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Synthetic cannabinoids: Epidemiology, pharmacodynamics, and clinical implications
Open accessAbstract
Background Synthetic cannabinoids (SC) are a heterogeneous group of compounds developed to probe the endogenous cannabinoid system or as potential therapeutics. Clandestine laboratories subsequently utilized published data to develop SC variations marketed as abuseable “designer drugs.” In the early 2000’s, SC became popular as “legal highs” under brand names such as “Spice” and “K2,” in part due to their ability to escape detection by standard cannabinoid screening tests. The majority of SC detected in herbal products have greater binding affinity to the cannabinoid CB1 receptor than does Δ9-tetrahydrocannabinol (THC), the primary psychoactive compound in the cannabis plant, and greater affinity at the CB1 than the CB2 receptor. In-vitro and animal in-vivo studies show SC pharmacological effects 2-100 times more potent than THC, including analgesic, anti-seizure, weight-loss, anti-inflammatory, and anti-cancer growth effects. SC produce physiological and psychoactive effects similar to THC, but with greater intensity, resulting in medical and psychiatric emergencies. Human adverse effects include nausea and vomiting, shortness of breath or depressed breathing, hypertension, tachycardia, chest pain, muscle twitches, acute renal failure, anxiety, agitation, psychosis, suicidal ideation, and cognitive impairment. Long-term or residual effects are unknown. Due to these public health consequences, many SC are classified as controlled substances. However, frequent structural modification by clandestine laboratories results in a stream of novel SC that may not be legally controlled or detectable by routine laboratory tests. Methods We present here a comprehensive review, based on a systematic electronic literature search, of SC epidemiology and pharmacology and their clinical implications.
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Therapeutic potential of cannabis-related drugs
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Effects of increasing cannabis potency on adolescent health
Wilson, J., Freeman, T. P., & Mackie, C. J. (2019) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(18)30342-0 · Cited by 113
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Toxicity of Synthetic Cannabinoids in K2/Spice: A Systematic Review
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Lovelace, J. W., Corches, A., Vieira, P. A., Hiroto, A. S., Mackie, K., & Korzus, E. (2015) · Neuropharmacology · doi:10.1016/j.neuropharm.2015.04.034 · Cited by 43
Substance misuse-related poisoning deaths, England and Wales, 1993–2016
Handley, S., Ramsey, J., & Flanagan, R. (2018) · Drug Science, Policy and Law · doi:10.1177/2050324518767445 · Cited by 16
Activity-based detection of synthetic cannabinoid receptor agonists in plant materials
Timmerman, A., Balcaen, M., Coopman, V., Degreef, M., Pottie, E., & Stove, C. P. (2024) · Harm Reduction Journal · doi:10.1186/s12954-024-01044-4 · Cited by 8
Metadata
- Authors
- Castaneto, M. S., Gorelick, D. A., Desrosiers, N. A., Hartman, R. L., Pirard, S., & Huestis, M. A.
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2014-11
- Volume
- 144
- Pages
- 12-41
- ISSN
- 0376-8716 (ISSN-L)
- OpenAlex
- W2074114778
- Cited by
- 709
- References
- 6
- FWCI
- 86.76
- Type
- journal article
- Language
- en
- Open access
- green
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