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psx:substance/acetylfentanyl/claim/10517622-eaf5-471d-85d0-b90bf1b81259

claim2026-05-08recordsupported

feeds · downstream

Closure of psx:substance/acetylfentanyl/claim/10517622-eaf5-471d-85d0-b90bf1b81259: 61 upstream, 66 downstream.

psx:substance/acetylfentanyl/claim/10517622-eaf5-471d-85d0-b90bf1b81259
├─ used  src/doi:10.1111/1556-4029.13517  Report of Increasing Overdose Deaths that include Acetyl Fentanyl in Multiple Counties of the Southwestern Region of Pennsylvania in 2015-2016.
  ├─ informed_by  claim/83362a5e-f849-4763-89b0-51f246d8c40d  Claim in safety — inconclusive  working
  ├─ informed_by  claim/d6807154-fdda-4682-89e7-e61dbc844f10  Claim in safety — inconclusive  working
  ├─ informed_by  claim/11512751-c761-468b-bb30-5ee284a472e8  Claim in safety — supported
  ├─ informed_by  claim/a28db923-f0c2-4a96-b4b5-244793906e78  Claim in safety — supported
  ├─ informed_by  claim/da744bf7-cee3-49ba-bc0a-2b4d332c68d2  Claim in safety — supported
  ├─ informed_by  claim/c98450b2-a47e-405b-a062-a4d13538333c  Claim in safety — supported
  ├─ informed_by  claim/b0bf7ba3-5d2f-47ac-9c46-3b8348d2fb60  Claim in safety — inconclusive  working
  ├─ informed_by  claim/155e61aa-d41a-4fe8-b9ce-fae7bda15bdf  Claim in safety — supported
  ├─ informed_by  claim/7180afb8-1f23-4957-8a96-76d3568e712c  Claim in safety — supported
  ├─ informed_by  claim/ea383487-a699-45d9-ad0e-4d26ae30a42f  Claim in safety — supported
  ├─ informed_by  claim/509596f9-8722-401c-922b-d6cb84e05658  Claim in safety — supported
  ├─ informed_by  claim/bfbfc7ce-870a-470f-bc62-4dfa3ee6f7a4  Claim in safety — supported
  ├─ informed_by  claim/69e9cc68-5633-4ad4-9f0b-2e446dee64a8  Claim in safety — supported
  ├─ informed_by  claim/b5cfa0bb-de2f-4494-991c-7c16d61370ef  Claim in safety — supported
  ├─ informed_by  claim/1bed0adb-d93e-4a77-8f97-ee5d4772769c  Claim in safety — supported
  ├─ informed_by  claim/698e0b92-0d3c-45a2-89ae-91fca79f6492  Claim in safety — not_supported  working
    ├─ used  src/url:c6a0358a3bcf1206  Acetylfentanyl Drug Chemistry Information
    ├─ used  src/doi:10.23907/2017.004  Emerging Synthetic Fentanyl Analogs.
    ├─ used  src/doi:10.1373/clinchem.2017.281626  The Fentanyl Epidemic and Evolution of Fentanyl Analogs in the United States and the European Union.
    ├─ used  src/doi:10.1007/s13181-015-0477-9  Acetyl Fentanyl, a Novel Fentanyl Analog, Causes 14 Overdose Deaths in Rhode Island, March-May 2013.
    ├─ used  src/doi:10.3389/fpsyt.2017.00110  An Expanding World of Novel Psychoactive Substances: Opioids
    ├─ used  src/doi:10.1097/ADM.0000000000000324
    ├─ used  src/doi:10.1016/j.legalmed.2016.05.006  An autopsy case of acetyl fentanyl intoxication caused by insufflation of 'designer drugs'.
    ├─ used  src/doi:10.15585/mmwr.mm6643e1  Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700 - 10 States, July-December 2016.
    ├─ used  src/url:388d156ea48b04ce  EMCDDA-Europol Joint Report on Acetylfentanyl
    ├─ used  src/doi:10.3389/fphar.2019.00238  Metabolic Pathways and Potencies of New Fentanyl Analogs.
    ├─ used  src/doi:10.1111/1556-4029.13840  Acetyl Fentanyl: Trends and Concentrations in Metro Detroit.
    ├─ used  src/pmid:28591974  Schedules of Controlled Substances: Placement of Acetyl Fentanyl Into Schedule I. Final order.
    ├─ used  src/doi:10.1016/j.forsciint.2019.109999  Distribution of synthetic opioids in postmortem blood, vitreous humor and brain.
    ├─ used  src/doi:10.1248/bpb.b20-00780  Evaluation of Agonistic Activity of Fluorinated and Nonfluorinated Fentanyl Analogs on μ-Opioid Receptor Using a Cell-Based Assay System.
    ├─ used  src/doi:10.1007/s11419-021-00602-w  Agonistic activity of fentanyl analogs and their metabolites on opioid receptors.
    ├─ used  src/doi:10.1007/s11419-018-0425-x  Use of hepatocytes isolated from a liver-humanized mouse for studies on the metabolism of drugs: application to the metabolism of fentanyl and acetylfentanyl.
    ├─ used  src/doi:10.3389/fphar.2018.01210  Postmortem Toxicology of New Synthetic Opioids.
    ├─ used  src/doi:10.1093/jat/bkab051  Long-Term Stability of 13 Fentanyl Analogs in Blood.
    ├─ used  src/doi:10.1016/j.pbb.2023.173572  Fentanyl analog structure-activity relationships demonstrate determinants of diverging potencies for antinociception and respiratory depression.
    ├─ used  src/doi:10.1093/jat/bkab085  Fentanyl, Acetylfentanyl and Carfentanil in Impaired Driving Cases: A Review of 270 Cases.
    ├─ used  src/doi:10.1093/jat/bkv043  An Acute Acetyl Fentanyl Fatality: A Case Report With Postmortem Concentrations.
