Acute effects of synthetic cannabinoids: Update 2015

ABSTRACT

Background: Cannabis is the most widely used illicit drug in the United States and Europe. In recent years, a range of new substances with cannabis-like effects—known as synthetic cannabinoids (SCs)—have suddenly burst on the drug scene. However, there is limited information about the clinical hazards linked to the use of these emerging substances. This review summarizes the literature to date relating the health effects of SCs. Method: A systematic literature review of original case studies was performed using PubMed and Web of Science (January 1980–July 2015). Only articles in which a drug screening was reported were included in this review. Results: Forty-six articles meeting the inclusion criteria were included in this review, reporting data on 114 patients who went to hospital emergency departments after exposure to SCs. The majority of patients were adolescent or young adult males (14–25 years; 24.5 ± 10.1 years). The most common route of administration was smoking. The SCs most involved were John William Huffman (JWH) derivatives, followed by XRL-11, ADB-PINACA, AM-2201, MAM-2201, and 5F-PB-22. This analysis showed that the use of these substances may cause minor and moderate side effects similar to those of cannabis intoxication, including tachycardia, nausea, somnolence, hallucinations, paranoia, xerostomia, and injected conjunctivae among others. However, atypical cannabis intoxication effects and worse complications (such as renal injuries, aggressiveness, cerebral ischemia, myocardial infarction, etc.) were also observed, which led to a significant morbidity were also observed. Some SCs were highlighted as being involved in 24 cases of deaths. Conclusions: In this review, the nature and frequency of the signs and symptoms of SC poisoning were estimated in order to inform health professionals about the health risks of these new and emerging substances.

KEYWORDS:

• Acute and fatal effects
• literature review
• synthetic cannabinoids
• toxicity

Acknowledgments

The authors wish to sincerely thank Madam Frederique Hass for her help and support assistance in preparing the manuscript and tables for publication.

Author contributions

Author J.T. managed the literature searches, checked the full text of selected articles for inclusion or exclusion, extracted data from every paper included, and wrote the first draft of the manuscript and the final version of the article. Author V.G. co-wrote the draft, checked the full text of selected articles for inclusion or exclusion, extracted data from every paper included, and contributed to writing the final version of the article. Author J.P.K. co-wrote the draft and contributed to writing the final version of the article. All authors have reviewed and accepted the contents of the manuscript prior to its submission.