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 These synthetic cannabinoids (SCBs) are not detectable with standard
drug screening for the active substance in marijuana because they
are very different, and potentially dangerous, molecules, the study
team writes in Trends in Pharmacological Sciences.
“Synthetic cannabinoids produce a number of adverse effects such as
neurological, gastrointestinal, cardiovascular, and renal toxicities
as well as tolerance, dependence, and even withdrawal,” lead author
Benjamin Ford from the University of Arkansas for Medical Sciences
in Little Rock said.
Evidence of K2 and Spice use in the United States was first reported
in 2009, Ford and his colleagues write, but it wasn’t until late
2010 that the National Forensic Laboratory Information System
reported tremendous spikes in K2 and Spice product usage.
“Alarmingly, there have been over 20 deaths reported between 2011
and 2014 due to some of these toxicities,” Ford told Reuters Health
by email.
A major issue regarding acute toxicities of SCBs concerns the poor
and inconsistent quality control of synthetic cannabinoids in these
products, Ford said.
“It is common for a single K2 or Spice product to contain between
three to five different synthetic cannabinoid compounds at
arbitrary, and sometimes dangerous, doses,” he said.
Ford and his colleagues reviewed existing studies of the chemical
structure of these compounds, how they work in the brain, how they
affect animals in experiments, and the types of side effects seen
among human users.
Ford concludes that terms like “synthetic marijuana” or "synthetic
pot" are very misleading descriptions. They suggest that K2 and
Spice products contain marijuana-like compounds and produce effects
similar to those of marijuana, he said. But, the SCBs are much more
potent than regular marijuana and sometimes cause more intense
reactions.
It’s important to note that there is very little crossover between
the adverse effects observed with synthetic cannabinoids and
marijuana, he added.
“The problem is that people are abusing these new synthetic
cannabinoid receptor agonists because a lot of them don't show up on
the urine tox screen,” Dr. Rana Biary, an emergency physician at NYU
Langone Medical Center in New York, told Reuters Health.
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“So it's a way to bypass any form of drug screen monitoring, and so
a lot of people who are regularly having their own drug screens sent
on might be using this in lieu of marijuana,” said Biary, who wasn’t
involved in the review.
Biary noted that the earliest synthetic cannabinoids were chemically
designed to look just like THC, the psychoactive substance in
marijuana, and were studied as a way to reduce cancer-induced
vomiting.
“But what ended up happening is there was an unexpected side effect
where they found that people were having different effects, and so
they then started to create different molecules that actually no
longer resemble THC,” she said.
“The reason that we're kind of getting concerned about synthetic
cannabinoids now is that first of all, the molecules are changing so
quickly that we actually don't really know what is in the bag that
people are selling,” Biary said.
“As soon as we start to regulate one, there's already several that
are down the pipeline of new synthetic cannabinoids that are
available,” she said.
One problem in with overuse symptoms is that there’s no consistent
presentation as far as symptoms, Biary added.
“So with one batch, patients might come in wildly agitated,
screaming, needing to be restrained, needing large amounts of
medication to sedate them, while the next batch, they're coming in
not breathing so well, their blood pressures might be low,” she
said. “So part of the problem is the presentations are so
unpredictable, and you can't really say you know if someone
overdosed on, or is using, a synthetic cannabinoid.”
SOURCE: http://bit.ly/2kumfAA Trends in Pharmacological Sciences,
online February 2, 2017.
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