Relationship between suicide attempts and synthetic cannabinoids in adjustment disorder

New Psychoactive Substances and Suicidality: A Systematic Review of the Current Literature

“…The studies retrieved included: six case reports [24][25][26][27][28][29][30]; eight retrospective studies [31][32][33][34][35][36][37][38]; one cohort study [39]; and one case-control study [40]. Data mostly came from European countries, e.g., Finland [36]; Poland [26,28]; Slovenia [25]; Spain [37], and the United Kingdom (UK) [24,33]; but also from Australia [31,32]; Japan [34,35]; Turkey [39,40]; and the United States (US) [27]. Most cases involved young males (total M/F = 1837/223 = 8.23).…”

“…Most cases involved young males (total M/F = 1837/223 = 8.23). NPS identified included the following categories: synthetic cathinones, e.g., 4-methyl methcathinone (4-MMC or mephedrone), 3-methyl methcathinone (3-MMC), 3,4-methylenediox-ypyrovalerone (MDPV), alpha-pyrrolidinohexiophenone, alphapyrrolidinopentiophenone, 4-4-chloromethcathinone and 4-fluoromethcathinone (flephedrone) [7,26,30,31,[33][34][35][36][37][38]; synthetic cannabinoids, e.g., AB-CHMINACA, AB-FUBINACA, and JWH-018 [32][33][34][35]37,39,40]; phenetylamines, e.g., the β-keto-N-methylbenzodioxolylbutanamine (βk-MBDB) [24,28,31,33,37]; tryptamines [33]; piperazines [33]; aminoindanes [33]; the ketamine analogue methoxethamine [34]; synthetic opioids, e.g., acetyl fentanyl [35]; and a mix of synthetic cannabinoids and synthetic cathinones [25] or mix of drugs in general [37]. The most common route of administration, when indicated, was oral [24][25][26]28]; in one case the substance was smoked [27] and in one inhaled [30].…”

“…The dose was reported in one case only [28]. Psychiatric comorbidities, including a mood/anxiety disorder [25,30,39], a psychotic disorder [27,30], history of attempted suicide [24], or a SUD [25,27,40], were reported. Concomitant drugs used with NPS were benzodiazepines [25]; alcohol [24]; cannabis [30]; other NPS or a mix of other traditional licit drugs, or other prescription drugs, e.g., benzodiazepines, opioids, antidepressants, antipsychotics [31][32][33][34][35][36]38]; in the case of suicide by self-poisoning several drugs were detected in the post-mortem toxicological urine screening, including opiates/opioids, cocaine, amphetamines, benzodiazepines, antidepressants, antihistamines, mood stabilizers, Z-drugs, and antipsychotics, as well as cardiac drugs from the beta-blocker group and painkillers [26].…”

“…Finally, in several cases the outcome was fatal [24,26,28,[31][32][33]36]. When reported, severe fatal self-poisonings [26,28,39], defenestration [24,33], hanging [33,39], burning [39], and firearms [33,39] were described.…”

The severity of non-planning impulsivity and cannabis use problems in distinguishing patients with synthetic cannabinoid use disorder and cannabis use disorder

“…The researchers investigated the risk-taking and violent behavior in 9th-12th grade students with SC and cannabis use, and those experimented with SC were found to display more physical and sexual violence during dating, to engage in fights, injure others, and to have a higher rate of carrying a weapon (28). The rate of suicide or attempted self-mutilation was found to be associated with SC use in some studies (29,30). The sensitivity of CB1 receptors in the prefrontal cortex is believed to be effective in the pathophysiology of suicidal behavior (31).…”