    ├─ used  src/doi:10.1177/1925362119892005  Evaluation of Acetylfentanyl Following Suspected Heroin Overdose When Complicated by the Presence of Toxic Fentanyl and Alprazolam Concentrations.
    ├─ used  src/doi:10.1080/15563650.2018.1554187  New synthetic opioid cyclopropylfentanyl together with other novel synthetic opioids in respiratory insufficient comatose patients.
    ├─ used  src/doi:10.1007/s00213-024-06641-6  Reinforcing effects of fentanyl analogs found in illicit drug markets.
    ├─ derived_from  gen/d6774ac7-810c-49b0-8361-dcb7efae68a8  Generation — pipeline-v5
    ├─ generated_by  pub/79793a1f-556c-4428-8f26-aac0feade377  Publication — backfill
      ├─ used  search/bd22c37a-66ef-4f89-953a-56f4e5db4867  Searched PubChem for "acetylfentanyl"
      ├─ used  search/48c635aa-3563-4d15-aa13-8f3069543b0d  Searched PubMed for "acetylfentanyl pharmacology opioid receptor"
      ├─ used  search/8d477b95-9296-4a9b-a519-7ab1ec6ca7c4  Searched PubMed for "acetylfentanyl overdose death toxicology"
      ├─ used  search/4de15a0a-57c9-4b67-a262-c3807fde69ab  Searched OpenAlex for "acetylfentanyl fentanyl analog opioid pharmacology"
      ├─ used  search/258fa41c-39c5-45cc-baaa-822a98e107e7  Searched PubMed for "acetylfentanyl Rhode Island outbreak public health deaths 2013"
      ├─ used  search/ee7507c0-1007-453b-b8e2-616cb0f84484  Searched PubMed for "acetylfentanyl metabolism hepatocytes CYP"
      ├─ used  search/3efed21c-f763-4526-8fd8-d0b9d242c60b  Searched PubMed for "acetylfentanyl misuse novel synthetic opioids Prekupec review"
      ├─ used  search/b8acae32-fd8c-46d2-8bd5-665109a8d8bd  Searched ClinicalTrials.gov for "acetylfentanyl"
      ├─ used  search/f738707c-4d66-458e-9a20-5c04f239e0bc  Searched Federal Register / DEA for "acetylfentanyl DEA Schedule I scheduling date"
      ├─ used  search/b4d5d967-9fba-4b71-8bf4-2ebd7b188df8  Searched Web search / EUDA for "acetylfentanyl legal status UK Canada Australia EU scheduling"
      ├─ used  search/056f6898-6bb6-4dc8-bb4a-e0e83868f749  Searched Web for "acetylfentanyl potency morphine fentanyl comparison ED50 LD50"
      ├─ used  search/62925943-d447-49ab-8493-918d2aa4f03b  Searched Web / PMC for "acetylfentanyl potency ED50 LD50 therapeutic index"
      ├─ used  search/ddaa946b-884e-4f02-a6ca-145dec2e96fc  Searched Web for "acetylfentanyl first synthesized Janssen history 1960s"
      ├─ used  search/2e5f557b-6a63-4a9b-8928-708523875457  Searched PubMed / Federal Register for "DEA Schedule I final order acetylfentanyl 2017"
      ├─ used  search/66491023-f3f9-4b87-b76c-663aa8f27b85  Searched Web / Canada.ca for "acetylfentanyl Canada CDSA schedule fentanyl analog"
      ├─ used  search/1975c16d-4f4a-4659-a653-333d8c545acc  Searched Web / Gov.uk for "acetylfentanyl UK Misuse of Drugs Act Class A"
      ├─ used  search/2b1bb709-5552-4b8b-bb38-7bc5b4d818ae  Searched Multiple sources for "acetylfentanyl blood concentration fatal vs non-fatal comparison"
      └─ used  search/7e5d7802-1ebc-4992-a857-c2811cba9a36  Searched Web / DEA drug info sheet for "acetylfentanyl pharmacological data ED50 LD50 therapeutic index"
├─ informed_by  section/safety.full@1
  ├─ used  version/1  Revision 1
  ├─ used  claim/5d16d3b8-a682-4c59-8ff7-d76afccaf73f  Claim in pharmacokinetic-detail — supported
  ├─ used  claim/f907c305-6247-4752-8d7c-3fa4fa405504  Claim in safety — supported
  ├─ used  claim/3e43cc22-e8ff-417f-9ebb-e57ac26fd348  Claim in safety — supported
  ├─ used  claim/fe514e14-b0cb-406d-ac21-abc16d077bc4  Claim in safety — supported
  ├─ used  claim/4603caa5-e1e2-4740-95bd-ac8b32330381  Claim in safety — supported
  ├─ used  claim/355d423c-1f59-4d3c-b56c-022b02dcebbf  Claim in safety — supported
  ├─ used  claim/174876e8-b3d2-44be-aa34-31b3da7e737e  Claim in clinical-evidence — supported
    ├─ derived_from  issue/notice@cd57081bd655  Issued notice
    ├─ derived_from  issue/info_card@6f1e42e79d25  Issued info_card
    ├─ derived_from  issue/emergency@f85b2d2362c9  Issued emergency
    ├─ derived_from  issue/info_card@5913a08795e0  Issued info_card
    ├─ informed_by  section/pharmacokinetic-detail.full@1
    ├─ informed_by  section/clinical-evidence.full@1
      ├─ used  claim/6bee80fa-bb2a-44ce-ae36-236c0bfeea79  Claim in summary — inconclusive  working
      ├─ used  claim/d3f02d8c-9f52-47a5-b63a-87d0a6f07450  Claim in summary — inconclusive  working
      ├─ used  claim/3dc92892-a570-4635-9c56-b0e0868f9343  Claim in pharmacology — inconclusive  working
      ├─ used  claim/fa96a879-f55d-4dd8-859a-96e54d0102d7  Claim in history — inconclusive  working
