forensic cases: one of self-mutilation and two deaths. In peripheral blood, concentrations ranged from 457 to 5885 µg/L across the cases, and the main metabolites nor-2-FDCK, dihydro-nor-2-FDCK, and dihydro-2-FDCK were also found. Hair analysis in the two fatal cases showed 2-FDCK at approximately 4149 and 79824 pg/mg. Deschloroketamine (DCK) was present in all biological fluids and hair, but in one case it appeared to result from 2-FDCK metabolism rather than separate ingestion, suggesting the first report of DCK as a metabolite of 2-FDCK in both fluids and hair.

Study at a glance

Abstract

2-Fluorodeschloroketamine (2-FDCK) is a new psychoactive substance (NPS), close to the ketamine structure. Few cases of 2-FDCK intake are described in the forensic literature, especially concerning death cases. We report here a case of self-mutilation (Case 1) and two forensic deaths linked to 2-FDCK consumption. The second case involved a man found dead in the street, having been stabbed. The third case was a man found dead following a suspected overdose and in an advanced state of putrefaction. For all three cases, biological fluids such as blood and urine were analyzed, as was hair for the two fatal cases. The aim of this study was to identify and quantify 2-FDCK and its main metabolites in different matrices. Biological fluids and hair were analyzed by liquid chromatography coupled with tandem mass spectrometry after decontamination and extraction. Seized products were analyzed by gas chromatography-mass spectrometry and assayed, when possible, by ultra-performance liquid chromatography with diode-array detection. 2-FDCK was detected and quantified in the peripheral blood of Cases 1, 2 and 3 (457, 758 and 5885 µg/L, respectively), as were its main metabolites nor-2-FDCK, dihydro-nor-2-FDCK and dihydro-2-FDCK. In the 1 cm long hair of Cases 2 and 3, 2-FDCK was also detected (approximately 4149 and 79824 pg/mg, respectively). Deschloroketamine (DCK) was found in the biological fluids of Cases 1, 2 and 3 (10, 8 and 350 µg/L, respectively), as well as in hair of Cases 2 and 3 (65 and around 8119 pg/mg, respectively). In Case 3, as a small bag containing DCK powder was seized from his home, we can assume that DCK was taken. On the contrary, to our knowledge, it has not been established that Case 2 took DCK alone, so we can assume that it may be the first case to report DCK from 2-FDCK metabolism in fluids as well as in hair.