A Common Source Outbreak of Severe Delirium Associated with Exposure to the Novel Synthetic Cannabinoid ADB-PINACA

Schwartz, Michael D.; Trecki, Jordan; Edison, Laura; Steck, Alaina; Arnold, Justin K.; Gerona, Roy

doi:10.1016/j.jemermed.2014.12.038

Cited by 82 publications

(70 citation statements)

References 20 publications

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“…Smoking of ADB-PINACA-containing product "Crazy Clown" resulted in a wide-spectrum of adverse effects, including anxiety, delirium, aggressive behavior, psychosis, confusion/disorientation, seizures, somnolence, unresponsiveness, tachycardia, hypertension, acidosis, hypokalemia. One patient had myocardial infarction, and another one developed rhabdomyolysis (CDC, 2013b;Schwartz et al, 2015). In 7 out of 22 individuals ADB-PINACA and ADB-PINACA 5-pentanoic acid were identified in plasma (Schwartz et al, 2015).…”

Section: Synthetic Cannabimimetics (Scs)mentioning

confidence: 99%

“…One patient had myocardial infarction, and another one developed rhabdomyolysis (CDC, 2013b;Schwartz et al, 2015). In 7 out of 22 individuals ADB-PINACA and ADB-PINACA 5-pentanoic acid were identified in plasma (Schwartz et al, 2015). A case of acute cerebral ischemia and infarction (Takematsu et al, 2014), and two fatal cases (Shanks et al, 2015b) related to analytically confirmed use of XLR-11 have been reported.…”

Section: Synthetic Cannabimimetics (Scs)mentioning

confidence: 99%

See 1 more Smart Citation

Next generation of novel psychoactive substances on the horizon – A complex problem to face

Zawilska

Andrzejczak

2015

Drug and Alcohol Dependence

166

123

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Section: Synthetic Cannabimimetics (Scs)mentioning

confidence: 99%

Section: Synthetic Cannabimimetics (Scs)mentioning

confidence: 99%

Next generation of novel psychoactive substances on the horizon – A complex problem to face

Zawilska

Andrzejczak

2015

Drug and Alcohol Dependence

166

123

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“…ADB-PINACA is not as common, but there have been reports of toxicity associated with its use by recreational users. Anxiety, delirium, psychosis, aggressive behaviors and seizures were observed in 8 individuals who presented to an emergency room after smoking "Crazy Clown", which was found to contain ADB-PINACA (Schwartz et al, 2015). In Colorado, 76 patients presented to emergency rooms in a one-month period after smoking "black mamba", which also was found to contain ADB-PINACA (Monte et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Δ9-Tetrahydrocannabinol-like effects of novel synthetic cannabinoids in mice and rats

Gatch

Forster

2016

Psychopharmacology

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Rationale Novel cannabinoid compounds continue to be marketed as "legal" marijuana substitutes, even though little is known about their molecular and behavioral effects. Objectives Six of these compounds (ADBICA, ADB-PINACA, THJ-2201, RCS-4, JWH-122, JWH-210) were tested for in vitro and in vivo cannabinoid-like effects to determine their abuse liability. Methods Binding to and functional activity at CB1 cannabinoid receptors was tested. Locomotor activity in mice was tested to screen for behavioral activity and to identify behaviorally active dose ranges and times of peak effect. Discriminative stimulus effects of the six compounds were tested in rats trained to discriminate Δ9-tetrahydrocannabinol (Δ9-THC). Results ADBICA, ADB-PINACA, THJ-2201, RCS-4, JWH-122, JWH-210 showed high affinity binding at the CB1 receptor at nanomolar affinities (0.59 nM to 22.5 nM) and all acted as full agonists with nanomolar potencies (0.024 to 111 nM) when compared to the CB1 receptor full agonist CP 55,940. All compounds depressed locomotor activity below 50% of vehicle responding, with depressant effects lasting 1.5 to nearly 4 h. All compounds fully substituted (<80% Δ9-THC-appropriate responding) for the discriminative stimulus effects of Δ9-THC. 3,4-Methylenedioxy-methamphetamine (MDMA) was tested as a negative control and did not substitute for Δ9-THC (11% Δ9-THC-appropriate responding). Conclusions All six of the compounds acted at the CB1 receptor and produced behavioral effects common to abused cannabinoid compounds, which suggest that these compounds have substantial abuse liability common to controlled synthetic cannabinoid compounds.

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“…Prolactin levels are not increased in these patients. Seizures could develop in subjects without known epilepsy secondary to drug toxicity, and their detection during sustained physical confrontations, especially if akinetic, might be quite difficult [54, 55]. …”

Section: Resultsmentioning

confidence: 99%

Comprehensive Histological and Immunochemical Forensic Studies in Deaths Occurring in Custody

Nugent

Orellana-Barrios²,

Buscemi

2017

International Scholarly Research Notices

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In-custody deaths have several causes, and these include homicide, suicide, natural death from chronic diseases, and unexplained death possibly related to acute stress, asphyxia, excited delirium, and drug intoxication. In some instances, these deaths are attributed to undefined accidents and natural causes even though there is no obvious natural cause apparent after investigation. Understanding these deaths requires a comprehensive investigation, including documentation of circumstances surrounding the death, review of past medical history, drug and toxicology screens, and a forensic autopsy. These autopsies may not always clearly explain the death and reveal only nonspecific terminal events, such as pulmonary edema or cerebral edema. There are useful histologic and biochemical signatures which identify asphyxia, stress cardiomyopathy, and excited delirium. Identifying these causes of death requires semiquantitative morphologic and biochemical studies. We have reviewed recent Bureau of Justice Statistics on in-custody death, case series, and morphological and biochemical studies relevant to asphyxia, stress cardiomyopathy, and excited delirium and have summarized this information. We suggest that regional centers should manage the investigation of these deaths to provide more comprehensive studies and to enhance the expertise of forensic pathologists who would routinely manage potentially complex and difficult cases.

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A Common Source Outbreak of Severe Delirium Associated with Exposure to the Novel Synthetic Cannabinoid ADB-PINACA

Cited by 82 publications

References 20 publications

Next generation of novel psychoactive substances on the horizon – A complex problem to face

Next generation of novel psychoactive substances on the horizon – A complex problem to face

Δ9-Tetrahydrocannabinol-like effects of novel synthetic cannabinoids in mice and rats

Comprehensive Histological and Immunochemical Forensic Studies in Deaths Occurring in Custody

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