The “New” Marijuana

Abstract

Synthetic cannabinoid-induced toxicity is increasing in frequency across the US, with more than 1057 reported cases as of August 2010. There is a paucity of literature on synthetic cannabinoid toxicity; however, there are various reports of adverse effects including tachycardia, hypertension, tachypnea, chest pain, heart palpitations, hallucinations, racing thoughts, and seizures. While reports suggest that toxic symptoms last no longer than 3-4 hours, with no residual adverse effects in many cases, there is concern about serious acute and long-term toxicities. This article reviews the development, abuse, toxicity, treatment, and legal status of synthetic cannabinoids. It is important for health-care professionals to recognize and appropriately treat synthetic cannabinoid-induced toxicity.

The Synthesis and Pharmacological Evaluation of Adamantane-Derived Indoles: Cannabimimetic Drugs of Abuse

“…33−35 As of August 2010, more than 1000 cases of synthetic cannabinoidinduced toxicity had been reported across the United States. 36 The toxicological assessment of synthetic cannabinoids requires the development of methodologies for the identification of metabolites of clinical or forensic relevance, and there is a paucity of pertinent literature for the most recent emergent synthetic cannabimimetics. 37 In the case of JWH-018, several hydroxylated potential metabolites retained potent agonist activity at CB 1 receptors, while a major glucuronidated metabolite showed neutral antagonist activity at the same receptors.…”

Emergence of New Classes of Recreational Drugs—Synthetic Cannabinoids and Cathinones

“…These substances include either THC or THC-like compounds, and were originally developed for potential medicinal purposes and to study cannabinoid receptor pharmacology. [16][17][18][19][20] SC products first emerged in Europe in 2004 as "Spice," and in the U.S. in 2008 as "K2." Today, SC products are distributed worldwide under countless trade names, such as "Aztec Gold," "Black Mamba," "Cloud 9," and "Mad Hatter" (Table 1).…”

“…Today, SC products are distributed worldwide under countless trade names, such as "Aztec Gold," "Black Mamba," "Cloud 9," and "Mad Hatter" (Table 1). [16][17][18][19][20] These products are generally marked with disingenuous labels such as "not for human consumption" or "herbal incense" and often packaged in colorful wrappers designed to appeal to teens, young adults, and first-time drug users. 11 They are often inhaled via a pipe or rolled into a cigarette.…”

“…21 SCs appear to be three to five times more potent than traditional marijuana, and therefore are more likely to be 22,23 These products also have weak monoamine oxidase inhibition activity at large doses, which results in a risk for serotonin syndrome. 16,24 Analysis of several "K2" products has suggested the presence of high concentrations of other chemicals, including vitamin E and clenbuterol, a potent β 2 -agonist. 16,24 SC use causes symptoms similar to marijuana use, such as altered mental status, tachycardia, and injected conjunctivae.…”

“…16,24 Analysis of several "K2" products has suggested the presence of high concentrations of other chemicals, including vitamin E and clenbuterol, a potent β 2 -agonist. 16,24 SC use causes symptoms similar to marijuana use, such as altered mental status, tachycardia, and injected conjunctivae. [17][18][19][20][25][26][27] Studies in adults have linked SCs to other cardiovascular, psychiatric, and neurological signs and symptoms (Table 2).…”