First detected in Canada in early 2023, the synthetic opioid ortho-Methylfentanyl (oMF) has now crossed into the United States, according to a recent alert from the Center for Forensic Science Research and Education (CFSRE). This potent mu-opioid receptor agonist closely resembles fentanyl in structure and effects, raising concerns among forensic and public health experts.

A Potent New Threat

Ortho-Methylfentanyl, like fentanyl, is synthetically manufactured and exists in three positional isomeric forms: ortho-, meta-, and para-methylfentanyl. Its effects include analgesia, sedation, euphoria, and, in severe cases, respiratory depression or death. While oMF’s potency mirrors fentanyl’s, its presence in drug samples poses new challenges for detection and intervention.

Since its identification, over 200 forensic specimens containing oMF have been reported, predominantly from British Columbia, Canada (182 cases). In the United States, the substance has so far been identified in California (4 cases), Arizona (1), and Massachusetts (1), with pending investigations in Pennsylvania, Florida, and West Virginia.

Co-Positivity and Drug Combinations

Ortho-Methylfentanyl rarely appears alone. Among 83 tested samples containing oMF, 70 also contained fentanyl, and 65 tested positive for methamphetamine. THC and cocaine were detected less frequently. Additionally, oMF samples often show co-positivity with novel psychoactive substances (NPS), such as para-Fluorofentanyl (pFF) and bromazolam:

– pFF: A fentanyl analogue detected in 60 of the samples. While 3x less potent than fentanyl, its role in drug-related deaths suggests comparable risks.

– Bromazolam: A synthetic benzodiazepine found in 55 samples. Bromazolam has surged in prevalence, making up 73% of the novel benzodiazepine market by mid-2023, compared to just 4% in 2021.

Growing Concern for Public Health and Forensics

The rise of ortho-Methylfentanyl highlights the evolving complexity of synthetic drug markets and their associated risks. As oMF often appears alongside other potent substances, its presence complicates overdose prevention and treatment efforts. The data underscores the need for enhanced forensic testing capabilities and increased awareness among public health agencies. Early detection efforts like those of the CFSRE play a vital role in monitoring these emerging threats and informing harm reduction strategies.

This latest wave of synthetic opioids serves as a stark reminder of the ever-changing dynamics of the drug landscape and the urgency of coordinated responses from forensic and public health communities.

Data provided by the Center for Forensic Science Research and Education (CFSRE).

Content courtesy of the The Center for Forensic Science Research & Education

Note content has been edited
https://www.cfsre.org/nps-discovery/