Fusel alcohols, including 2M2B, are a by-product of grain fermentation and are therefore present in many alcoholic beverages.  Traces of 2M2B have also been detected in various food substances, including fried bacon and cassava, rooibos tea and fruits (such as apple and pineapple). We present the case of a 26-year-old patient with acute intoxication and dependence on 2-methyl-2-butanol (2m2b). This material is cheap, easily accessible, for example via the Internet, and is increasingly distributed. Especially for patients with polysubstance addiction or patients with legal restrictions on abstinence from alcohol, it is of great attraction. Due to its multiple psychotropic effects, this can easily lead to dangerous intoxication or withdrawal syndromes. Since the substance is not detectable by standard drug monitoring procedures, it is important to know its existence. However, once the substance is detected, detoxification appears to be manageable. Treatment of withdrawal symptoms using the CIWA-AR protocol (Sullivanâ et al., 1989), including diazepam and clonidine, has been shown to be effective and has prevented serious side effects.
Doxepine was suitable for reducing internal tension and mild withdrawal symptoms. Our patient can be considered an excellent example of what Orsolini et al. called “psychonauts” (Orsolini, 2015). This formed group operates mainly online, orders substances via the Internet and has some knowledge of chemical and pharmacological properties. However, this is precisely where there is considerable danger, as potential health risks are trivialized. The concept of “e-psyconauts” could identify people who are close to this substance and be useful for colleagues in identifying patients at risk. Our case report offers possible clues for other treatment options and shows the difficulty of detecting this substance in clinical routine, as there is only a short window of about 2 days after consumption and sophisticated methods (more precisely: gas chromatography-mass spectrometry) are required to obtain positive results. TAA is a colorless liquid with a burning taste and an unpleasant odor similar to paraldehyde with a hint of camphor.  TAA remains liquid at room temperature, making it a useful alternative to tert-butyl alcohol.
Tapered alcohols such as TAA are by-products of cereal fermentation and, therefore, traces of TAA are present in many alcoholic beverages.  Traces of TAA have been detected in other foods such as fried bacon, cassava and rooibos tea.  TAA is also present in rabbit milk and appears to play a role as a pheromone, which induces breastfeeding in newborn rabbits.  As with any other GABA receptor agonist, repeated use and increased tolerance eventually lead to a abrupt withdrawal syndrome similar to withdrawal from alcohol, barbiturates or benzodiazepines, up to delirium tremens (“shakes”). Chronic use of this compound can be considered moderately addictive with a high potential for abuse and may lead to psychological dependence in some users. If an addiction has developed, cravings and withdrawal symptoms can occur if a person suddenly stops using it. 2-2-Butanol inhibits binding to a proconvulsant site at the GABA receptor, causing negatively charged chloride ions to enter neurons and increase the excitation needed to trigger neurons. Because it is a tertiary alcohol, it cannot be converted to aldehydes by alcohol dehydrogenase (which causes hangovers associated with consuming large amounts of ethanol). This makes 2M2B significantly safer than primary alcohols.  However, a consequence of this is that 2-methyl-2-butanol has a prolonged duration of action with effects that last up to 12 hours after consumption. Fatal overdose can occur when GABAergic substances are combined with other tranquilizers such as opiates, benzodiazepines, barbiturates, gabapentinoids, thienodiazepines or alcohol.  Compared to other tranquilizers of a similar nature, 2M2B is comparatively closer to alcohol than GHB in terms of subjective effect and is also significantly more sedative than alcohol, but less sedative than GHB.
An overdose causes symptoms similar to alcohol poisoning and is a medical emergency due to the sedative/depressive properties that manifest as life-threatening respiratory depression in the event of an overdose. Sudden loss of consciousness, concomitant respiratory and metabolic acidosis, rapid heartbeat, increased blood pressure, pupillary constriction, coma, respiratory depression and death may result from overdose. The oral LD50 in rats is 1 g/kg. The subcutaneous LD50 in mice is 2.1 g/kg.  2-Methyl-2-butanol (also known as tert-amyl alcohol or 2M2B) is a tertiary alcoholic substance that produces depressive, hypnotic and anxiolytic effects. In the past, it was used in anesthesia as a component of a warning liquid mixed with tribromoethanol and water.  It has a strong solvent smell reminiscent of gasoline, but has little taste. The simple structure and intoxicating effect of 2M2B led to its use as a recreational drug.  Tert-amyl alcohol (TAA) or 2-methylbutan-2-ol (2M2B) is a branched pentanol. 2-Methyl-2-butanol is also known as tert-amyl alcohol, 2M2B or amylene hydrate. 2-Methyl-2-butanol is an alcohol with the formula C5H11OH. 2-2-Butanol consists of butane, an alkyl chain of four carbons.
This chain is substituted in R 2 by a methyl group CH 3 and an alcohol group OH-. It is synthesized by the reaction of 2-methyl-2-butene with water in the presence of an acid catalyst. . All source data on which the summaries on this page are based are provided by industry and stored in ECHA`s databases. Data from all registered dossiers for the same substance are used in the summary and aggregation process, as it is assumed that all data submitted by registrants are relevant for the substance to be registered. If the test material used differs from the substance to be registered, this shall be reported. Please note that the information contained in the free text fields will not be published in short profiles. It should also be noted that these effects do not necessarily occur predictably or reliably, although higher doses tend to induce the full spectrum of effects. Similarly, side effects with higher doses are increasingly likely and may include addiction, serious injury or death ?.
The min – max ranges of the PRIORITED values in the five highest priority groups of the data provided are displayed. Data are generally standardized and are displayed in milligrams per litre or moles per litre. It is possible that harmonisation will be introduced by amending the CLP. In this case, the ATP (adaptation to technical progress) number is displayed. More information about CLH can be found here. The release of this substance into the environment can take place through industrial use: in processing aids on industrial sites, as an intermediate step in the subsequent production of another substance (use of intermediates) and in the manufacture of products. The degradation rate constant (OH radicals) provides information about the degradation rate constant of the substance with OH radicals as a type of reaction in cm3molecule-1s-1, cm3molecule-1d-1, m3molecule-1s-1 or m3molecule-1d-1. Note: Registrants may also accept “BMD”, “BMC”, “Dose Level” and “conc. level” as a dose descriptor. If this is the case, the data provided will not be processed for the short profile. Prioritisation by test species: the substance identity section links substance identification information from all databases managed by ECHA.
The substance identifiers, where available and not declared confidential, displayed in the substance identity section of the profile are as follows: The substance properties indicated in this section (with the exception of PBT properties) are derived from harmonised classification and labelling information (CLH) and/or REACH registered dossier information. If the classification of the substance is not harmonised and the substance is not registered, the properties are derived from the classifications specified in the CLP notifications. PBT properties are derived from REACH-registered substance dossiers. CSID:6165, www.chemspider.com/Chemical-Structure.6165.html (accessed 08:12, 2 December 2022). The “substance description” provides an overview of the main identifiers of the substance, the classification of the substance, ongoing regulatory activities, major uses of the substance, and the notifiers who manufacture and/or import the substance. By bringing this information together on a single page, ECHA aims to make this information accessible in a user-friendly way, in line with the Agency`s objectives and standards. This substance is used in the following activities or processes in the workplace: chemical transfer, batch processing in synthesis or formulation with potential for exposure, mixing in open batch processes, transfer of substances in small containers, laboratory work, closed processes without risk of exposure, closed and continuous processes with occasional controlled exposure, and closed batch treatment in synthesis or formulation. It is strongly discouraged to combine these substances, especially in conjunction with high doses.