A survey of Eutylone Prevalence in New Zealand during 2020 and 2021

ABSTRACT

Aim This study provides an insight into the prevalence of eutylone in New Zealand by analysis of the post-mortem forensic toxicology cases over the period 2020 and 2021, as well as analysis of suspected drug items collected from three music festivals between December 2020 and February 2021. Eutylone, also known as bk-EBDB or n-ethylbutylone, is a synthetic cathinone that has no known therapeutic use. In New Zealand it is sold recreationally as an alternative to methylendioxymethamphetamine (MDMA) and has increasingly been found as an adulterant or substitution substance in MDMA samples. Eutylone is known to cause harm and has been associated with fatalities [World Health Organization. “WHO Expert Committee on Drug Dependence forty-fourth report.” (2022)]. In many cases, users are unaware that the eutylone is present believing they are taking MDMA. Method ESR undertakes post-mortem forensic toxicology casework for the whole of New Zealand. We investigated the post-mortem cases received during 2020 and 2021 for eutylone and investigated trends. In addition to the post-mortem forensic toxicology cases, ESR analysed 656 drug samples from three music festivals held between December 2020 and February 2021 for the presence of drugs including eutylone. Results The post-mortem blood samples were analysed using liquid chromatography with time of flight mass spectrometry (LC-TOFMS) for eutylone. Eutylone was detected in three cases during 2020 and in twelve (12) cases during 2021. Of the 12 cases from 2021, ten decedents were male, nine cases had a known cause of death (e.g. hanging), two cases were at or just after a music festival and two cases appeared to be drug overdoses where multiple drugs were involved. Eutylone was the only drug detected in three of the cases (all with a known cause of death). When other drugs were involved the most common were methamphetamine (n=4), MDMA (n=3), alcohol (n=3) and cannabis (n=3). For the 656 samples analysed from the three music festivals MDMA and eutylone were detected in 33% and 32% of the samples, respectively. This can be contrasted with a previous survey from December 2018 to March 2019 that found MDMA in 64% of samples and eutylone detected in less than 1% of the samples. If a mixture was present in a sample, it was common for it to contain both eutylone and MDMA. Conclusion There was a significant increase in eutylone detections both in blood samples from post-mortem forensic toxicology casework and in seized drug samples over the time period studied, with associated increases in the harm, including deaths, associated with the drug use. It has been postulated that this trend was influenced by factors such as the limited supply of MDMA in New Zealand due to law enforcement activity including a large MDMA seizure prior to the survey period for the music festivals, COVID-19 restrictions and the use of eutylone as an adulterant or replacement drug.