Synthetic cannabinoids
Synthetic cannabinoids
Synthetic cannabinoids are a heterogeneous group of substances that were originally designed and developed by scientific researchers at universities and pharmaceutical companies to facilitate the study of the endogenous cannabinoid system or as potential therapeutic tools.
In general, the initial compounds attempted to mimic the chemical structure of Δ 9-THC to try to reproduce the physiological effects of natural cannabis. However, it must be made clear that these substances are not marijuana or cannabis, and that they are not natural substances either. In addition, the potential consumer should know that they are normally much more potent than natural cannabis or its derivatives, since they bind with greater affinity to brain cannabinoid receptors, and are also capable of activating other receptors on which the natural components do not act. of the plant. The effect of these compounds usually appears more quickly than if natural cannabis is consumed, although in some cases their duration is shorter. Both the onset of effects and their duration will usually depend on the route of administration, which in the case of synthetic cannabinoids is usually smoked, inhaled, or orally.
At the beginning of the 21st century, different drug mafias used the published scientific information on these compounds to synthesize them in clandestine laboratories and introduce them to the black market as “legal” or “safe” alternatives to cannabis. Once synthesized, synthetic cannabinoids are dissolved in ethanol or acetone and spray-dried on a mixture of dried plants to be falsely marketed as incense or herbal products. They can also be sold in liquid form to be vaporized and inhaled in electronic cigarettes and other devices (liquid incenses). These synthetic cannabinoids are sold on the internet through different websites, or in certain specialized stores, under a variety of trade names such as “Spice”, ” In many cases, a single product may contain a mixture of three or four different synthetic cannabinoids, or may even appear mixed with other types of psychoactive substances such as mephedrone, methamphetamine or piperazines. Furthermore, the clandestine manufacturing process for these products can lead to an uneven distribution of synthetic substances within the herbal mixture. For this reason, some products may have parts in which the synthetic cannabinoid is much more concentrated so that the doses are higher than expected and there is an increased risk of serious adverse effects.
The clandestine manufacturing process for these products can lead to an uneven distribution of synthetic substances within the herbal mix. For this reason, some products may have parts in which the synthetic cannabinoid is much more concentrated so that the doses are higher than expected and there is an increased risk of serious adverse effects. The clandestine manufacturing process for these products can lead to an uneven distribution of synthetic substances within the herbal mix. For this reason, some products may have parts in which the synthetic cannabinoid is much more concentrated so that the doses are higher than expected and there is an increased risk of serious adverse effects.
The success of these compounds and the extension of their consumption in recent years has been due to several reasons, among them their “a legal” commercialization, taking advantage of the legal gaps existing in the different laws of each country, obtaining them at cheaper prices than the Natural cannabis itself, its misperception among consumers as safe or even medicinal substances, the fact that it can be easily obtained through the internet, and the difficulty of being detected in routine tests. Despite this, the appearance in recent years of hundreds of cases of serious poisoning, and even dozens of deaths, Associated with the consumption of these substances has led to legislative and European initiatives that have ended with the inclusion of several synthetic cannabinoids in the list of prohibited substances. However, the high number of synthetic cannabinoids, their chemical diversity, and their speed of appearance make detection, control, and response to this group of compounds, particularly difficult challenges. Thus, when a synthetic cannabinoid is or is about to be, legally controlled, manufacturers have one or more substitute substances ready to go on sale. As an example, the European Union Early Warning System has detected 160 different synthetic cannabinoids between 2008 and 2015.
Synthetic cannabinoids bind to CB1 and CB2 cannabinoid receptors with a varying degree of affinity and in most cases activate these receptors. Thus, these compounds produce effects similar to those of Δ 9-THC, although between 2 and 100 times more powerful. Therefore, in many cases, they can trigger acute poisonings that can endanger the consumer’s life. In this sense, it has been shown that the risk of needing emergency medical treatment is between 14 and 30 times higher after the consumption of synthetic cannabinoids than if natural cannabis is consumed. A recent online survey of synthetic cannabinoid users showed that 2.5% had required emergency treatment in the last year related to the adverse effects of consuming these substances. Thus, the need for medical assistance is tripled with synthetic cannabinoids with respect to cannabis or other drugs such as cocaine, ketamine or alcohol. Further,
In general, the person consuming synthetic cannabinoids looks for effects similar to those produced by natural cannabis, mainly a certain feeling of euphoria, stimulation, hilarity or a state of slight relaxation. However, in addition to these effects, cardiovascular, gastrointestinal, neurological side effects or even psychiatric disorders can also appear in most cases. In the documented cases of synthetic cannabinoid poisoning, numerous signs and symptoms have been described, including: nausea, vomiting, respiratory difficulties, hypertension, tachycardia, hyperthermia, nephrotoxicity, acute cerebral ischemia, seizures, anxiety, agitation and psychotic episodes.
Another of the most striking features of synthetic cannabinoids is their ability to cause outbreaks of mass poisoning. Sometimes these are hundreds of people affected for a short period, and it has been a major problem in recent years in various countries. For example, in 2014, the synthetic cannabinoid MDMB-FUBINACA caused over 600 poisonings in Russia over a two-week period, of which 15 people died. In 2016, an “zombie epidemic” caused by the artificial cannabinoid AMB-FUBINACA was jointly delimited in New York. Those affected presented a serious alteration in their mental state with erratic behavior that was defined by witnesses as similar to that of a Zombie. This massive poisoning affected 33 people, of whom 18 had to be evacuated to the hospital.
The clinical management of synthetic cannabinoid poisoning is mainly symptomatic, requiring basic life support with the administration of intravenous sera and in some cases benzodiazepines. The changing composition of the products sold as synthetic cannabinoids, as well as the lack of routine toxicological tests that can accurately and quickly determine the identity of the compound or compounds consumed, greatly hinders the correct diagnosis of this type of poisoning, as well as its treatment. Within this context, one of the main problems associated with poisoning by these compounds is that they are not detected by the usual screening methods used in hospitals and health centers. Therefore, the use of more complex detection methods is required, such as gas chromatography or mass spectrometry, which can delay the identification of the specific compound causing the poisoning for even several days. In general, the detection period in the blood or oral fluids of different synthetic cannabinoids varies between 12 and 48 hours, while in urine samples, they can appear up to 72 hours after consumption.
The consumption of synthetic cannabinoids can also produce addictive behaviors and interact with other drugs of abuse, increasing the risk of poisoning and its severity. In this sense, the existence of a withdrawal syndrome in habitual users of synthetic cannabinoids has been described, which appears rapidly after cessation of consumption and has been associated with the appearance of serious symptoms such as difficulty breathing, seizures or cardiovascular complications severe.
There are also several scientific studies that have warned about the consequences that the consumption of synthetic cannabinoids can have for driving. Thus, it has been shown that people who drove under the effects of a synthetic cannabinoid had less motor coordination, a longer reaction time and, in many cases, more aggressive driving. All this causes a significant increase in the risk of having a traffic accident.
In conclusion, it is worth emphasizing that the different synthetic cannabinoids are potentially dangerous substances since they are much more potent than natural cannabis, and in most cases their toxic effects in humans are unknown.
