{"id":"https://openalex.org/W7223001002","doi":"https://doi.org/10.3389/ftox.2026.1951240","title":"Case Report: Mislabeling of an online \u201calprazolam triazolobenzophenone\u201d pill leads to severe intoxication with the novel synthetic opioid cychlorphine","display_name":"Case Report: Mislabeling of an online \u201calprazolam triazolobenzophenone\u201d pill leads to severe intoxication with the novel synthetic opioid cychlorphine","publication_year":2026,"publication_date":"2026-10-20","ids":{"openalex":"https://openalex.org/W7223001002","doi":"https://doi.org/10.3389/ftox.2026.1951240","pmid":"https://pubmed.ncbi.nlm.nih.gov/42979587","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13730470"},"language":"en","primary_location":{"id":"doi:10.3389/ftox.2026.1951240","doi":"https://doi.org/10.3389/ftox.2026.1951240","is_oa":true,"landing_page_url":"https://doi.org/10.3389/ftox.2026.1951240","pdf_url":"https://www.frontiersin.org/journals/toxicology/articles/10.3389/ftox.2026.1951240/pdf","source":{"id":"https://openalex.org/S4210231588","display_name":"Frontiers in Toxicology","issn_l":"2673-3080","issn":["2673-3080"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Toxicology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/toxicology/articles/10.3389/ftox.2026.1951240/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5075349158","display_name":"Annette Zschiesche","orcid":"https://orcid.org/0009-0005-9017-0111","observed_orcids":["https://orcid.org/0009-0005-9017-0111"]},"institutions":[{"id":"https://openalex.org/I161046081","display_name":"University of Freiburg","ror":"https://ror.org/0245cg223","country_code":"DE","type":"education","lineage":["https://openalex.org/I161046081"]},{"id":"https://openalex.org/I2801240073","display_name":"University Medical Center Freiburg","ror":"https://ror.org/03vzbgh69","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I2801240073"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Annette Zschiesche","raw_affiliation_strings":["Hermann Staudinger Graduate School, University of Freiburg","Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hermann Staudinger Graduate School, University of Freiburg","institution_ids":["https://openalex.org/I161046081"]},{"raw_affiliation_string":"Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg","institution_ids":["https://openalex.org/I161046081","https://openalex.org/I2801240073"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5037931955","display_name":"Johannes Nadler","orcid":"https://orcid.org/0000-0003-3881-2883","observed_orcids":["https://orcid.org/0000-0003-3881-2883"]},"institutions":[{"id":"https://openalex.org/I161046081","display_name":"University of Freiburg","ror":"https://ror.org/0245cg223","country_code":"DE","type":"education","lineage":["https://openalex.org/I161046081"]},{"id":"https://openalex.org/I2801240073","display_name":"University Medical Center Freiburg","ror":"https://ror.org/03vzbgh69","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I2801240073"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Johannes Nadler","raw_affiliation_strings":["Poisons Information Center Freiburg, Department of General Pediatrics, Adolescent Medicine and Neonatology, Faculty of Medicine, Center for Pediatrics, Medical Center \u2013 University of Freiburg, University of Freiburg"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Poisons Information Center Freiburg, Department of General Pediatrics, Adolescent Medicine and Neonatology, Faculty of Medicine, Center for Pediatrics, Medical Center \u2013 University of Freiburg, University of Freiburg","institution_ids":["https://openalex.org/I161046081","https://openalex.org/I2801240073"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5084244272","display_name":"Benedikt Pulver","orcid":"https://orcid.org/0000-0002-7772-2111","observed_orcids":["https://orcid.org/0000-0002-7772-2111"]},"institutions":[{"id":"https://openalex.org/I161046081","display_name":"University of Freiburg","ror":"https://ror.org/0245cg223","country_code":"DE","type":"education","lineage":["https://openalex.org/I161046081"]},{"id":"https://openalex.org/I2801240073","display_name":"University Medical Center