Purple Fentanyl: A New Face on an Old Enemy.

INTRODUCTION: Overdoses due to novel potent opioids continue to increase across the United States. The availability of colored fentanyl products that may appeal to younger patients is concerning. CASE PRESENTATION: We present the case of an adult male with an unknown ingestion subsequently identified as purple fentanyl. Brorphine is a common component of purple fentanyl and is considered an emerging novel potent opioid. DISCUSSION: Only limited number of case reports describing brorphine exposure are available, and many clinicians remain unfamiliar with this substance. It is a potent opioid with a presumed long half-life. Clinical presentation is similar to that of other opioid toxidromes, including respiratory depression, miosis, and sedation, and is managed similarly. Patients may require extended monitoring after exposure to brorphine. CONCLUSIONS: Awareness of emerging substances of abuse will enable clinicians to diagnose and treat affected patients more readily.