      ├─ used  claim/5b45f32a-2075-4c8b-af3b-43f4f157ce3b  Claim in history — inconclusive  working
      ├─ used  claim/a614e963-bc5e-4361-be26-7c25b9db4261  Claim in history — inconclusive  working
      ├─ used  claim/9bf9ae4e-62c1-40c6-822b-720e4c27cbab  Claim in chemistry — inconclusive  working
      ├─ used  claim/4b9a99a4-3983-4c47-8fc0-35bf21ad4462  Claim in comparative-pharmacology — inconclusive  working
      ├─ used  claim/06f4ecb7-a951-4033-8cd0-8a7739aa9827  Claim in summary — inconclusive  working
      ├─ used  claim/c8857a96-7211-4cd2-994f-003d2668234f  Claim in history — inconclusive  working
      ├─ used  claim/a511dab7-50ba-406d-8a98-002f207e9bc7  Claim in history — inconclusive  working
      ├─ used  claim/8cc81b4e-ec96-4a18-b33c-21c08f5254eb  Claim in chemistry — inconclusive  working
      ├─ used  claim/cab311ab-db3c-4e90-8bb6-eef505989144  Claim in summary — supported
      ├─ used  claim/2acbc21a-14bf-4717-81f8-11073d872c96  Claim in history — supported
      ├─ used  claim/c9505bdf-857a-4a44-a99a-28071218d145  Claim in summary — supported
      ├─ used  claim/6f6e540a-4427-46d6-96bd-f64497bb371f  Claim in pharmacology — supported
      ├─ used  claim/ca685156-fc9c-488e-9ae3-e56913a78be8  Claim in history — inconclusive  working
      ├─ used  claim/aa2e4782-a2ad-4c92-8fb4-509294217e4e  Claim in summary — supported
      ├─ used  claim/0e7acdf6-b7b7-4b72-855f-1315e03c726a  Claim in pharmacology — supported
      ├─ used  claim/21d2f1f0-bce7-4db2-997a-55747f8a1da3  Claim in history — supported
      ├─ used  claim/d3cae817-404b-44f1-adf4-204a6c7c2216  Claim in summary — inconclusive  working
      ├─ used  claim/8783942f-9703-44a6-82a0-e007b2666d88  Claim in pharmacology — inconclusive  working
      ├─ used  claim/214de479-7e18-4b58-b8c9-887382b5fa8b  Claim in pharmacokinetic-detail — supported
      ├─ used  claim/e3ac4dff-76d2-4ce3-978a-54acdd821f94  Claim in comparative-pharmacology — inconclusive  working
      ├─ used  claim/f6ce78dd-c2bf-4dd3-bcc2-e58fa5247daf  Claim in history — inconclusive  working
      ├─ used  claim/b84dd7e9-0be8-46b3-968d-2fb456ec0e78  Claim in pharmacology — supported
      ├─ used  claim/d3427ef8-c3a1-43fc-a834-9d107ab0e3fc  Claim in history — not_supported  working
      ├─ used  claim/2bc71e3e-c096-4500-b037-9de5b0c4bd58  Claim in pharmacokinetic-detail — supported
      ├─ used  claim/15d4f8bb-dd98-4aae-bcfd-2a2d76b0d747  Claim in history — supported
      ├─ used  claim/676adf46-20cb-4a07-a66f-e2fbeafc1288  Claim in clinical-evidence — supported
      ├─ used  claim/361d867c-bb12-48e7-82ee-db71b5a54a96  Claim in pharmacology — supported
      ├─ used  claim/f7b2657e-7cd1-4ed9-a2aa-9573f5f1f741  Claim in chemistry — supported
      ├─ used  claim/d7a87b86-24c4-4f07-8b75-d42e08c0f4ce  Claim in pharmacokinetic-detail — supported
      ├─ used  claim/681cef72-0f55-41bb-830e-7c110f590b58  Claim in neuroscience — supported
      ├─ used  claim/178d633f-2238-44b7-b36e-4887441e8a88  Claim in pharmacology — supported
      ├─ used  claim/c9f846db-5713-4317-a73f-8e03aed3f86b  Claim in receptor-pharmacology — supported
      ├─ used  claim/e2ec7bd2-2ef4-4131-b408-a1739a88df2c  Claim in comparative-pharmacology — supported
      ├─ used  claim/e74491c1-9515-4fde-9104-876a0505437b  Claim in pharmacology — supported
      ├─ used  claim/8bdd8ff6-ae8a-4142-8134-42d9be062c3d  Claim in receptor-pharmacology — supported
      ├─ used  claim/1f9d7485-3cfd-41bb-a016-d7ad1e6303d8  Claim in comparative-pharmacology — supported
      ├─ used  claim/ac8dd523-3d27-4116-b389-7e9288c16c52  Claim in pharmacology — supported
      ├─ used  claim/00547815-438c-4904-ba4f-c2c8482751f3  Claim in pharmacokinetic-detail — supported
      ├─ used  claim/debe525e-a2b2-4005-af4c-e5bc49351cd5  Claim in pharmacology — inconclusive  working
      ├─ used  claim/beb5c191-5b19-4e50-875e-96a5d2f18a8c  Claim in pharmacokinetic-detail — supported
      ├─ used  claim/39cb2612-2b7a-40fe-959b-2804057598b4  Claim in legal-status — inconclusive  working
      ├─ used  claim/64428375-a307-4023-8ad9-8c9a3b22227a  Claim in pharmacology — supported
      ├─ used  claim/5887847f-738c-49e5-afc3-807f9271f9b2  Claim in receptor-pharmacology — supported
      ├─ used  claim/5362b661-ca97-4ad7-8716-f4290a738dde  Claim in neuroscience — supported
      ├─ used  claim/30d371ae-d178-4de3-aa15-9b9276589e76  Claim in clinical-evidence — supported
      ├─ used  claim/34c83e85-2599-4aa1-88de-6ed3a4d20e8e  Claim in pharmacokinetic-detail — supported
      └─ used  claim/1c48d53a-1a20-47b4-8ec2-10dea4aef00a  Claim in pharmacokinetic-detail — inconclusive  working
… closure truncated at 200 nodes

