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A new synthetic opioid gaining presence is U-49900. U-49900 is a structural analogue of U-47700, another synthetic opioid recently scheduled by the drug enforcement administration (DEA) to address toxicity-related fatalities as a result of its inappropriate use in the past two years [2]. The Upjohn Company, Michigan, USA, developed both U-47700 and U-49900; however, this substance is not scheduled federally [1]. U-49900 never received food and drug administration (FDA) approval, and, presently, no clinical trial data exists for it.

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Although preclinical data on rodents exist for U-47700, describing its potency and pharmacodynamics [3], no preclinical data associated with the development of U-49900 exists. Currently, the only published clinical data available on this substance is a singular case report from the United States of a 31-year-old male who ingested this substance and returned a positive metabolite from a urine specimen; there were no reported signs or symptoms associated with the use of U-49900 [1]. Given that the potency of U-47700 is theorized to be 7.5 times that of morphine and the structural similarities between U-47700 and this substance, there is cause for concern regarding the risks associated with this substance use [1].

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Very little is known about U-49900’s toxico-epidemiology. A simple online search of “U-49900” retrieved multiple results advertising this substance as a “research chemical.” Some of the vendors listed this substance as a “hot-selling” item, having an “effect stronger than U-47700,” and of being “top-quality.” Purchasing this substance is straightforward; however, this is not surprising since it follows a similar trend to that of other synthetic opioids made readily available for purchase as a supposed “research chemical.

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Interestingly, individuals are willing to take the risk of trying this substance and posting about their experience online. The popular website Reddit currently hosts a forum known as “Research Chemicals” where individuals describe their experiences with synthetic agents [4]. A search for “U-49900” within this particular forum revealed individuals describing little to no effect from this substance at doses ranging from 5 mg to 75 mg by intravenous injection, insufflation, or oral ingestion. Furthermore, individuals state that the odor of U-49900 is caustic, it provides no analgesic relief, can cause loss of smell/taste, can cause nerve damage, and can produce a foam-like substance in the lungs [4]. Although these claims are anecdotal in nature, this information can provide clues to clinicians who may encounter patients taking this substance

Tags: new psychoactive substances; new synthetic opioids; illicit fentanyl; Mitragyna speciosa; o-desmethyltramadol; novel fentanyl derivatives; new generation of novel synthetic opioids; harm reduction strategies; comprehensive treatment; CAS 67579-76-4