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AH-7921 is an
opioid Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. Other medical uses include suppression of diarrhea, replacement therapy for opioid us ...
analgesic An analgesic drug, also called simply an analgesic (American English), analgaesic (British English), pain reliever, or painkiller, is any member of the group of drugs used to achieve relief from pain (that is, analgesia or pain management). It ...
drug selective for the
μ-opioid receptor The μ-opioid receptors (MOR) are a class of opioid receptors with a high affinity for enkephalins and beta-endorphin, but a low affinity for dynorphins. They are also referred to as μ(''mu'')-opioid peptide (MOP) receptors. The prototypical Π...
, having around 90% the potency of
morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a analgesic, pain medication, and is also commonly used recreational drug, recreationally, or to make ...
when administered orally. It was discovered in the 1970s by a team at
Allen and Hanburys Allen and Hanburys Ltd was a British pharmaceutical manufacturer, absorbed by Glaxo Laboratories in 1958. GlaxoSmithKline, its successor company, used the Allen and Hanburys name for the specialist respiratory division until beginning to phase ...
located in the United Kingdom. The drug is considered a new psychoactive substance (NPS) in which it is synthetically created in laboratories to mimic that of controlled substances. The substance has also been sold on the internet since 2012 as a "research chemical". When sold online it may be called the alternative name doxylam, not to be confused with
doxylamine Doxylamine, sold under the brand name Unisom among others, is an antihistamine medication which is used in the treatment of insomnia and allergies. In combination with pyridoxine ( vitamin B6), it is also used to treat morning sickness in pre ...
. AH-7921 has never progressed to clinical trials. The DEA is not aware of any medical usage in the United States, and has not insisted the Health and Human Services department (HHS) to conduct any medical research of the substance's uses.


Types of administration

* Intravenous injection * Nasal insufflation * Oral or rectal (when in the form of a powder, tablet, or capsule) * Sublingual application


Side effects and withdrawal

With doses that usually range from 10 to 150 mg, users are likely to experience effects similar to
heroin Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brow ...
,
morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a analgesic, pain medication, and is also commonly used recreational drug, recreationally, or to make ...
, and
fentanyl Fentanyl, also spelled fentanil, is a very potent synthetic opioid used as a pain medication. Together with other drugs, fentanyl is used for anesthesia. It is also used illicitly as a recreational drug, sometimes mixed with heroin, cocaine ...
such as euphoria and respiratory depression. When an overdose occurs users often experience
tachycardia Tachycardia, also called tachyarrhythmia, is a heart rate that exceeds the normal resting rate. In general, a resting heart rate over 100 beats per minute is accepted as tachycardia in adults. Heart rates above the resting rate may be normal (su ...
,
hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
, and seizures. Mice, dogs, and monkeys, have been used in tests which showed the drug was almost equivalently potent to morphine, and had a very steep dose response curve. Rats given 20 mg doses three times a day for five days, experienced withdrawal symptoms similar to other opioids. Reports have shown users to experience depression and insomnia when withdrawing from this drug.


Chemistry

AH-7921 is commonly found as an off-white solid with a melting point between 215–216 degrees Celsius. It is one single covalently bonded unit with 4 rotatable bonds. It also has two hydrogen bond acceptors, and one hydrogen bond donor.