indented by distance from this node, not by parentage

1Provenance card

the boundary, as counts

Sources

2522 with DOI

5 strong · 13 moderate · 7 weak

Compilations

12026-05-08T11:10:20.875Z

pipeline-v5 · prompt hash not recorded — run predates 2026-09

Decisions

29last ruled 2026-06-04

0 awaiting a ruling

Issued documents

42026-10-19T20:30:25.633Z

notice · info card · emergency

Searches

181 with no results

queries and counts on the build

Claims checked

7550 supported

50 supported · 25 not

Correspondence

0received

consent field ships in Phase 4

Edges

235

derivations recorded for this entity

Complete over 25 sources, 1 compilation, and 29 decisions.Not here: the private journal (never).Working material — drafts, discards, unsupported claims — is listed below and readable on the working page.Cite: psychedex.org/substances/acetylfentanyl/archive

2Build

one panel per compilation run

generation run 2026-05-08

65 min completedmodel pipeline-v5plan not recordedrun/4ae0b0d4…

Selection

results seen75
selected by the model33
consumed as sources25

Verification

claims checked75
supported50
partially supported0
not supported2
inconclusive23
  • record
  • seen / partial
  • working

The model's own caveats

  • sparse_evidence
  • structural_inference
  • safety_data_unverified

Reproduce

inputs
25 source keys (listed under Sources)
plan
not recorded — template version, prompt hash and git SHA are written from 2026-09 onward
model
pipeline-v5
streams
none — agent transcripts are persisted from 2026-09 onward
18 searches — query, source, results, what was kept and why
18 searches for this run
#sourcequeryseenkeptrationale
1Webacetylfentanyl potency morphine fentanyl comparison ED50 LD50102Specific pharmacological parameters not available via API
2PubMedacetylfentanyl Rhode Island outbreak public health deaths 201311Critical historical paper on first US outbreak
3PubMedacetylfentanyl misuse novel synthetic opioids Prekupec review11Key review with epidemiological death counts and naloxone guidance
4PubMedacetylfentanyl pharmacology opioid receptor54Core pharmacology and receptor activity data
5OpenAlexacetylfentanyl fentanyl analog opioid pharmacology105Landmark reviews most relevant to acetylfentanyl pharmacology, metabolism, and epidemiology
6PubMedacetylfentanyl overdose death toxicology1510Epidemiology, overdose concentrations, case reports for toxicity section
7Web search / EUDAacetylfentanyl legal status UK Canada Australia EU scheduling101European legal status and fatality data
8ClinicalTrials.gov · absenceacetylfentanyl00No trials - confirmed acetylfentanyl has no approved medical use or clinical development
9PubChemacetylfentanyl11Primary chemical identity verification
10PubMedacetylfentanyl metabolism hepatocytes CYP11Specific acetylfentanyl metabolism data
11Federal Register / DEAacetylfentanyl DEA Schedule I scheduling date11Primary US legal scheduling source
12Web / Gov.ukacetylfentanyl UK Misuse of Drugs Act Class A11UK legal status - unresolved/flag for review
13Multiple sourcesacetylfentanyl blood concentration fatal vs non-fatal comparison51Verify seed dose/toxicity data and establish fatal concentration ranges
14PubMed / Federal RegisterDEA Schedule I final order acetylfentanyl 201711Primary legal source for US Schedule I status
15Web / PMCacetylfentanyl potency ED50 LD50 therapeutic index11Key source for potency data and historical context
16Web / Canada.caacetylfentanyl Canada CDSA schedule fentanyl analog11Canadian legal status
17Web / DEA drug info sheetacetylfentanyl pharmacological data ED50 LD50 therapeutic index10Pharmacological parameters from DEA document; could not extract directly from PDF
18Webacetylfentanyl first synthesized Janssen history 1960s101Synthesis history data
75 claims by section — every cited sentence, checked against its source
safety22 · 18 ok
  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • This has been confirmed across multiple case series.supported

    First major US public health report on acetylfentanyl. 14 overdose deaths in Rhode Island, March-May 2013. Key early outbreak report. s13181-015-0477-9

  • This has been confirmed across multiple case series.supported

    CDC surveillance of opioid overdose deaths; acetylfentanyl identified in >10% of opioid overdose deaths in some states; confirmed acetylfentanyl as one of the most frequently detected fentanyl analogs. mmwr.mm6643e1

  • This has been confirmed across multiple case series.supported

    41 overdose deaths associated with acetylfentanyl in Pennsylvania 2015-2016. 1556-4029.13517

  • Single-agent fatalities: approximately 250–270 ng/mL peripheral bloodsupported

    Acetylfentanyl peripheral blood 260 ng/mL. Cause of death: acute acetylfentanyl intoxication. No other drugs detected. bkv043

  • Single-agent fatalities: approximately 250–270 ng/mL peripheral bloodsupported

    Blood concentration 270 ng/mL. j.legalmed.2016.05.006

  • Polysubstance fatalities: 0.13–2100 ng/mLsupported

    Blood acetylfentanyl concentrations: range 0.13–2100 ng/mL, median 11 ng/mL. 96% multiple drug toxicities. 1556-4029.13517

  • Claim in safety — inconclusiveinconclusiveworking →

  • Pennsylvania series (n=41): median 11 ng/mL, mean 169.3 ng/mL; 96% involved multiple drugssupported

    41 overdose deaths associated with acetylfentanyl in Pennsylvania 2015-2016. Blood acetylfentanyl concentrations: range 0.13–2100 ng/mL, median 11 ng/mL. 96% multiple drug toxicities. 1556-4029.13517

  • Impaired driving (living subjects): 1.0–9.2 ng/mLsupported

    Acetylfentanyl always co-detected with fentanyl; blood concentrations 1.0–9.2 ng/mL. bkab085

