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Chapter 3 - Synthetic Cannabinoids

from Part I - Pharmacology of Cannabis and the Endocannabinoid System

Published online by Cambridge University Press:  12 May 2023

By
Liana Fattore  and
Matteo Marti
Edited by
Deepak Cyril D'Souza ,
David Castle  and
Sir Robin Murray
Deepak Cyril D'Souza
Affiliation:
Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine
David Castle
Affiliation:
University of Tasmania, Australia
Sir Robin Murray
Affiliation:
Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
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Summary

New synthetic cannabinoid agonists have been synthesized during the last decades and promoted for their psychoactive effects, mimicking those of delta-9-tetrahydrocannabinol. These newest cannabimimetic drugs show binding affinities for the cannabinoid CB1 and/or the CB2 receptors. They are manufactured by spraying the synthetic cannabinoid onto relatively inert vegetable material or by solubilizing them in ’e-liquids’ for electronic cigarettes. They are lipid soluble and non-polar and volatilize easily when smoked. However, these drugs have been associated with psychiatric and medical complications. The most typical adverse effects of synthetic cannabinoid agonists included agitation, confusion, anxiety, psychosis, nausea, and vomiting, but drowsiness, tachycardia, and hypertension are also reported frequently. Atypical effects can also manifest, including shock, seizures, fever, rhabdomyolysis, myocardial infarction, stroke, acute kidney injury, and multiple organ failure. The cardiovascular and neuropsychiatric effects, which in some cases can be severe and long-lasting, are among the most common reasons for emergency medical treatment. Due to limited knowledge about their pharmacology and toxicity, managing acute intoxications is challenging and treatment strategies are mostly limited to symptomatic and supportive care.

Keywords

novel psychoactive substances (NPS)spice drugslegal highCB1 receptor agonistsacute intoxicationstoxicitygenotoxicity
Type
Chapter
Information
Marijuana and Madness , pp. 21 - 30
Publisher: Cambridge University Press
Print publication year: 2023

