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Forensic Toxic 29 : 25 — Uchiyama N Kikura-Hanajiri R Goda Y b Identification of a novel cannabinomimetic phenylacetylindole, cannabipiperididiethanone, as a designer drug in a herbal product and its affinity for CB1 and CB2 receptors. Chem Pharm Bull 59 : — Forensic Sci Int : 21 — Synthetic cannabinoids in herbal products. Eur J Pharmacol : — Toxicol Lett : — Pediatr Emerg Care 26 : — Life Sci 80 : — Winstock AR Barratt MJ Synthetic cannabis: a comparison of patterns of use and effect profile with natural cannabis in a large global sample.
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Volume Article Contents Abstract. Synthetic cannabimimetics — the major biologically active components of Spice. Spice — prevalance, pattern of use, users profile. Synthetic cannabimimetics — mode of action, biodisposition and metabolism. Effects of synthetic cannabimimetics in humans. Statement of Interest. Zawilska , Jolanta B. Department of Pharmacodynamics, Medical University of Lodz.
Address for correspondence: Professor J. Oxford Academic. Jakub Wojcieszak. Revision received:. Cite Cite Jolanta B. Select Format Select format.
Permissions Icon Permissions. Abstract Smokeable herbal mixtures containing synthetic agonists of cannabinoid receptors, known under brand names such as Spice, K2 and Kronic, represent a relatively new type of designer psychoactive drugs that has recently emerged on the recreational drug market. Abuse , adverse effects , Spice , synthetic cannabimimetics , THC. Open in new tab Download slide. Chemical structures of synthetic cannabimimetics.
Table 1 Affinities of synthetic cannabimimetics most commonly detected in products and biological samples to cannabinoid CB 1 and CB 2 receptors. Chemical name. Open in new tab.
Table 2 Case reports on the adverse effects of synthetic cannabimimetics. Gender, age. Compound identified. Reddened conjunctivae, increase in pulse rate, xerostomia, alteration in mood and perception.
Symptoms lasted up to 6 h. Serum samples positive for homolog of CP 47, Self-experiment conducted by two of the authors who smoked one cigarette containing 0. Paranoid hallucinations, paranoid delusions. Screening for cannabis urine, hair and other drugs urine — negative.
Identification not conducted. Patient suffered from ADHD. Anxiety resolved after lorazepam. Symptoms resolved 2 h after administration of lorazepam. Vearrier and Osterhoudt, Female, 20 Anxiety. Schneir et al. Schneir and Baumbacher, Male, 20 Severe anxiety, paranoia, halting speech, avoidance of eye contact, tachycardia, diaphoresis. THC not detected in urine sample. Benford and Caplan, Male, 48 Generalized seizures, temperature of Consumption of an alcohol mixture containing white powder 30 min before seizures.
Lapoint et al. Urine sample positive for JWH metabolite. Symptoms resolved with benzodiazepines and iv fluids. Simmons et al. Symptoms resolved with iv fluids. Male, 19 Paranoia, agitation, visual hallucinations. Screening of urine sample — negative. Bebarta et al. Levorphanol in urine sample. Male, 23 Delusions, paranoia. Young et al. Patient admitted to smoking K2. Faircloth et al. Peglow et al. Mental disturbances after 4 weeks of daily K2 use Tung et al.
Diagnosis: acute myocardial infarction. Patient admitted to using K2. Mir et al. EEG revealed ST-segment elevation in the inferolateral leads; increased troponin level Urine sample negative for cannabis and cocaine. Male, 16 Patient presented with a 3 d history of retrosternal and episodic chest pain, lasting for 1—2 h at a time.
Urine sample positive for THC. Male, 17 Faint, generalized muscular tone in extremities, cyanosis, apnea, ocular redness, swelling. At the hospital — confused speech, somnolence, complaints of chest and back pain. Patient admitted to smoking K2 an hour prior to admission.
Heath et al. Amnesia, mild headache, fatigue. Male, 20 Agitation, confusion, suicidal ideation, self-inflicted trauma, sinus tachycardia. Symptoms appeared after smoking K2. Thomas et al. Pant et al. On the seventh hospital day the patient developed acute psychosis with delusions. Patient admitted to long-term regular use of Spice. His negative symptoms, disorganized behaviour and speech persisted despite abstinence from Spice for 2 months.
Urine sample negative for cannabis and other drugs of abuse. He described being in multiple dreams that he could not get out. The patient complained of inability to move his limbs. Male, 19 Seizure-like activity, cyanosis, unresponsiveness.
Patient admitted to smoking K2 approx. Patient admitted smoking 3 g of K2. Patient admitted to smoking K2 herbal for the first time and complained of being in a dream state that he could not get out. Male, 18 Nausea and vomiting, flank pain. Diagnosed: acute kidney injury. Product: XLR Blood: N-pentanoic acid metabolite of XLR Male, 17 Nausea and vomiting, flank pain. Male, 18 Nausea and vomiting, abdominal pain.