  • The extreme variability in fatal concentrations reflects the dominant role of co-intoxicants, individual opioid tolerance, and postmortem redistribution artifacts.supported

    Review of postmortem toxicology of synthetic opioids. Covers acetylfentanyl: tissue concentration ranges, postmortem redistribution, pharmacokinetic parameters, stability. fphar.2018.01210

  • Postmortem distribution studies demonstrate that brain tissue accumulates the highest concentrations, followed by blood and vitreous humor, consistent with high lipophilicity and preferential CNS sequestration.supported

    Highest concentrations in brain > blood > vitreous humor. j.forsciint.2019.109999

  • The clinical presentation in documented cases uniformly involves loss of consciousness and deep sedation, precluding assessment of acute psychological effects at sub-sedating doses from published forensic data.supported

    Opioid toxidrome: loss of consciousness, bradypnea, hypercapnia, hypotension, miosis. 15563650.2018.1554187

  • The clinical presentation in documented cases uniformly involves loss of consciousness and deep sedation, precluding assessment of acute psychological effects at sub-sedating doses from published forensic data.supported

    NSOs including acetylfentanyl cause classic opioid toxidrome reversible by naloxone. adm.0000000000000324

  • The DEA permanently scheduled acetylfentanyl in Schedule I partly on the basis of its high potential for abusesupported

    Final order maintaining acetylfentanyl in Schedule I CSA, including isomers, esters, ethers, salts. pmid:28591974

  • Maitland and colleagues specifically investigated the reinforcing properties of fentanyl analogs including acetylfentanyl in the context of illicit drug market substancessupported

    There is little information about the reinforcing effects of clandestine fentanyl analogs (FAs). s00213-024-06641-6

  • This mechanism accounts for the majority of documented acetylfentanyl fatalities: 96% of deaths in the Pennsylvania series involved multiple drugs.supported

    96% multiple drug toxicities. 1556-4029.13517

  • Documented in multiple polysubstance fatality series.supported

    41 overdose deaths associated with acetylfentanyl in Pennsylvania 2015-2016. 96% multiple drug toxicities. 1556-4029.13517

  • A documented fatality involved alprazolam at toxic concentration (64.9 µg/L) alongside acetylfentanyl (32.9 µg/L) and fentanyl.supported

    Acetylfentanyl 32.9 μg/L, fentanyl 34.7 μg/L, alprazolam 64.9 μg/L. 1925362119892005

  • Claim in safety — not_supportednot supportedworking →

  • Concurrent CNS depressant use: Co-administration with benzodiazepines, alcohol, GHB/GBL, barbiturates, or other opioids carries lethal synergistic respiratory depression risk, as documented in case series.supported

    41 overdose deaths associated with acetylfentanyl in Pennsylvania 2015-2016. 96% multiple drug toxicities. 1556-4029.13517

history11 · 3 ok
  • Between March and May 2013, 14 overdose deaths in Rhode Island, United States, were attributed to acetylfentanyl — the first major outbreak documented in the published literaturesupported

    First major US public health report on acetylfentanyl. 14 overdose deaths in Rhode Island, March-May 2013. Key early outbreak report. s13181-015-0477-9

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — not_supportednot supportedworking →

  • Analysis of the Detroit metropolitan area showed that earlier cases (2015–2016) presented acetylfentanyl as the primary or co-primary intoxicant with mean blood concentrations of 8.9 ng/mL, whereas later cases (2016–2017) showed it predominantly as a minor component alongside fentanyl, with mean concentrations of only 0.9 ng/mLsupported

    2016-2017 Detroit deaths: mean acetylfentanyl 0.9 ng/mL; 2015-2016 cohort: mean 8.9 ng/mL acetylfentanyl. Trend shift toward fentanyl-primary with acetylfentanyl artifact of manufacture. 1556-4029.13840

  • Claim in history — inconclusiveinconclusiveworking →

  • By 2017, 52 confirmed acetylfentanyl deaths had been documented in the United States since 2013supported

    52 acetylfentanyl deaths in US since 2013. adm.0000000000000324

pharmacology11 · 8 ok
  • Acetylfentanyl is a full agonist at the mu-opioid receptor (MOR), the primary molecular target responsible for its analgesic, euphoric, and respiratory depressant effectssupported

    Comprehensive review of novel synthetic opioids including fentanyl analogs. Covers pharmacological properties, patterns of use, desired/unwanted effects, fatal and non-fatal intoxications. fpsyt.2017.00110

  • Acetylfentanyl is a full agonist at the mu-opioid receptor (MOR), the primary molecular target responsible for its analgesic, euphoric, and respiratory depressant effectssupported

    NSOs including acetylfentanyl cause classic opioid toxidrome reversible by naloxone. adm.0000000000000324

  • Cell-based assay data established a rank order of MOR agonistic activity among fentanyl analogs: fentanyl > isobutyrylfentanyl ≈ butyrylfentanyl ≈ methoxyacetylfentanyl > acetylfentanylsupported

    Agonistic activity of fentanyl analogs on μ-opioid receptor via cell-based assay. Rank: fentanyl > isobutyrylfentanyl ≈ butyrylfentanyl ≈ methoxyacetylfentanyl > acetylfentanyl. bpb.b20-00780

  • A subsequent study confirmed that this rank order extended to the compounds' metabolites.supported

    Study measuring agonistic activity of fentanyl analogs and metabolites on opioid receptors using cell-based assay. Acetylfentanyl rank: fentanyl > isobutyrylfentanyl ≈ butyrylfentanyl ≈ methoxyacetylfentanyl > acetylfentanyl. s11419-021-00602-w

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Postmortem distribution studies demonstrate that brain tissue accumulates higher concentrations than peripheral blood or vitreous humor, consistent with preferential CNS sequestrationsupported

