Focus on cannabinoids and synthetic cannabinoids

Abstract

The recent emergence of a multitude of synthetic cannabinoids (SCs) has generated a wealth of new information, suggesting the usefulness of state-of-the-art on lato sensu cannabinoids. By modulating a plurality of neurotransmission pathways, the endocannabinoid system is involved in many physiological processes that are increasingly explored. SCs desired and adverse effects are considered to be more intense than those observed with cannabis smoking, which is partly explained by the full agonist activity and higher affinity for cannabinoid receptors. Neurological and cardiovascular side effects observed after cannabinoid poisoning generally respond to conventional supportive care, but severe outcomes may occur in a minority of cases, mainly observed with SCs. The likelihood of severe abuse and addiction produced by SCs are of concern for the scientific community also interested in the potential therapeutic value of cannabinoids.

Synthetic cannabinoids: characteristics, use and clinical implications

“…SCs pose a risk to the conventional treatment of other drugs because they are not easily detected by common urinalysis techniques. They are not routinely detected because current drug tests are specific to THC, which is not an active chemical compound in SCs [50,51], so patients may be consuming SCs without clinicians' knowledge.…”

Differences in sociodemographic characteristics, clinical features and serum liver function tests of male cannabis and synthetic cannabinoid users

“…1,2 The World Health Organization estimating in 2013 that 181.8 million people aged 15-64 years used C for nonmedical purposes. 3 On the other hand, the medical use of C products to treat disease or improve symptoms remains debated, even if the benefits and risks of such medications have been investigated in a number of clinical trials on multiple sclerosis, pain, neurodegenerative disorders, and appetite suppression. 3 Synthetic cannabinoids (SCs) were first created in the 1980s as laboratory research ligands for studying human endocannabinoid receptor systems.…”

“…3 On the other hand, the medical use of C products to treat disease or improve symptoms remains debated, even if the benefits and risks of such medications have been investigated in a number of clinical trials on multiple sclerosis, pain, neurodegenerative disorders, and appetite suppression. 3 Synthetic cannabinoids (SCs) were first created in the 1980s as laboratory research ligands for studying human endocannabinoid receptor systems. Synthetic cannabinoid (SC) containing products supplied by illicit manufacturers were then marketed as herbal incense.…”

“…4,5 And the vast explosion of SCs aims to actually create compounds that will be used abusively, to avoid legal restrictions, and to make large profits for underground laboratories. 3 SC users are frequently C users and may experience psychotropic effects such as euphoria and alteration in mood and sensorium similar to C users. 6 The largest group of users is males in their 20s who participate in polydrug use, but prevalence of SCs abuse is yet unclear.…”

“…6 The largest group of users is males in their 20s who participate in polydrug use, but prevalence of SCs abuse is yet unclear. 3,7 SCs have full agonistic effect on both central nervous system cannabinoid type 1 (CB1) and type 2 (CB2) receptors, whereas C is a partial agonist of these receptors. 5,8 As a result, SCs potentially pose a greater risk to users' health than natural forms of C. 9,10 Abuse of SCs has been shown to produce serious adverse health effects, including but not limited to hyperactive delirium, psychotic episodes, acute kidney injury, seizures, stroke, myocardial infarctions, and even occasional deaths.…”