Reports of adverse health effects related to synthetic cannabinoid use in New York State

Papadopoulos, Eleni A.; Cummings, Karen R.; Marraffa, Jeanna M.; Aldous, Kenneth M.; Li, Lingyun; Ahmad, Nina

doi:10.1111/ajad.12636

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…It is now over 10 years since Auwärter et al first reported the detection of the indole synthetic cannabinoid receptor agonist (SCRA), JWH‐018 ( 1 ), and cyclohexylphenol SCRA, cannabicyclohexanol ( 2 ), in herbal blends purchased in Germany (Figure ) . Nonetheless, the negative health effects associated with SCRA abuse still represent a major global public health concern . Several generations of structurally distinct illicit indole ( 3 ) and indazole ( 4 ) SCRAs have since emerged on the recreational drug market, in response to legislative measures seeking to control their use.…”

Section: Introductionmentioning

confidence: 99%

“…1 Nonetheless, the negative health effects associated with SCRA abuse still represent a major global public health concern. 2-5 Several generations of structurally distinct illicit indole (3) and indazole (4) SCRAs have since emerged on the recreational drug market, in response to legislative measures seeking to control their use. The latter exchange between law enforcement and SCRA manufacturers is often described as a game of cat and mouse.…”

mentioning

confidence: 99%

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Adding more “spice” to the pot: A review of the chemistry and pharmacology of newly emerging heterocyclic synthetic cannabinoid receptor agonists

Alam

Keating

2020

Drug Testing and Analysis

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Synthetic cannabinoid receptor agonists (SCRAs) first appeared on the international recreational drug market in the early 2000s in the form of SCRA‐containing herbal blends. Due to the cannabimimetic effects associated with the consumption of SCRAs, they have acquired an ill‐informed reputation for being cheap, safe, and legal alternatives to illicit cannabis. Possessing high potency and affinity for the human cannabinoid receptor subtype‐1 (CB1) and ‐2 (CB2), it is now understood that the recreational use of SCRAs can have severe adverse health consequences. The major public health problem arising from SCRA use has pressed legislators around the world to employ various control strategies to curb their recreational use. To circumvent legislative control measures, SCRA manufacturers have created a wide range of SCRA analogs that contain, more recently, previously unencountered azaindole, γ‐carbolinone, or carbazole heterocyclic scaffolds. At present, little information is available regarding the chemical syntheses of these newly emerging classes of SCRA, from a clandestine perspective. When compared with previous generations of indole‐ and indazole‐type SCRAs, current research suggests that many of these heterocyclic SCRA analogs maintain high affinity and efficacy at both CB1 and CB2 but largely evade legislative control. This review highlights the importance of continued research in the field of SCRA chemistry and pharmacology, as recreational SCRA use remains a global public health issue and represents a serious control challenge for law enforcement agencies.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Adding more “spice” to the pot: A review of the chemistry and pharmacology of newly emerging heterocyclic synthetic cannabinoid receptor agonists

Alam

Keating

2020

Drug Testing and Analysis

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“…The presentations are ever changing due to the rapid turnover of specific compounds and the heterogeneity of the clinical effects of this group of novel psychoactive substances. Evidence suggests that recent SC intoxications result in higher severity of illness than previously reported (1).…”

Section: Introductionmentioning

confidence: 85%

Coma, Seizures, Atrioventricular Block, and Hypoglycemia in an ADB-FUBINACA Body-Packer

Nacca

Schult

Loflin

et al. 2018

The Journal of Emergency Medicine

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Background: Synthetic Cannabinoid (SC) intoxication has become difficult to diagnose and manage in the United States in part due to varying clinical effects within this heterogeneous group of compounds. Case Report: A 38 year-old male was admitted with altered mental status and bradycardia. He demonstrated progressive encephalopathy, seizure activity, second degree atrioventricular (AV) block, type I, respiratory failure, hypotension, hypothermia, and hypoglycemia. A computed tomography (CT) abdomen and pelvis revealed multiple packages in the patient’s stomach and rectum. Multiple attempts at gastrointestinal decontamination were unsuccessful. On hospital day eight the patient developed hypertensive emergency and was taken to the operating room for exploratory laparotomy. Twenty-two poorly wrapped packages were removed from the bowel. Post-operatively the patient demonstrated both generalized and focal seizure activity. His mental status slowly returned to baseline over the period of about one week and he was ultimately discharged without neurological sequelae after one month. Analysis of patient serum, urine, and plant matter from packages identified cannabis and 2.N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)-1H-indazole-3-carboxamide (ADB-FUBINACA). Why should an emergency physician be aware of this?: The case presented demonstrates the suspected toxidrome associated with severe ADB-FUBINACA intoxication including mental status depression, bradycardia, autonomic instability, seizure, hypoglycemia, and hypothermia. Although the patient had simultaneous exposure to cannabis, his constellation of symptoms is not consistent with cannabis intoxication. A previous animal model supports the potential of this specific SC to cause the reported toxidrome.

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The Changing Face of Synthetic Cannabinoids in Texas

Maxwell

2018

Journal of Psychoactive Drugs

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Reports of adverse health effects related to synthetic cannabinoid use in New York State

Abstract: New SC compounds may pose a different or more severe risk than those previously identified. (Am J Addict 2017;26:772-775).

Cited by 6 publications

References 5 publications

Adding more “spice” to the pot: A review of the chemistry and pharmacology of newly emerging heterocyclic synthetic cannabinoid receptor agonists

Adding more “spice” to the pot: A review of the chemistry and pharmacology of newly emerging heterocyclic synthetic cannabinoid receptor agonists

Coma, Seizures, Atrioventricular Block, and Hypoglycemia in an ADB-FUBINACA Body-Packer

The Changing Face of Synthetic Cannabinoids in Texas

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