Probable cychlorphine exposure in a patient with opioid use disorder: A case report

BACKGROUND AND OBJECTIVES: Cychlorphine is an emerging synthetic opioid with limited clinical data. METHODS: We describe a patient's reported cychlorphine use and its's clinical effects. RESULTS: Thirty-five years old male with opioid use disorder reported purchasing cychlorphine online. He described marked sedation and respiratory depression. Standard toxicology did not detect cychlorphine. Patient died 2 months later from a drug poisoning event. DISCUSSION AND CONCLUSION: Clinicians should ask about online drug purchases and manage suspected opioid intoxication based on clinical symptoms. SCIENTIFIC SIGNIFICANCE: This case highlights the risk associated with emerging NSOs, the limitations of standard and even sophisticated toxicology screening.