Fluorofentanyl and novel synthetic opioids in accidental overdose deaths.

This article focuses on the prevalence of novel synthetic opioids (NSOs), particularly fluorofentanyl, in accidental overdose deaths in San Francisco during 2022. Using a validated liquid chromatography with tandem mass spectrometry (LC–MS-MS) method to analyze over 250 NSOs, the study found that 7.8% of 617 tested overdose cases contained at least one NSO, with fluorofentanyl detected in 6.5% of cases. Fluorofentanyl was frequently found alongside fentanyl and stimulants such as methamphetamine and cocaine, indicating polysubstance use. The detection of fluorofentanyl in both biological specimens and drug paraphernalia suggests its migration from the US East Coast to the West Coast, marking one of the first reports of this opioid in California. The study highlights the importance of including NSOs in routine toxicological screening to better understand and mitigate overdose fatalities.