Increase in Adverse Reactions Associated with Use of Synthetic Cannabinoids — Anchorage, Alaska, 2015–2016

Springer, Yuri P.; Gerona, Roy; Scheunemann, Erich; Shafer, Sarah L.; Lin, Thomas S.; Banister, Samuel D.; Cooper, Michael P.; Castrodale, Louisa; Levy, Michael; Butler, Jay C.; McLaughlin, Joseph

doi:10.15585/mmwr.mm6540a4

Cited by 36 publications

(27 citation statements)

References 6 publications

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“…However, to circumvent drug legislation, manufacturers of these substances continue to develop new compounds with slightly modified chemical structures. These modifications enable manufacturers to legally distribute the substances until they are registered and banned by law [12,13,14,15]. …”

Section: Introductionmentioning

confidence: 99%

Synthetic Cannabinoid Use in a Psychiatric Patient Population: A Pilot Study

Welter¹,

Lücke

Lam³

et al. 2017

Eur Addict Res

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Background: Consumption of natural cannabis (NC) and synthetic cannabinoids (SCs) has been associated with psychotic disorders. We compared the prevalence of use, consumer profiles, and psychosis-inducing potential of NC and SCs in a specific high-risk population. Methods: This prospective pilot study included 332 patients (18-64 years, mean 36.83, SD 13.33). Patients' sociodemographics and medical histories as well as illicit substance use and psychiatric symptom histories were collected using a drug consumption survey that assessed the use of new psychoactive substances and the Psychotic Symptoms Interview. Results: In total, 7.2% of all patients, 10.6% of psychotic patients, and 4.5% of nonpsychotic patients reported SC consumption. Compared with SCs, NC was consumed much more frequently by its users (mean 222.73, SD 498.27). NC and SC use induced persistent psychosis. Psychotic symptoms were first experienced by patients with a history of NC or SC use during intoxication and persisted after cessation (>1 year) of drug use. Positive and negative symptoms tended to be more severe in SC and NC users, respectively. Conclusions: NC and SCs may cause different symptom clusters. These relationships should be further evaluated.

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Section: Introductionmentioning

confidence: 99%

Synthetic Cannabinoid Use in a Psychiatric Patient Population: A Pilot Study

Welter¹,

Lücke

Lam³

et al. 2017

Eur Addict Res

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show abstract

“…41 Despite the evidence that synthetic cannabinoid use is declining, recent reports indicate that synthetic cannabinoids are still available and that acute poisonings from synthetic cannabinoids have increased. 4,42,43 There are several limitations of our study. Because our data are crosssectional, it was not possible to determine the temporality of the associations we observed between type of marijuana use and health risk behavior domains.…”

Section: Discussionmentioning

confidence: 88%

Health Risk Behaviors With Synthetic Cannabinoids Versus Marijuana

et al. 2017

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“…However, there are other negative effects, including nausea, altered mental status, drug-induced psychosis, agitation, elevated blood pressure, tachycardia, seizures, acute organ function impairment and death (Castellanos & Gralnik, 2016; Centers for Disease Control and Prevention [CDC], 2012; CDC, 2013a; CDC, 2013b; Kasper et al, 2015; Sacco & Finklea, 2013). The effects observed after Spice consumption are highly variable, partly because packages of Spice can contain one or more synthetic cannabinoids that can vary in composition and potentially have synergistic effects (Springer et al, 2016). These drugs, since ostensibly not intended for human consumption, are not controlled in the same manner as legitimate pharmaceuticals, and thus do not undergo the same extensive health and safety testing prior to sale.…”

Section: Introductionmentioning

confidence: 99%

“…Poison Control Centers was observed between January and April (Law, Schier, Martin, Chang, & Wolkin, 2015). Later in the same year, between July and September 2015, a substantial increase in synthetic cannabinoid-related ambulance transports (ranging from <1% to up to 36.9% of daily transports) was observed in Anchorage, AK (Springer et al, 2016). This outbreak has sparked efforts to curb the use of Spice in Alaska.…”

Section: Introductionmentioning

confidence: 99%

“…This has forced recent legislation to focus on regulating packaging, which has successfully reduced the distribution of Spice through legal avenues by forcing smoke shops to stop selling Spice until the packages meet regulations for products intended for human consumption or pay a $500 citation for each package of Spice (AK Stat § 17.21.010, 2014). However, this has not eradicated the widespread presence and use of Spice within the state (Andrews, 2015; Springer et al, 2016). …”

Section: Introductionmentioning

confidence: 99%

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Geographic Variability of Active Ingredients in Spice as an Indicator of Mechanisms of Distribution and Manufacture Within Alaska

Emery

Iceman

Hayes

2018

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Designer drugs, like Spice, are synthetic psychoactive analogs of illegal substances with understudied health effects since they have traditionally been sold in packages labeled “not for human consumption” and the molecular structures can be specifically altered to circumvent legislation. Recent legislation has focused on regulating packaging and has reduced, but not eliminated, the distribution of Spice in Alaska. Legally obtained Spice samples from three geographic regions in Alaska were analyzed using liquid injection gas chromatography-mass spectrometry (GC-MS). Most (70%) of the samples contained illegal cannabinoids that have been regulated by the Drug Enforcement Agency and 47% contained multiple active ingredients. We hypothesized that the heterogeneity of the active ingredients between brands and across regions could be used to indicate small- or larger-scale manufacturing, and the results indicate multiple manufacturing scales. Evidence for small-scale manufacturing included inconsistent packaging, several of which contained similar active ingredient profiles in different brands purchased from a single store. Evidence for large-scale production was also found with some brands having consistent active ingredient profiles across regions. This study provides preliminary data for the geographic variability of active ingredients in Spice as an indicator of mechanisms of manufacture and distribution to inform legislators and law enforcement and help prioritizing resource allocation in an effort to quell Spice use in Alaska.

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Increase in Adverse Reactions Associated with Use of Synthetic Cannabinoids — Anchorage, Alaska, 2015–2016

Cited by 36 publications

References 6 publications

Synthetic Cannabinoid Use in a Psychiatric Patient Population: A Pilot Study

Synthetic Cannabinoid Use in a Psychiatric Patient Population: A Pilot Study

Health Risk Behaviors With Synthetic Cannabinoids Versus Marijuana

Geographic Variability of Active Ingredients in Spice as an Indicator of Mechanisms of Distribution and Manufacture Within Alaska

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