Rare Disease Report

Synthetic Cannabinoid Drug Causes A 'Zombie Outbreak'

DECEMBER 15, 2016
Andrew Black
Ever wonder what being in AMC’s hit tv show “The Walking Dead” is like? A few EMS first responders in Brooklyn, New York got the chance to see people in a ‘zombie’ state who were under the influence of a synthetic cannabinoid drug. Data published in the New England Journal of Medicine describes the drug tested and results of the potency in which symptoms it caused the individuals to experience.
 Fortunately for the responders, no bites or eaten brains occurred.
On July 12, 2016, NYC’s EMS team was called to a multiple-casualty incident. Bystanders of the incident described the people involved as “zombielike” with blank stares, and slow reactions. 33 people, ages 25 to 59 were under the influence of the drug (unknown at the time) AK-47 24 Karat Gold, 18 people involved had to go to a medical center.
When brought to the medical center, doctors described the individuals of having a blank stare, slowed reactions, and lethargic, but all following tests showed no abnormities or trauma. After a 9-hour hospital visit and being cleared, examined patients were released following a statement of inhaling a bagged-drug substance and feeling symptoms.
The DEA subsequently obtained biologic samples from 8 of the 18 patients in the outbreak who were transported for medical care and sent the samples to their collaborators for comprehensive drug analysis with the use of high-resolution mass spectrometry. The tests came back of the drug Ak-47 24 Karat Gold.
Several aliquots of the product (AK-47 24 Karat Gold) and blood and urine samples from 8 of the patients from the medical center were sent to the Clinical Toxicology and Environmental Biomonitoring Laboratory at the University of California, San Francisco. The samples were analyzed by means of liquid chromatography–quadrupole time-of-flight mass spectrometry (LC–QTOF/MS) (Agilent LC 1260-QTOF/MS 6550).


The LC–QTOF/MS analysis of the herbal product revealed a unique signal at a concentration of 1 mg per milliliter, of a synthetic cannabinoid drug, AMB-FUBINACA. The researchers also discovered that it was 85 times more potent than marijuana in plant form.
While no AMB-FUBINACA parent compound was detected in the blood or urine of the patients, but its de-esterified acid metabolite, 2-(1-(4-fluorobenzyl)-1H-indazole-3-carboxamido)-3-methylbutanoic acid, was detected in every patient,
The extreme potency of AMB-FUBINACA is consistent with strong CNS depressant effects that would cause “zombielike” behavior of users that was reported in the mass intoxication.


AMB-FUBINACA (also known as FUB-AMB and MMB-FUBINACA) is an indazole-based synthetic cannabinoid that is a potent agonist of the CB1 receptor and has been sold online as a designer drug. It was originally developed by Pfizer which described the compound in a patent in 2009, but was later abandoned and never tested on humans.


Adams A, Banister S, Irizarry L, et al. “Zombie” Outbreak Caused by the Synthetic Cannabinoid AMB-FUBINACA in New York NEJM Published online December 14, 2016. DOI: 10.1056/NEJMoa1610300

Stay informed on the latest rare disease news and developments by signing up for our newsletter.
Copyright © RareDR 2013-2018 Rare Disease Communications. All Rights Reserved.