Bad trip due to 25I-NBOMe: a case report from the EU project SPICE II plus.
Maren Hermanns-Clausen, Verena Angerer, Josephine Kithinji, Christina Grumann, Volker Auwärter
Clinical toxicology (Philadelphia, Pa.) September 1, 2017 DOI: 10.1080/15563650.2017.1319572 via PubMed
Summary
AI-generated from the abstractA 42-year-old man accidentally ingested 25I-NBOMe, a potent hallucinogenic drug, after taking a sip of pediatric analgesic syrup that had been refilled with a self-made solution of the drug in ethanol. Within 30 minutes he became restless, and in the emergency department he showed dilated pupils, heavy sweating, disorientation, agitation, and later severe agitation, coenesthesia, and complex hallucinations. Blood tests at admission detected 25I-NBOMe (34 ng/mL), its metabolite 2C-I (12 ng/mL), and 25I-NBOH (<1 ng/mL). The syrup contained 2800 μg/mL of 25I-NBOMe. Symptoms resolved after six hours without complications. The presence of 2C-I 50 minutes after intake suggests rapid metabolic breakdown of 25I-NBOMe via first-pass metabolism.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 42-year-old drug-naïve man |
| Duration | Six hours |
| Keywords | 25i-nboh 25i-nbome 2c-i New psychoactive substances Designer drugs |
| Citations | 22 |
| Key finding | Accidental ingestion of 25I-NBOMe caused severe hallucinogenic intoxication, and the rapid appearance of its metabolite 2C-I in serum indicates fast first-pass metabolism. |
Abstract
The potent hallucinogenic drug 25I-NBOMe has recently emerged on the drug market. We present a case with analytically confirmed 25I-NBOMe intoxication from the prospective study "SPICE II Plus". Because of a severe headache a 42-year-old man took one sip of a pediatric analgesic syrup, which had been refilled with a self-made solution of 25I-NBOMe in ethanol. Thirty minutes later restlessness occurred. On arrival in the emergency department mydriasis, strong sweating, disorientation, and agitation were noticed. Within short time the patient developed severe agitation, coenesthesia, and complex hallucinations. In blood serum samples obtained at admission revealed the presence of 25I-NBOMe (34 ng/mL), 2C-I (12 ng/mL) and 25I-NBOH (<1 ng/mL) (LC-ESI-MS/MS). The presumed analgesic syrup contained 25I-NBOMe (2800 μg/mL), and besides ethanol no other compounds were detected. After six hours, the symptoms resolved without further complications. This is a unique case of an analytically confirmed, accidental ingestion of 25I-NBOMe in a drug naïve adult. The finding of 2C-I in the serum sample 50 minutes after intake indicates a fast metabolic breakdown of 25I-NBOMe due to first-pass metabolism.