Urine: N-pentanoic acid metabolite of XLR Male, 15 Nausea and vomiting, abdominal pain. Male, 20 Nausea and vomiting for 2 d. Diagnosed: oliguric acute kidney injury Identification not conducted.
Patient admitted to using Spice for few weeks. Bhanushali et al. Male, 26 Nausea, vomiting, diarrhea and lower abdominal pain for 2 d. Diagnosed: oliguric acute kidney injury.
Patient admitted to using Spice over the last two years. Male, 30 Nausea, vomiting, diarrhea and lower abdominal pain for 3 d. Patient admitted to using Spice over the last year. Blood: JWH The next day: elevated levels of creatine kinase, leukocytosis, trombolysis. Seizures developed after the second consumption. Male, 21 Dyspnea, 2-month history of chronic cough, occasional hemoptysis, two episodes of syncope.
Chest imaging revealed diffuse, bilateral, subacute lung infiltrates. Suspected: hypersensitivity pneumonitis. Patient smoked several Spice products for the last 4 months. Alhadi et al. McQuade et al. High times, low sats: diffuse pulmonary infiltrates associated with chronic synthetic cannabinoid use. Google Scholar Crossref. Search ADS. Influence of the N-1 alkyl chain length of cannabimimetic indoles upon CB 1 and CB 2 receptor binding.
Psychiatric sequelae of Spice, K2, and synthetic cannabinoid receptor agonists. Phase I hydroxylated metabolites of the K2 synthetic cannabinoid JWH retain in vitro and in vivo cannabinoid 1 receptor affinity and activity.
Monohydroxylated metabolites of the K2 synthetic cannabinoid JWH retain intermediate to high cannabinoid 1 receptor CB 1 R affinity and exhibit neutral antagonist to partial agonist activity. Differential drug-drug interactions of the synthetic cannabinoids JWH and JWH implications for drug abuse liability and pain therapy. Acute kidney injury associated with synthetic cannabinoid use — multiple states, Solid-phase extraction and quantitative measurement of omega and omega-1 metabolites of JWH and JWH in human urine.
Simultaneous analysis of synthetic cannabinoids in the materials seized during drug trafficking using GC-MS. Monitoring of herbal mixtures potentially containing synthetic cannabinoids as psychoactive compounds. Development and validation of a liquid chromatography-tandem mass spectrometry method for the quantitation of synthetic cannabinoids of the aminoalkylindole type and methanandamide in serum and its application to forensic samples.
Liquid chromatography-tandem mass spectrometry analysis of urine specimens for K2 JWH metabolites. New challenges and innovation in forensic toxicology. Chromatography-mass spectrometry studies on the metabolism of synthetic cannabinoids JWH and JWH, psychoactive components of smoking mixtures. The detection of the urinary metabolites of 3-[ adamantanyl carbonyl]pentylindole AB , a novel cannabimimetic, by gas chromatography-mass spectrometry.
The detection of the urinary metabolites of 1-[ 5-fluoropentyl -1 H -indolyl]- 2-iodophenyl methanone AM , a high affinity cannabimimetic, by gas chromatography — mass spectrometry. Google Scholar PubMed. Acute toxicity due to the confirmed consumption of synthetic cannabinoids: clinical and laboratory findings. International Union of Pharmacology. A characterization of synthetic cannabinoid exposures reported to the National Poison Data System in College students and use of K2: an emerging drug of abuse in young persons.
Cannabinomimetic indoles, pyrroles and indenes: structure-activity relationships and receptor interactions. Determination of 22 synthetic cannabinoids in human hair by liquid chromatography-tandem mass spectrometry. Characterization of the designer drug and synthetic cannabinoid receptor agonist AM regarding its chemistry and metabolism.
UR in products sold via the internet: identification of related compounds and characterization of pyrolysis products. Cannabinoid-induced immune suppression and modulation of antigen-presenting cells.
Analysis of 30 synthetic cannabinoids in serum by liquid chromatography-electrospray ionization tandem mass spectrometry after liquid-liquid extraction. Long-term use of HU adversely affects spermatogenesis in rats by modulating the endocannabinoid system.
Spice, bath salts, and the U. Triphasic blood pressure responses to cannabinoids: do we understand the mechanism? First European case of convulsions related to analytically confirmed use of the synthetic cannabinoid receptor agonist AM Structure-activity relationships for cannabinoid receptor-binding and analgesic activity: studies of bicyclic cannabinoid analogs. Myocardial infarction associated with use of the synthetic cannabinoid K2.
Screening for the synthetic cannabinoid JWH and its major metabolites in human doping controls. Rapid identification of synthetic cannabinoids in herbal samples via direct analysis in real time mass spectrometry.