    Postmortem distribution of synthetic opioids in 58 NYC-OCME cases; acetylfentanyl detected; highest concentrations in brain > blood > vitreous humor. j.forsciint.2019.109999

  • Metabolism: A liver-humanized mouse study using PXB-cells (hepatocytes from chimeric humanized-liver mice) directly characterized acetylfentanyl's metabolic pathwayssupported

    Liver-humanized mouse hepatocytes used to characterize acetylfentanyl metabolism; predictive model for human in vivo metabolism. s11419-018-0425-x

  • The general metabolic scheme reviewed for fentanyl analogs applies:supported

    Systematic review of metabolic profiles of new fentanyl analogs. Metabolism involves hydrolysis, hydroxylation, N/O-dealkylation, O-methylation, and phase II glucuronide/sulfate conjugation. fphar.2019.00238

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Analytical stability: Acetylfentanyl is stable in blood specimens for up to 9 months under refrigerated (4°C) and room-temperature storage conditions, distinguishing it from less stable analogs such as acryloylfentanylsupported

    Validated method and stability study for 13 fentanyl analogs in blood; acetylfentanyl stable under refrigerated/room temp conditions for 9 months. bkab051

pharmacokinetic-detail8 · 7 ok
  • Single-agent fatalities: approximately 250–270 ng/mL peripheral bloodsupported

    Acetylfentanyl peripheral blood 260 ng/mL, central blood 250 ng/mL. Cause of death: acute acetylfentanyl intoxication. bkv043

  • Single-agent fatalities: approximately 250–270 ng/mL peripheral bloodsupported

    Blood concentration 270 ng/mL. j.legalmed.2016.05.006

  • Polysubstance fatalities: 0.13–2100 ng/mL, reflecting co-intoxicant effects and tolerance variabilitysupported

    Blood acetylfentanyl concentrations: range 0.13–2100 ng/mL, median 11 ng/mL. 96% multiple drug toxicities. 1556-4029.13517

  • Claim in pharmacokinetic-detail — inconclusiveinconclusiveworking →

  • Brain concentrations of acetylfentanyl exceeded those in peripheral blood and vitreous humor, consistent with the high lipophilicity characteristic of the anilidopiperidine classsupported

    Highest concentrations in brain > blood > vitreous humor. j.forsciint.2019.109999

  • Postmortem redistribution from central to peripheral blood compartments has been documented, complicating interpretation of postmortem blood concentrations.supported

    Covers acetylfentanyl: tissue concentration ranges, postmortem redistribution, pharmacokinetic parameters, stability. fphar.2018.01210

  • The most species-relevant metabolic characterization was conducted using PXB-cells — hepatocytes isolated from liver-humanized chimeric micesupported

    Liver-humanized mouse hepatocytes used to characterize acetylfentanyl metabolism; predictive model for human in vivo metabolism. s11419-018-0425-x

  • Major Phase I metabolic pathways include acetamide bond hydrolysis (yielding 4-ANPP), N-dealkylation (yielding nor-acetylfentanyl), and hydroxylation at piperidine and phenyl ring positionssupported

    Metabolism involves hydrolysis, hydroxylation, N/O-dealkylation, O-methylation, and phase II glucuronide/sulfate conjugation. fphar.2019.00238

summary7 · 3 ok
  • Claim in summary — inconclusiveinconclusiveworking →

  • Claim in summary — inconclusiveinconclusiveworking →

  • It appeared on illicit drug markets in 2012–2013, initially sold as a "research chemical," and rapidly generated public health concern after 14 overdose deaths in Rhode Island between March and May 2013supported

    First major US public health report on acetylfentanyl. 14 overdose deaths in Rhode Island, March-May 2013. Key early outbreak report. s13181-015-0477-9

  • Acetylfentanyl acts as a full agonist at the mu-opioid receptor, producing the classical opioid effect constellation: analgesia, sedation, euphoria, anxiolysis, and dose-dependent respiratory depressionsupported

    Comprehensive review of novel synthetic opioids including fentanyl analogs. Covers pharmacological properties, patterns of use, desired/unwanted effects, fatal and non-fatal intoxications. fpsyt.2017.00110

  • Acetylfentanyl acts as a full agonist at the mu-opioid receptor, producing the classical opioid effect constellation: analgesia, sedation, euphoria, anxiolysis, and dose-dependent respiratory depressionsupported

    NSOs including acetylfentanyl cause classic opioid toxidrome reversible by naloxone. adm.0000000000000324

  • Claim in summary — inconclusiveinconclusiveworking →

  • Claim in summary — inconclusiveinconclusiveworking →

comparative-pharmacology4 · 2 ok
  • Cell-based MOR functional assays rank acetylfentanyl at the lower end of the anilidopiperidine potency spectrum: fentanyl > isobutyrylfentanyl ≈ butyrylfentanyl ≈ methoxyacetylfentanyl > acetylfentanylsupported

    Rank: fentanyl > isobutyrylfentanyl ≈ butyrylfentanyl ≈ methoxyacetylfentanyl > acetylfentanyl. bpb.b20-00780

  • Cell-based MOR functional assays rank acetylfentanyl at the lower end of the anilidopiperidine potency spectrum: fentanyl > isobutyrylfentanyl ≈ butyrylfentanyl ≈ methoxyacetylfentanyl > acetylfentanylsupported

    Acetylfentanyl rank: fentanyl > isobutyrylfentanyl ≈ butyrylfentanyl ≈ methoxyacetylfentanyl > acetylfentanyl. s11419-021-00602-w

  • Claim in comparative-pharmacology — inconclusiveinconclusiveworking →

  • Claim in comparative-pharmacology — inconclusiveinconclusiveworking →

chemistry3 · 1 ok
  • Claim in chemistry — inconclusiveinconclusiveworking →

  • Claim in chemistry — inconclusiveinconclusiveworking →

  • As an anilidopiperidine, acetylfentanyl exhibits high lipophilicity — a class property that enables rapid blood-brain barrier penetration and significant CNS accumulation, as confirmed by postmortem distribution studies showing brain concentrations exceeding those in peripheral blood.supported