Freiburg","ror":"https://ror.org/03vzbgh69","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I2801240073"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Benedikt Pulver","raw_affiliation_strings":["Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg","institution_ids":["https://openalex.org/I161046081","https://openalex.org/I2801240073"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5040428252","display_name":"Martin Scheu","orcid":"https://orcid.org/0009-0001-8356-2177","observed_orcids":["https://orcid.org/0009-0001-8356-2177"]},"institutions":[{"id":"https://openalex.org/I161046081","display_name":"University of Freiburg","ror":"https://ror.org/0245cg223","country_code":"DE","type":"education","lineage":["https://openalex.org/I161046081"]},{"id":"https://openalex.org/I2801240073","display_name":"University Medical Center Freiburg","ror":"https://ror.org/03vzbgh69","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I2801240073"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Martin Scheu","raw_affiliation_strings":["Hermann Staudinger Graduate School, University of Freiburg","Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hermann Staudinger Graduate School, University of Freiburg","institution_ids":["https://openalex.org/I161046081"]},{"raw_affiliation_string":"Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg","institution_ids":["https://openalex.org/I161046081","https://openalex.org/I2801240073"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5004340821","display_name":"Volker Auw\u00e4rter","orcid":"https://orcid.org/0000-0002-1883-2804","observed_orcids":["https://orcid.org/0000-0002-1883-2804"]},"institutions":[{"id":"https://openalex.org/I161046081","display_name":"University of Freiburg","ror":"https://ror.org/0245cg223","country_code":"DE","type":"education","lineage":["https://openalex.org/I161046081"]},{"id":"https://openalex.org/I2801240073","display_name":"University Medical Center Freiburg","ror":"https://ror.org/03vzbgh69","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I2801240073"]}],"countries":["DE"],"is_corresponding":true,"raw_author_name":"Volker Auw\u00e4rter","raw_affiliation_strings":["Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg","institution_ids":["https://openalex.org/I161046081","https://openalex.org/I2801240073"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5085277389","display_name":"Maren Hermanns\u2010Clausen","orcid":"https://orcid.org/0000-0002-9803-7324","observed_orcids":["https://orcid.org/0000-0002-9803-7324"]},"institutions":[{"id":"https://openalex.org/I161046081","display_name":"University of Freiburg","ror":"https://ror.org/0245cg223","country_code":"DE","type":"education","lineage":["https://openalex.org/I161046081"]},{"id":"https://openalex.org/I2801240073","display_name":"University Medical Center Freiburg","ror":"https://ror.org/03vzbgh69","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I2801240073"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Maren Hermanns-Clausen","raw_affiliation_strings":["Poisons Information Center Freiburg, Department of General Pediatrics, Adolescent Medicine and Neonatology, Faculty of Medicine, Center for Pediatrics, Medical Center \u2013 University of Freiburg, University of Freiburg"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Poisons Information Center Freiburg, Department of General Pediatrics, Adolescent Medicine and Neonatology, Faculty of Medicine, Center for Pediatrics, Medical Center \u2013 University of Freiburg, University of Freiburg","institution_ids":["https://openalex.org/I161046081","https://openalex.org/I2801240073"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5004340821"],"corresponding_institution_ids":["https://openalex.org/I161046081","https://openalex.org/I2801240073"],"apc_list":{"value":2550,"currency":"CHF","value_usd":3077},"apc_paid":{"value":2550,"currency":"CHF","value_usd":3077},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.79178108,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"8","issue":null,"first_page":"1951240","last_page":"1951240"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10800","display_name":"Forensic Toxicology and Drug Analysis","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/3005","display_name":"Toxicology"},"field":{"id":"https://openalex.org/fields/30","display_name":"Pharmacology, Toxicology