The synthetic cannabinoid Spice as a trigger for an acute exacerbation of cannabis induced recurrent psychotic episodes. National Conference of State Legislatures. Office of National Drug Control Policy. Behavioural effects of CB2 cannabinoid receptor activation and its influence on food and alcohol consumption. K2 toxicity: fatal case of psychiatric complocations following AM exposure. Synthetic cannabinoid induced psychosis in a previously nonpsychotic patient.
International Union of Basic and Clinical Pharmacology. Human metabolites of synthetic cannabinoids JWH and JWH bind with high affinity and act as potent agonists at cannabinoid type-2 receptors. Marijuana-based drugs: innovative therapeutics or designer drugs of abuse? Identification and analytical properties of new synthetic cannabimimetics bearing 2,2,3,3-tetramethylcyclopropanecarbonyl moiety. Evaluation of binding in a transfected cell line expressing a peripheral cannabinoid receptor CB 2 : identification of cannabinoid receptor subtype selective ligands.
Detection of JWH metabolites in smoking mixture post-administration urine. Sensitive and rapid quantification of the cannabinoid receptor agonist naphthalenyl- 1-pentylindolyl methanone JWH in human serum by liquid chromatography-tandem mass spectrometry. Acute mental disturbance caused by synthetic cannabinoid: a potential emerging substance of abuse in Hong Kong.
Chemical analysis of synthetic cannabinoids as designer drugs in herbal products. Identification of a novel cannabinomimetic phenylacetylindole, cannabipiperididiethanone, as a designer drug in a herbal product and its affinity for CB1 and CB2 receptors.
Effects of synthetic cannabinoids on electroencephalogram power spectra in rats. URB a new class of designer drug and 12 synthetic cannabinoids detected in illegal products. A survey study to characterize use of Spice products synthetic cannabinoids. Spice drugs as a new trend: mode of action, identification and legislation.
Cytochrome P enzymes involved in the metabolism of tetrahydrocannabinols and cannabinol by human hepatic microsomes. Synthetic cannabis: a comparison of patterns of use and effect profile with natural cannabis in a large global sample.
In vitro phase I metabolism of the synthetic cannabimimetic JWH Brain cannabinoid CB 2 receptors modulate cocaine's actions in mice. Cardiotoxicity associated with the synthetic cannabinoid, K9, with laboratory confirmation. Issue Section:. Download all slides. View Metrics. Email alerts Article activity alert. Advance article alerts.
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Showalter et al. Makriyannis and Deng, Melvin et al. Aung et al. Huffman et al. Panic attacks for 2 h , irritability, anxiety, fear, blurred vision, unsteady gait, weakness, diaphoresis, palpitations, tachycardia. Vearrier and Osterhoudt, Schneir and Baumbacher, For several years, synthetic cannabinoid mixtures have been easy to buy in drug paraphernalia shops, novelty stores, gas stations, and over the internet.
Because the chemicals used in them have no medical benefit and a high potential for abuse, authorities have made it illegal to sell, buy, or possess some of these chemicals.
However, manufacturers try to sidestep these laws by changing the chemical formulas in their mixtures. Easy access and the belief that synthetic cannabinoid products are natural and therefore harmless, have likely contributed to their use among young people. Another reason for their continued use is that standard drug tests cannot easily detect many of the chemicals used in these products.
The most common way to use synthetic cannabinoids is to smoke the dried plant material. Users also mix the sprayed plant material with marijuana or brew it as tea. Other users buy synthetic cannabinoid products as liquids to vaporize in e-cigarettes. Synthetic cannabinoids act on the same brain cell receptors as THC deltatetrahydrocannabinol , the mind-altering ingredient in marijuana. So far, there have been few scientific studies of the effects of synthetic cannabinoids on the human brain, but researchers do know that some of them bind more strongly than marijuana to the cell receptors affected by THC and can produce much stronger effects.
The resulting health effects can be unpredictable and dangerous. Because the chemical composition of many synthetic cannabinoid products is unknown and may change from batch to batch, these products are likely to contain substances that cause dramatically different effects than the user might expect.
People who have used synthetic cannabinoids and have been taken to emergency rooms have shown severe effects including:. Yes, synthetic cannabinoids can be addictive. Regular users trying to quit may have the following withdrawal symptoms:.
Behavioral therapies and medications have not specifically been tested for treatment of addiction to these products. Health care providers should screen patients for possible co-occurring mental health conditions. An overdose occurs when a person uses too much of a drug and has a dangerous reaction that results in serious, harmful symptoms or death.
Use of synthetic cannabinoids can cause:. Deaths can also occur when dangerous synthetic opioids, such as fentanyl, are added to the packaged mixture without the user knowing it.
This publication is available for your use and may be reproduced in its entirety without permission from NIDA. Department of Health and Human Services.
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