Use

Although AH-7921 was extensively studied in vitro and in animals, though not in humans, by the developing company, it was never sold commercially for medical use. In 2013, AH-7921 was discovered to have been used as an active ingredient in "
synthetic cannabis Synthetic cannabinoids are a class of designer drug molecules that bind to the same receptors to which cannabinoids (THC, CBD and many others) in cannabis plants attach. These novel psychoactive substances should not be confused with synthetic ...
" products in Japan. In October 2015, two horses (Bossmon and Literata) trained by owner-trainer Roy Sedlacek tested positive for AH-7921 at Belmont Park racetrack. Norway and Iceland use this substance as an analytical reference standard in which it can be ordered online from chemical suppliers; however, labels are required to state that it is not for human consumption thus conforming to the law. Within ten months from 2013 - 2014, there have been serious fatalities reported from this drug from four different countries. The first fatality was a 19-year-old male who had a 3.9 mg/L AH-7921 concentration of heart blood leading medical examiners to confirm the death was an opioid intoxication. In another case, a 22-year-old woman was found dead with a femoral blood to AH-7921 concentration of 450μg/L. A 2018 review of published case reports found a total of 14 cases, of which 13 resulted in death. The oral route of administration was reported in two cases, and most cases reported use of concomitant pharmaceutical agents. Postmortem autopsies found that pulmonary edema was the most common finding, with nine of the cases having heavier lungs. Overall, fatalities occurred with low and high concentrations of AH-7921 in femoral blood.


Legality

AH-7921 was made a Prohibited Substance (Schedule 9 of the
Standard for the Uniform Scheduling of Medicines and Poisons The Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP) is an Australian legislative instrument produced by the Therapeutic Goods Administration (TGA)., subsection 4A. Before 2010, it was known as the ''Standard for the Unifor ...
) in Australia in May 2014. Although this amendment was repealed in June 2014, which simply means the amendment document ceases, but the actual scheduling is permanent as part of the main document (all SUSMP amendments cease after a few weeks). It may, however, still be a banned import. AH-7921 has been illegal to distribute in Israel since December 2013. In the UK, AH-7921 was included as a Class A drug in January 2015 as part of The
Misuse of Drugs Act 1971 The Misuse of Drugs Act 1971 is an Act of the Parliament of the United Kingdom. It represents action in line with treaty commitments under the Single Convention on Narcotic Drugs, the Convention on Psychotropic Substances, and the United Nation ...
(Amendment) (No. 2) Order 2014. In Brazil, AH-7921 has been an illegal drug since May 2015. As of October 2015 AH-7921 is a controlled substance in China. AH-7921 is banned in the Czech Republic. In the United States, AH-7921 was placed into Schedule I of the
Controlled Substances Act The Controlled Substances Act (CSA) is the statute establishing federal government of the United States, federal drug policy of the United States, U.S. drug policy under which the manufacture, importation, possession, use, and distribution of ...
on May 16, 2016 due to its lack of medical use. Furthermore, any person who wishes to manufacture, distribute, import, export, research, and educate using the substance, must be registered by the Drug Enforcement Administration. The Canadian
Controlled Drugs and Substances Act The ''Controlled Drugs and Substances Act'' (french: Loi réglementant certaines drogues et autres substances) (the ''Act'') is Canada's federal drug control statute. Passed in 1996 under Prime Minister Jean Chrétien's government, it repeals ...
was amended in 2016 to include the substance as a Schedule I substance. Possession without legal authority can result in maximum 7 years imprisonment. Further,
Health Canada Health Canada (HC; french: Santé Canada, SC)Health Canada is the applied title under the Federal Identity Program; the legal title is Department of Health (). is the Structure of the Canadian federal government#Departments, with subsidiary unit ...
amended the ''Food and Drug Regulations'' in May, 2016 to classify AH-7921 as a restricted drug. Only those with a law enforcement agency, person with an exemption permit or institutions with Minister's authorization may possess the drug in Canada.


See also

* Bromadoline *
U-47700 U-47700, also known as U4, pink heroin, pinky, and pink, is an opioid analgesic drug developed by a team at Upjohn in the 1970s which has around 7.5 times the potency of morphine in animal models. U-47700 is a structural isomer of the earlier o ...
*
U-77891 U-77891 is an opioid analgesic drug that was first synthesized in 1983 by the Upjohn company. It was originally synthesized to prove that the removal of a single methylene spacer of the benzamide would alter a κ-opioid receptor agonist such as ...


References

{{Opioidergics Synthetic opioids Chloroarenes Benzamides Mu-opioid receptor agonists Euphoriants