    Highest concentrations in brain > blood > vitreous humor. j.forsciint.2019.109999

clinical-evidence3 · 3 ok
  • The compound has no approved medical indication in any jurisdiction and was permanently placed in DEA Schedule I in 2017, a classification that designates the substance as having no currently accepted medical use.supported

    Final order maintaining acetylfentanyl in Schedule I CSA, including isomers, esters, ethers, salts. pmid:28591974

  • All available human data derive from poisoning case reports, postmortem toxicology, and impaired driving analyses.supported

    Retrospective study of 270 impaired driving cases (2017–2019) positive for fentanyl, carfentanil, or acetylfentanyl. bkab085

  • All available human data derive from poisoning case reports, postmortem toxicology, and impaired driving analyses.supported

    41 overdose deaths associated with acetylfentanyl in Pennsylvania 2015-2016. Blood acetylfentanyl concentrations. 1556-4029.13517

receptor-pharmacology3 · 3 ok
  • The rank order of MOR activity was: fentanyl > isobutyrylfentanyl ≈ butyrylfentanyl ≈ methoxyacetylfentanyl > acetylfentanylsupported

    Rank: fentanyl > isobutyrylfentanyl ≈ butyrylfentanyl ≈ methoxyacetylfentanyl > acetylfentanyl. bpb.b20-00780

  • A follow-up study extended this rank order to the metabolites of these compoundssupported

    Study measuring agonistic activity of fentanyl analogs and metabolites on opioid receptors. s11419-021-00602-w

  • A structure-activity relationship study across the N-acyl chain length series (acetylfentanyl → fentanyl → butyrylfentanyl → valerylfentanyl) demonstrated that the rank order of potencies for respiratory depression (hypoventilation) diverges from the rank order for antinociceptionsupported

    SAR study of 17 fentanyl-related substances including acetylfentanyl. Acetylfentanyl among the series evaluated for antinociception and hypoventilation in mice. Rank order of potencies for hypoventilation established. j.pbb.2023.173572

neuroscience2 · 2 ok
  • Postmortem distribution data showing preferential brain accumulation of acetylfentanyl relative to blood and vitreous humor confirm the compound's high CNS partitioning, consistent with the rapid onset of central effects observed clinically.supported

    Highest concentrations in brain > blood > vitreous humor. j.forsciint.2019.109999

  • Does the divergence between antinociceptive and respiratory depressant potency rank orders within the N-acyl series reflect biased agonism at MOR (differential G-protein vs. beta-arrestin signaling), or pharmacokinetic differences in brainstem vs. spinal cord drug delivery?supported

    SAR study of 17 fentanyl-related substances including acetylfentanyl. Evaluated for antinociception and hypoventilation in mice. Rank order of potencies for hypoventilation established across N-acyl chain length series. j.pbb.2023.173572

legal-status1 · 0 ok
  • Claim in legal-status — inconclusiveinconclusiveworking →

