Fatality from DOC reported

[Pfafffed]

"A fatal intoxication of 2,5-dimethoxy-4-chloroamphetamine: a case report"

J. Anal. Toxicol. 2014 Oct;38(8):589-91. doi: 10.1093/jat/bku087.

Designer drugs appear to be increasing in popularity because of the ease of obtaining these constituents, the lack of ability to identify the substance(s) in routine drug screening, the appeal of the drug(s) being 'safe' due to them being marketed as a 'legal high' and possibly due to stronger restrictions that are being placed on prescription drugs. As components of designer drugs are identified and regulated by the DEA, new constituents, or analogs, of these designer drugs are being manufactured to circumvent legislation. 2,5-Dimethoxy-4-chloroamphetamine (DOC) is a substituted alpha-methylated phenethylamine and acts as a selective serotonin receptor partial agonist. There is limited literature on this particular compound and no literature that attributes death to use of this drug alone. We present a case of a 37-year-old male found at home lying face down next to a book titled 'Psychedelic Chemistry' by Michael Valentine Smith and in the early stages of decomposition. The decedent was a known methamphetamine abuser. A peripheral blood sample collected at autopsy was sent to toxicology for routine analysis. Results yielded negative for the drugs of abuse classes on the enzyme-linked immunosorbent assay screen but was positive for DOC during routine GC-MS analysis. A urine sample collected at autopsy was subjected to a routine urine liquid/liquid analysis via GC-MS, and the specimen was positive for DOC. Quantification analyses showed DOC concentration levels to be 377 ng/mL in iliac blood; 3,193 ng/mL in urine; 3,143 ng/g in liver and 683 ng/g in brain. DOC was not detected in the gastric contents. Caffeine was the only other compound detected in blood and urine. Due to the lack of literature, we believe that this is the first case where death can be attributed to DOC alone.

http://www.ncbi.nlm.nih.gov/pubmed/25217551

I don't know if this should go here, the DOC Big & Dandy, or in The Dark Side forum, but I haven't seen this mentioned on the forums (or on Erowid!) and I thought it was important.

 

[DatNiggaJ]

That must of been the ugliest most fucked up looking death I hope no one saw.. Poor guy

 

[CrypticArc]

A shame. Rest in peace

 

[SKL]

We present a case of a 37-year-old male found at home lying face down next to a book titled 'Psychedelic Chemistry' by Michael Valentine Smith and in the early stages of decomposition.

Ouch.

I wonder what the original dose is. Suspect it was a massive overdose but who knows, other complications are hardly impossible although probably quite rare going on shared experience in our community. I don't know if we have the research to back up any calculations based on the concentrations reported above, though.

 

[Help?!?!]

A shame. Rest in peace

This.

 

[SONN]

thats so odd, by what mechanism would he have died from I wonder? a seizure?

either way its terribly unfortunate.

 

[joshii123]

full agonists of the 5ht receptor are not safe. Use this as a warning guys

 

[jammin83]

DOC is a partial agonist.

 

[joshii123]

My bad, I'm sure it targets more receptors than say lsd though and is highly selective for them receptors.

 

[Kaleida]

While this death is indeed tragic, that report is nearly a year old, and it definitely has been discussed here. There was a whole big thread about this kind of stuff (with this specific link in it) going on within the last month.

My bad, I'm sure it targets more receptors than say lsd though and is highly selective for them receptors.

This sentence is illogical, and false. Targeting a wide array receptors for its effects inherently makes a drug not very selective between them, and LSD targets many more receptors than DOC.

 

[manboychef]

Man, I have had bad trips on LSD before and those were extremely horrific. I really feel for this guy. His last few hours must have been in a scary nightmare world. RIP, no longer do you need to be afraid.

 

[noone1]

Can anyone do a conversion of the amounts? "Quantification analyses showed DOC concentration levels to be... 683 ng/g in brain" and ">100 μg/L in victims of acute overdosage"

Am I to understand that he was several hundred over the overdose range? I'm just curious. Poor bastard.

Anyways as always even water will kill you if you take enough so...

 

[Solipsis]

Estimation of amount ingested

The amount of a drug ingested is occasionally an issue in cases of suspected
over-prescribing. Unfortunately, toxicology cannot accurately answer this question, because of
issues like incomplete distribution, and absorption, mixed chronic and acute dosing, and
post-mortem redistribution. Obviously the amount of drug in the stomach would represent the
minimum amount ingested, and this can sometimes be the only reliable answer. For these
purposes, it is essential that either the entire gastric contents be collected and analyzed or that a
representative, homogeneous portion be assayed. This is most often the cause of error in these
types of estimation.
Often an inspection of the dates of prescriptions and the contents of the prescription
bottles can be more helpful in this regard.

http://forensicscienceeducation.org.../01/Death-Investigation-Toxicology-Manual.pdf

?

Then why bother?

I wouldve hoped that you could at least calculate blood levels over the about 5L of blood people have to reach the ballpark order of magnitude - is that not possible then?

If we would do that for ~ 1000 ng / mL , a little more than the 377 ng / mL - accounting for loss, metabolism, etc etc - in iliac blood (which is a bit low in the body, I thought DOB / DOI accumulated near the lungs first weirdly enough, but might have passed that stage probably and had redistribution several iterations) and multiply by 5000, we get 5 mg. So if he took the drug, distributed it evenly over all blood and then died immediately after that would be about it? It is not 100x overdose I would guess. Mind you I might be totally off here!
The dying right next to a copy of "psychedelic chemistry" *might* suggest to us that it was not several halflives or days after he dosed the drug - or perhaps he felt his end was nigh and feverishly read the book cover to cover over and over.. that would be terribly sad.

RIP by the way, very sorry to hear this (again?) - before I abstain from any DOX indefinitely for the rest of my life, I'd want to check and calculate the number of fatal / injury involved cases against how common the drug is. Otherwise, be careful - people are naturally extremely bad at interpreting data statistically, we are not wired for that.