Synthetic Cannabinoids: Overview and Risks

Introduction

• Synthetic Cannabinoids: Also known as synthetic marijuana, noids, herbal incense, K2, or spice.
• Bind to cannabinoid receptors producing cannabis-like effects.
• Typically analogs of THC, the main active compound in cannabis.

Forms and Usage

• Usually sprayed or soaked into dry herbs to resemble marijuana.
• Available as pure powder online.
• Commonly smoked or vaporized for quick onset.
• Also orally active when dissolved in lipids which can extend duration.
• Insoluble in water but soluble in ethanol and lipids.

Health Risks

• Serious Health Risks: Over 1,000 hospitalizations and 94 deaths linked to specific compounds.
  • MDMB-FUBINACA: Linked to hospitalizations and deaths in Russia and Belarus.
  • MDMB-CHMICA and 5F-ADB: Associated with 54 deaths in Europe between 2014-2017.
• Strongly discouraged to use for extended periods or in high doses.
• More severe side effects and toxicity compared to cannabis.
• Associated with deaths and severe health risks.

Popular Products

Herb Blends

• Popular names include K2 and Spice.
• Marketed as "herbal incense" or "herbal smoking blends."
• Pre-mixed blends more dangerous due to unknown chemicals and dosages.

Specific Compounds

• Indazolecarboxamides: 5F-AKB48, AB-CHMINACA, AB-FUBINACA
• Indolecarboxamides: APICA, STS-135, MDMB-CHMICA
• Indolecarboxylates: 5F-PB-22, BB-22
• Naphthoylindoles: AM-2201, JWH-018, JWH-073, JWH-122
• Naphthoylindazoles: THJ-018, THJ-2201
• Tetramethylcyclopropanoylindoles: UR-144, 5F-UR-144

Toxicity and Harm Potential

• Multiple deaths from chronic abuse and severe side effects from long-term use.
• Effects include high blood pressure, heart attacks, agitation, hallucinations, psychosis, seizures, and convulsions.
• Linked to acute kidney injury and strokes in some cases.

Deaths and Serious Adverse Events

• MDMB-FUBINACA: Most deadly, with over 1,000 hospitalizations and 40 deaths.
• MDMB-CHMICA: 71 serious events including 29 deaths across Europe.
• 5F-MDMB-PINACA: Associated with 25 deaths in Europe.
• Other compounds also linked to hospitalizations and deaths.

Psychosis and Mental Health

• Prolonged use may increase risk of mental illness and psychosis, especially in individuals with risk factors.
• Psychotic states may persist long after cessation of use.

Toxicity Concerns

• Some compounds may be toxic or carcinogenic, such as those containing a naphthalene group.

Addiction Potential

• Synthetic cannabinoids are moderately addictive with a high potential for abuse.
• Can cause psychological dependence and withdrawal symptoms.

Dangerous Interactions

• Some combinations with other substances (e.g., stimulants, lithium, hallucinogens) can be dangerous or life-threatening.

Recommendations

• Strongly advised to avoid use; if used, follow harm reduction practices.
• Avoid pre-mixed blends and opt for pure powder if necessary.

Additional Resources

• Links to responsible use, cannabinoids, and external research.