In this episode, we dive deep into the world of methamphetamine enantiomers—those chemically identical but biologically distinct mirror-image molecules. We examine a paper that looks at the suitability of the 20% D-methamphetamine cutoff used to indicate illicit methamphetamine use in the US, and some of the challenges associated with enantiomer testing.

We also break down the differential respiratory effects of methamphetamine enantiomers when co-administered with fentanyl—a combination increasingly seen in overdose cases—and what this means for clinical and forensic interpretation. Plus, we take a data-driven look at how these enantiomers are showing up in real-world contexts, from seized drug samples to blood samples of impaired drivers in Iceland.

Hope you enjoy!

Links to papers we discussed:

https://academic.oup.com/jat/article-abstract/36/6/399/791636?redirectedFrom=fulltext&login=false

https://pmc.ncbi.nlm.nih.gov/articles/PMC11015966/

https://academic.oup.com/jat/article-abstract/48/6/456/7675298?redirectedFrom=fulltext&login=false

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