and Pharmaceutics"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T10800","display_name":"Forensic Toxicology and Drug Analysis","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/3005","display_name":"Toxicology"},"field":{"id":"https://openalex.org/fields/30","display_name":"Pharmacology, Toxicology and Pharmaceutics"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T11635","display_name":"Poisoning and overdose treatments","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10576","display_name":"Opioid Use Disorder Treatment","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/novel-synthetic-opioids","display_name":"novel synthetic opioids","score":0.8379999995231628},{"id":"https://openalex.org/keywords/drug-adulteration","display_name":"drug adulteration","score":0.7170000076293945},{"id":"https://openalex.org/keywords/respiratory-depression","display_name":"respiratory depression","score":0.8090000152587891},{"id":"https://openalex.org/keywords/opioid-overdose","display_name":"opioid overdose","score":0.5180000066757202},{"id":"https://openalex.org/keywords/new-psychoactive-substances","display_name":"new psychoactive substances","score":0.6970000267028809},{"id":"https://openalex.org/keywords/online-drug-sales","display_name":"online drug sales","score":0.5189999938011169},{"id":"https://openalex.org/keywords/benzodiazepine-toxicity","display_name":"benzodiazepine toxicity","score":0.6129999756813049}],"concepts":[{"id":"https://openalex.org/C2777196872","wikidata":"https://www.wikidata.org/wiki/Q319877","display_name":"Alprazolam","level":3,"score":0.7896999716758728},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7427999973297119},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.5430999994277954},{"id":"https://openalex.org/C2781063702","wikidata":"https://www.wikidata.org/wiki/Q427523","display_name":"Opioid","level":3,"score":0.5199999809265137},{"id":"https://openalex.org/C100136789","wikidata":"https://www.wikidata.org/wiki/Q1772448","display_name":"Coma (optics)","level":2,"score":0.4327999949455261},{"id":"https://openalex.org/C2781072394","wikidata":"https://www.wikidata.org/wiki/Q407541","display_name":"Fentanyl","level":2,"score":0.42829999327659607},{"id":"https://openalex.org/C2776779939","wikidata":"https://www.wikidata.org/wiki/Q1479485","display_name":"Hypoxemia","level":2,"score":0.41589999198913574},{"id":"https://openalex.org/C98274493","wikidata":"https://www.wikidata.org/wiki/Q128406","display_name":"Pharmacology","level":1,"score":0.4009000062942505},{"id":"https://openalex.org/C2780035454","wikidata":"https://www.wikidata.org/wiki/Q8386","display_name":"Drug","level":2,"score":0.37700000405311584},{"id":"https://openalex.org/C2778000748","wikidata":"https://www.wikidata.org/wiki/Q423071","display_name":"Midazolam","level":3,"score":0.3634999990463257},{"id":"https://openalex.org/C108215921","wikidata":"https://www.wikidata.org/wiki/Q603741","display_name":"Prodrug","level":2,"score":0.3357999920845032},{"id":"https://openalex.org/C2777972943","wikidata":"https://www.wikidata.org/wiki/Q409587","display_name":"Naltrexone","level":4,"score":0.33059999346733093},{"id":"https://openalex.org/C2778173252","wikidata":"https://www.wikidata.org/wiki/Q83871","display_name":"Benzodiazepine","level":3,"score":0.32269999384880066},{"id":"https://openalex.org/C2777846614","wikidata":"https://www.wikidata.org/wiki/Q19904200","display_name":"Synthetic cannabinoids","level":4,"score":0.319599986076355},{"id":"https://openalex.org/C2776814716","wikidata":"https://www.wikidata.org/wiki/Q574801","display_name":"Sedation","level":2,"score":0.296099990606308},{"id":"https://openalex.org/C2780282729","wikidata":"https://www.wikidata.org/wiki/Q3121121","display_name":"Saxagliptin","level":5,"score":0.2768000066280365},{"id":"https://openalex.org/C81603835","wikidata":"https://www.wikidata.org/wiki/Q3457430","display_name":"Pill","level":2,"score":0.27140000462532043},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.26420000195503235}],"mesh":[],"locations_count":5,"locations":[{"id":"doi:10.3389/ftox.2026.1951240","doi":"https://doi.org/10.3389/ftox.2026.1951240","is_oa":true,"landing_page_url":"https://doi.org/10.3389/ftox.2026.1951240","pdf_url":"https://www.frontiersin.org/journals/toxicology/articles/10.3389/ftox.2026.1951240/pdf","source":{"id":"https://openalex.org/S4210231588","display_name":"Frontiers in Toxicology","issn_l":"2673-3080","issn":["2673-3080"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Toxicology","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13730470","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13730470/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13730470/pdf/ftox-08-1951240.