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Synthetic Cannabis: Understanding the Risks

May 29, 2013

Cannabis has been used medicinally and recreationally for centuries. The principal active constituent of Cannabis, Δ-9-tetrahydrocannabinol (Δ9-THC), induces its psychoactive properties through agonistic interaction with cannabinoid CB1 receptors, which are located primarily in the central nervous system (Herkenham et al., 1990; Ishac et al., 1996). Since Gaoni and Mechoulam (1964) first discovered Δ9-THC in 1964 as the primary psychoactive ingredient in Cannabis, many other classical and nonclassical cannabinoids have been investigated for therapeutic use. It is generally thought that cannabinoid-based drugs offer great promise for the treatment of epilepsy, inflammation,  anxiety, neuro-degeneration, depression, and osteoporosis (Lee et al., 2009). However, because of legal issues around Cannabis, products containing synthetic cannabinoids are consumed as a surrogate for Cannabis due to their non-detectability with commonly used drug tests and their strong cannabimimetic effects.

Nacca, N., did a study to investigate withdrawal symptoms from synthetic Cannabis. Their study suggests that withdrawal from synthetic Cannabis has been described as a syndrome of anxiety, chills, and anorexia and could be due to the fact that synthetic products may contain several heterogeneous compounds, including amphetamine-like substances. (PMID: 23609214)

The Centres for Disease Control and Prevention published an article linking synthetic Cannabinoid use to acute kidney injury. (PMID: 23407124)  They state that synthetic Cannabinoids are typically dissolved in a solvent, applied to dried plant material, and smoked as an alternative to Cannabis.

Synthetic Cannabinoids are generally marketed as natural herbal incense mixtures under brand names such as “Spice” and “K2.” (PMID: 22691010)  These products are readily available on the internet and sold in many “head” shops and convenience stores.  There is mounting evidence identifying several synthetic Cannabinoids as causative agents responsible for psychoactive and adverse physical effects (PMID: 22561602).

Fattore, L and Fratta, W (2011) explain that synthetic Cannabinoids are functionally similar to THC, the psychoactive principle of Cannabis, and bind to the same Cannabinoid receptors in the brain and peripheral organs. From 2008, synthetic Cannabinoids were detected in herbal smoking mixtures sold on websites and in “head shops” under the brand name of Spice Gold, Yucatan Fire, Aroma, and others. Although these products do not contain tobacco or Cannabis, when smoked they produce effects similar to THC. Intoxication, withdrawal, psychosis, and death have been recently reported after consumption, posing difficult social, political, and health challenges. More than 140 different Spice products have been identified to date. The ability to induce strong Cannabis-like psychoactive effects, along with the fact that they are readily available on the Internet, still legal in many countries, marketed as natural safe substances, and undetectable by conventional drug screening tests, has rendered these drugs very popular and particularly appealing to young and drug-naïve individuals seeking new experiences. An escalating number of compounds with Cannabinoid receptor activity are currently being found as ingredients of Spice, of which almost nothing is known in terms of pharmacology, toxicology, and safety. Since legislation started to control the synthetic Cannabinoids identified in these herbal mixtures, many new analogs have appeared on the market. New Cannabimimetic compounds are likely to be synthesized in the near future to replace banned synthetic Cannabinoids. Spice smokers are exposed to drugs that are extremely variable in composition and potency, and are at risk of serious, if not lethal, outcomes (PMID: 22007163).

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