3Sources

25 consumed · sorted by year · feeds = sections resting on it

Sources
yearsourcetierstatusfeeds
2024Reinforcing effects of fentanyl analogs found in illicit drug markets.Maitland AD, McGriff SA, Glatfelter GC, Schindler CW, Baumann MH · Psychopharmacologydoi:10.1007/s00213-024-06641-6moderateconsumed1 section
2023Fentanyl analog structure-activity relationships demonstrate determinants of diverging potencies for antinociception and respiratory depression.Varshneya NB, Hassanien SH, Holt MC, Stevens DL, Layle NK, Bassman JR, Iula DM, Beardsley PM · Pharmacology, biochemistry, and behaviordoi:10.1016/j.pbb.2023.173572moderateconsumed2 sections
2022Agonistic activity of fentanyl analogs and their metabolites on opioid receptors.Kanamori T, Okada Y, Segawa H, Yamamuro T, Kuwayama K, Tsujikawa K, Iwata YT · Forensic toxicologydoi:10.1007/s11419-021-00602-wmoderateconsumed3 sections
2021Evaluation of Agonistic Activity of Fluorinated and Nonfluorinated Fentanyl Analogs on μ-Opioid Receptor Using a Cell-Based Assay System.Kanamori T, Okada Y, Segawa H, Yamamuro T, Kuwayama K, Tsujikawa K, Iwata YT · Biological & pharmaceutical bulletindoi:10.1248/bpb.b20-00780moderateconsumed3 sections
2021Fentanyl, Acetylfentanyl and Carfentanil in Impaired Driving Cases: A Review of 270 Cases.Kiely E, Juhascik M · Journal of analytical toxicologydoi:10.1093/jat/bkab085moderateconsumed2 sections
2021Long-Term Stability of 13 Fentanyl Analogs in Blood.Palmquist KB, Swortwood MJ · Journal of analytical toxicologydoi:10.1093/jat/bkab051moderateconsumed1 section
2019Acetyl Fentanyl: Trends and Concentrations in Metro Detroit.Avedschmidt S, Schmidt C, Isenschmid D, Kesha K, Moons D, Gupta A · Journal of forensic sciencesdoi:10.1111/1556-4029.13840moderateconsumed1 section
2019Distribution of synthetic opioids in postmortem blood, vitreous humor and brain.Chesser R, Pardi J, Concheiro M, Cooper G · Forensic science internationaldoi:10.1016/j.forsciint.2019.109999moderateconsumed5 sections
2019Evaluation of Acetylfentanyl Following Suspected Heroin Overdose When Complicated by the Presence of Toxic Fentanyl and Alprazolam Concentrations.Fagiola M, Hahn T, Avella J · Academic forensic pathologydoi:10.1177/1925362119892005weakconsumed2 sections
2019Metabolic Pathways and Potencies of New Fentanyl Analogs.Wilde M, Pichini S, Pacifici R, Tagliabracci A, Busardò FP, Auwärter V, Solimini R · Frontiers in pharmacologydoi:10.3389/fphar.2019.00238strongconsumed3 sections
2019New synthetic opioid cyclopropylfentanyl together with other novel synthetic opioids in respiratory insufficient comatose patients.Müller D, Neurath H, Neukamm MA et al. · Clinical toxicologydoi:10.1080/15563650.2018.1554187weakconsumed1 section
2019The Fentanyl Epidemic and Evolution of Fentanyl Analogs in the United States and the European Union.Jannetto PJ, Helander A, Garg U, Janis GC, Goldberger B, Ketha H · Clinical chemistrydoi:10.1373/clinchem.2017.281626strongconsumed3 sections
2018Postmortem Toxicology of New Synthetic Opioids.Concheiro M, Chesser R, Pardi J, Cooper G · Frontiers in pharmacologydoi:10.3389/fphar.2018.01210strongconsumed4 sections
2018Report of Increasing Overdose Deaths that include Acetyl Fentanyl in Multiple Counties of the Southwestern Region of Pennsylvania in 2015-2016.Dwyer JB, Janssen J, Luckasevic TM, Williams KE · Journal of forensic sciencesdoi:10.1111/1556-4029.13517moderateconsumed3 sections
2018Use of hepatocytes isolated from a liver-humanized mouse for studies on the metabolism of drugs: application to the metabolism of fentanyl and acetylfentanyl.Kanamori T, Togawa-Iwata Y, Segawa H, Yamamuro T, Kuwayama K, Tsujikawa K, Inoue H · Forensic toxicologydoi:10.1007/s11419-018-0425-xmoderateconsumed2 sections
2017Acetylfentanyl Drug Chemistry InformationDrug Enforcement Administrationurl:c6a0358a3bcf1206weakconsumedcited only
2017An Expanding World of Novel Psychoactive Substances: OpioidsZawilska JB · Frontiers in Psychiatrydoi:10.3389/fpsyt.2017.00110strongconsumed3 sections
2017Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700 - 10 States, July-December 2016.O'Donnell JK, Halpin J, Mattson CL, Goldberger BA, Gladden RM · MMWR. Morbidity and mortality weekly reportdoi:10.15585/mmwr.mm6643e1moderateconsumed2 sections
2017Emerging Synthetic Fentanyl Analogs.Schueler HE · Academic forensic pathologydoi:10.23907/2017.004moderateconsumed6 sections
2017Misuse of Novel Synthetic Opioids: A Deadly New Trend.Prekupec MP, Mansky PA, Baumann MH · Journal of addiction medicinedoi:10.1097/adm.0000000000000324strongconsumedcited only
2017Schedules of Controlled Substances: Placement of Acetyl Fentanyl Into Schedule I. Final order.Drug Enforcement Administration · Federal registerpmid:28591974moderateconsumed2 sections
2016An autopsy case of acetyl fentanyl intoxication caused by insufflation of 'designer drugs'.Takase I, Koizumi T, Fujimoto I, Yanai A, Fujimiya T · Legal medicine (Tokyo, Japan)doi:10.1016/j.legalmed.2016.05.006weakconsumed5 sections
2016EMCDDA-Europol Joint Report on AcetylfentanylEMCDDA/Europol · European Monitoring Centre for Drugs and Drug Addictionurl:388d156ea48b04ceweakconsumedcited only
2015Acetyl Fentanyl, a Novel Fentanyl Analog, Causes 14 Overdose Deaths in Rhode Island, March-May 2013.Lozier MJ, Boyd M, Stanley C, Ogilvie L, King E, Martin C, Lewis L · Journal of medical toxicologydoi:10.1007/s13181-015-0477-9weakconsumed3 sections
2015An Acute Acetyl Fentanyl Fatality: A Case Report With Postmortem Concentrations.McIntyre IM, Trochta A, Gary RD, Malamatos M, Lucas JR · Journal of analytical toxicologydoi:10.1093/jat/bkv043weakconsumed2 sections
—Searched ClinicalTrials.gov for "acetylfentanyl" — no resultsabsenceno results—

4Docket

one filing per activity — decisions, correspondence, reports

  1. 0012026-05-08revisionRevision 1

    Initial LLM generation (v5 pipeline, wiki, prose phase)

    psx:substance/acetylfentanyl/version/1
  2. 0022026-06-04proposal27 value proposals approved together

    one review action inferred from a shared reviewer and instant — the graph records one activity per proposal

    27 items in this filing

    • contraindication · other
    • contraindication · other
    • contraindication · hepatic
    • contraindication · neurological
    • contraindication · pregnancy_breastfeeding
    • dose_tier · threshold
    • dose_tier · light
    • dose_tier · common
    • dose_tier · strong
    • dose_tier · heavy
    • toxicity
    • dependence · full
    • withdrawal
    • tolerance
    • dosage · sublingual
    • dosage · insufflated
    • duration · sublingual · onset
    • duration · sublingual · total
    • duration · insufflated · onset
    • duration · insufflated · total
    • timeline · sublingual · onset
    • timeline · sublingual · peak
    • timeline · sublingual · resolution
    • timeline · insufflated · onset
    • timeline · insufflated · peak
    • timeline · insufflated · resolution
    psx:substance/acetylfentanyl/proposal/contraindication/86ea3e28-386f-4525-b78d-9469b06bd06e
  3. 0032026-06-04publicationPublication — backfill

5Issued documents

what the notice, info card and emergency page said, by hash

Issued documents
documentcontent hashissuedfrom versionsuperseded
info_card5913a08795e08fb311700a39…2026-10-19 20:30Revision 1current
emergencyf85b2d2362c98030e2585598…2026-09-04 04:28Revision 1current
info_card6f1e42e79d255d8b585886bd…2026-09-04 04:28Revision 1superseded2026-10-19
noticecd57081bd655e4119e4a6735…2026-09-04 04:28Revision 1current