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Front Toxicol","raw_type":"Text"},{"id":"pmid:42979587","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42979587","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in toxicology","raw_type":"Case Reports"},{"id":"pmh:oai:doaj.org/article:d839d1cfea1f4aaba2475ef88bc659a4","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/d839d1cfea1f4aaba2475ef88bc659a4","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Toxicology, Vol 8 (2026)","raw_type":"article"},{"id":"pmh:oai:freidok.uni-freiburg.de:288667","doi":null,"is_oa":false,"landing_page_url":"https://freidok.uni-freiburg.de/data/288667","pdf_url":null,"source":{"id":"https://openalex.org/S4306401057","display_name":"FreiDok plus (Universit\u00e4tsbibliothek Freiburg)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I161046081","host_organization_name":"University of Freiburg","host_organization_lineage":["https://openalex.org/I161046081"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in toxicology. - 8 (2026) , 1951240, ISSN: 2673-3080","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/ftox.2026.1951240","doi":"https://doi.org/10.3389/ftox.2026.1951240","is_oa":true,"landing_page_url":"https://doi.org/10.3389/ftox.2026.1951240","pdf_url":"https://www.frontiersin.org/journals/toxicology/articles/10.3389/ftox.2026.1951240/pdf","source":{"id":"https://openalex.org/S4210231588","display_name":"Frontiers in Toxicology","issn_l":"2673-3080","issn":["2673-3080"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Toxicology","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9476000070571899,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320321421","display_name":"Albert-Ludwigs-Universit\u00e4t Freiburg","ror":"https://ror.org/0245cg223"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7223001002.pdf","grobid_xml":"https://content.openalex.org/works/W7223001002.grobid-xml"},"referenced_works_count":42,"referenced_works":["https://openalex.org/W182927737","https://openalex.org/W1992153005","https://openalex.org/W2038659179","https://openalex.org/W2562365460","https://openalex.org/W2622699130","https://openalex.org/W2765107368","https://openalex.org/W2803035184","https://openalex.org/W2990571527","https://openalex.org/W3022984442","https://openalex.org/W3031354476","https://openalex.org/W3037730403","https://openalex.org/W3135956040","https://openalex.org/W3180270048","https://openalex.org/W4205691759","https://openalex.org/W4206577483","https://openalex.org/W4210358124","https://openalex.org/W4224438414","https://openalex.org/W4225013436","https://openalex.org/W4289520680","https://openalex.org/W4312046129","https://openalex.org/W4312067570","https://openalex.org/W4321748136","https://openalex.org/W4323313983","https://openalex.org/W4381611757","https://openalex.org/W4386817724","https://openalex.org/W4399280011","https://openalex.org/W4399665315","https://openalex.org/W4401713278","https://openalex.org/W4401968264","https://openalex.org/W4406071335","https://openalex.org/W4409877592","https://openalex.org/W4410332937","https://openalex.org/W4413094431","https://openalex.org/W4415325592","https://openalex.org/W4415349198","https://openalex.org/W4415720996","https://openalex.org/W4416767447","https://openalex.org/W4417034214","https://openalex.org/W7119511119","https://openalex.org/W7155376893","https://openalex.org/W7167822513","https://openalex.org/W7169877187"],"related_works":["https://openalex.org/W7169877187","https://openalex.org/W4376869060","https://openalex.org/W7167795840","https://openalex.org/W4417034214","https://openalex.org/W7132846191","https://openalex.org/W3037353025","https://openalex.org/W4281968174","https://openalex.org/W4412569597","https://openalex.org/W2497482214","https://openalex.org/W3033130081"],"abstract_inverted_index":{"Background":[0],"Mislabeling":[1],"of":[2,127,136,192,214,249,263,277],"illicit":[3],"drug":[4],"products":[5,279],"poses":[6],"a":[7,48,58,132,211,258,315],"serious":[8],"risk":[9],"to":[10,38,104],"public":[11],"health,":[12],"especially":[13],"in":[14,92,114,163,168,232,236,306],"the":[15,105,115,121,137,172,185,207,247,250,274],"rapidly":[16],"evolving":[17],"market":[18],"for":[19,144,177,288],"new":[20],"psychoactive":[21],"substances":[22],"(NPS).":[23],"Products":[24],"sold":[25],"as":[26,55,64,257],"benzodiazepines":[27,147],"may":[28],"contain":[29],"undisclosed":[30],"novel":[31],"synthetic":[32],"opioids":[33,145],"(NSOs),":[34],"exposing":[35],"opioid-na\u00efve":[36],"users":[37],"life-threatening":[39,265],"respiratory":[40,266,308],"depression.":[41],"Case":[42],"Report":[43],"A":[44],"34-year-old":[45],"man":[46],"ingested":[47],"pink":[49],"tablet":[50,122],"purchased":[51],"online":[52],"and":[53,74,78,88,146,165,243,272,324],"labeled":[54],"\u201calprazolam":[56],"triazolobenzophenone\u201d,":[57],"ring-opened":[59],"alprazolam":[60,108],"prodrug,":[61],"also":[62],"known":[63],"\u201calprazafone\u201d.":[65],"Approximately":[66],"45":[67],"min":[68],"after":[69,156,310],"ingestion,":[70,157],"he":[71],"developed":[72],"snoring":[73],"gasping":[75],"respiration,":[76],"hypoxemia":[77],"deep":[79],"coma":[80],"(Glasgow":[81],"Coma":[82],"Scale":[83],"3).":[84],"Prehospital":[85],"bag-valve":[86],"ventilation":[87],"subsequent":[89],"intubation":[90],"resulted":[91],"prompt":[93],"stabilization.":[94],"The":[95,226,290],"patient":[96],"could":[97],"be":[98],"extubated":[99],"6":[100,293],"hours":[101,155,294],"later.":[102],"Contrary":[103],"labeling,":[106],"neither":[107],"nor":[109],"its":[110],"prodrug":[111],"was":[112,148,229,317],"detected":[113,231],"tablet,":[116],"blood":[117,164,237,270],"or":[118,238],"urine.":[119],"Instead,":[120],"contained":[123],"approximately":[124],"1":[125],"mg":[126],"N":[128],"-propionitrile":[129],"chlorphine":[130],"(cychlorphine),":[131],"piperidine":[133],"benzimidazolone":[134],"opioid":[135],"emerging":[138],"\u201corphine\u201d":[139],"class.":[140],"Routine":[141],"immunoassay":[142],"screening":[143],"negative;":[149],"identification":[150],"required":[151],"targeted":[152],"LC-MS/MS.":[153],"Six":[154],"cychlorphine":[158,183,256],"concentrations":[159,175],"were":[160],"0.46":[161],"ng/mL":[162,167],"5.0":[166],"urine-to":[169],"our":[170],"knowledge":[171],"first":[173],"human":[174],"reported":[176],"this":[178],"substance.":[179],"In":[180],"vitro":[181],",":[182],"activated":[184],"\u00b5-opioid":[186],"receptor":[187],"with":[188,210,281],"an":[189],"EC":[190],"50":[191,202],"2.7":[193],"nM,":[194],"i.e.":[195],"4.5-fold":[196],"more":[197],"potent":[198,260],"than":[199],"fentanyl":[200],"(EC":[201],"=":[203,217,223],"12.2":[204],"nM)":[205],"within":[206],"same":[208],"assay,":[209],"binding":[212],"affinity":[213],"K":[215,221],"i":[216,222],"1.09":[218],"nM":[219],"(fentanyl:":[220],"1.91":[224],"nM).":[225],"nitazene":[227],"protonitazepyne":[228],"additionally":[230],"urine":[233],"but":[234],"not":[235],"serum,":[239],"indicating":[240],"earlier":[241],"intake":[242],"terminal":[244],"elimination":[245],"at":[246,268],"time":[248],"event.":[251],"Conclusion":[252],"This":[253],"case":[254],"documents":[255],"highly":[259],"NSO":[261,304],"capable":[262],"causing":[264],"depression":[267,309],"sub-nanogram-per-millilitre":[269],"concentrations,":[271],"illustrates":[273],"specific":[275],"danger":[276],"benzodiazepine":[278,316],"adulterated":[280],"opioids.":[282],"No":[283],"pharmacokinetic":[284],"data":[285],"are":[286,328],"available":[287],"cychlorphine.":[289],"concentration,":[291],"measured":[292],"post-intake,":[295],"therefore":[296],"likely":[297],"underestimates":[298],"peak":[299],"exposure.":[300],"Clinicians":[301],"should":[302],"consider":[303],"exposure":[305],"unexplained":[307],"NPS":[311],"use,":[312],"even":[313],"where":[314],"expected.":[318],"Accessible":[319],"drug-checking":[320],"services,":[321],"take-home":[322],"naloxone":[323],"NSO-capable":[325],"confirmatory":[326],"analysis":[327],"needed.":[329]},"counts_by_year":[],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2026-10-21T00:00:00"}