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References

Akram, H., Mokrysz, C., and Curran, H. V. (2019). What are the psychological effects of using synthetic cannabinoids? A systematic review. J Psychopharmacol, 33, 271–283.CrossRefGoogle ScholarPubMed
Alexandre, J., Carmo, H., Carvalho, F., et al. (2020). Synthetic cannabinoids and their impact on neurodevelopmental processes. Addict Biol, 25, e12824.Google Scholar
Altintas, M., Inanc, L., Oruc, G. A., et al. (2016). Clinical characteristics of synthetic cannabinoid-induced psychosis in relation to schizophrenia: A single-center cross-sectional analysis of concurrently hospitalized patients. Neuropsychiatr Dis Treat, 12, 1893–1900.Google Scholar
Altintop, I. (2020). A 4-year retrospective analysis of patients presenting at the emergency department with synthetic cannabinoid intoxication in Turkey. J Clin Psychopharmacol, 40, 464–467.Google Scholar
van Amsterdam, J., Brunt, T., and van den Brink, W. (2015). The adverse health effects of synthetic cannabinoids with emphasis on psychosis-like effects. J Psychopharmacol, 29, 254–263.Google Scholar
Angerer, V., Franz, F., Moosmann, B., et al. (2019). 5F-Cumyl-PINACA in ‘e-liquids’ for electronic cigarettes: Comprehensive characterization of a new type of synthetic cannabinoid in a trendy product including investigations on the in vitro and in vivo phase I metabolism of 5F-Cumyl-PINACA and its non-fluorinated analog Cumyl-PINACA. Forensic Toxicol, 37, 186–196.Google Scholar
Argamany, J. R., Reveles, K. R., and Duhon, B. (2016). Synthetic cannabinoid hyperemesis resulting in rhabdomyolysis and acute renal failure. Am J Emerg Med, 34, 765.e1–2.Google Scholar
Auwärter, V., Dresen, S., Weinmann, W., et al. (2009). ‘Spice’ and other herbal blends: Harmless incense or cannabinoid designer drugs? J Mass Spectrom, 44, 832–837.Google Scholar
Barbieri, M., Ossato, A., Canazza, I., et al. (2016). Synthetic cannabinoid JWH-018 and its halogenated derivatives JWH-018-Cl and JWH-018-Br impair novel object recognition in mice: Behavioral, electrophysiological and neurochemical evidence. Neuropharmacology, 109, 254–269.Google Scholar
Basavarajappa, B. S., and Subbanna, S. (2019). Potential mechanisms underlying the deleterious effects of synthetic cannabinoids found in spice/K2 products. Brain Sci, 9, 14.Google Scholar
Benford, D. M., and Caplan, J. P. (2011). Psychiatric sequelae of spice, k2, and synthetic cannabinoid receptor agonists. Psychosomatics, 52, 295.Google Scholar
Besli, G. E., Ikiz, M. A., Yildirim, S., et al. (2015). Synthetic cannabinoid abuse in adolescents: A case series. J Emerg Med, 49, 644–650.Google Scholar
Bilel, S., Tirri, M., Arfè, R., et al. (2019). Pharmacological and behavioral effects of the synthetic cannabinoid AKB48 in rats. Front Neurosci, 13, 1163.Google Scholar
Bilel, S., Tirri, M., Arfè, R., et al. (2020). Novel halogenated synthetic cannabinoids impair sensorimotor functions in mice. Neurotoxicology, 76, 17–32.Google Scholar
Brents, L. K., Gallus-Zawada, A., Radominska-Pandya, A., et al. (2012). Monohydroxylated metabolites of the K2 synthetic cannabinoid JWH-073 retain intermediate to high cannabinoid 1 receptor (CB1R) affinity and exhibit neutral antagonist to partial agonist activity. Biochem Pharmacol, 83, 952–961.CrossRefGoogle ScholarPubMed
Brents, L. K., Reichard, E. E., Zimmerman, S. M., et al. (2011). Phase I hydroxylated metabolites of the K2 synthetic cannabinoid JWH-018 retain in vitro and in vivo cannabinoid 1 receptor affinity and activity. PLoS ONE, 6, e21917.Google Scholar
Canazza, I., Ossato, A., Trapella, C., et al. (2016). Effect of the novel synthetic cannabinoids AKB48 and 5F-AKB48 on ‘tetrad’, sensorimotor, neurological and neurochemical responses in mice. In vitro and in vivo pharmacological studies. Psychopharmacology, 233, 3685–3709.Google Scholar
Canazza, I., Ossato, A., Vincenzi, F., et al. (2017). Pharmaco-toxicological effects of the novel third-generation fluorinate synthetic cannabinoids, 5F-ADBINACA, AB-FUBINACA, and STS-135 in mice. In vitro and in vivo studies. Hum Psychopharmacol, 32, 3.Google Scholar
Castellanos, D., Singh, S., Thornton, G., et al. (2011). Synthetic cannabinoid use: A case series of adolescents. J Adolesc Health, 49, 347–349.Google Scholar
Caviness, C. M., Tzilos, G., Anderson, B. J., et al. (2015). Synthetic cannabinoids: Use and predictors in a community sample of young adults. Subst Abus, 36, 368–373.Google Scholar
Coccini, T., De Simone, U., Lonati, D., et al. (2021). MAM-2201, one of the most potent-naphthoyl indole derivative-synthetic cannabinoids, exerts toxic effects on human cell-based models of neurons and astrocytes. Neurotox Res, 39, 1251–1273.Google Scholar
Cohen, K., Kapitány-Fövény, M., Mama, Y., et al. (2017). The effects of synthetic cannabinoids on executive function. Psychopharmacology, 234, 1121–1134.Google Scholar
Cohen, K., and Weinstein, A. M. (2018). Synthetic and non-synthetic cannabinoid drugs and their adverse effects: A review from public health prospective. Front Public Health, 6, 162.Google Scholar
Cooper, Z. D. (2016). Adverse effects of synthetic cannabinoids: Management of acute toxicity and withdrawal. Curr Psychiatry Rep, 18, 52.Google Scholar
Cooper, Z. D., and Craft, R. M. (2018). Sex-dependent effects of cannabis and cannabinoids: A translational perspective. Neuropsychopharmacology, 43, 34–51.Google Scholar
Cooper, Z. D., Evans, S. M., and Foltin, R. W. (2021). Self-administration of inhaled delta-9-tetrahydrocannabinol and synthetic cannabinoids in non-human primates. Exp Clin Psychopharmacol, 29, 137–146.Google Scholar
DAWN. (2012). The DAWN Report: Drug-Related Emergency Department Visits Involving Synthetic Cannabinoids; Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality: Rockville, MD.Google Scholar
De Luca, M. A., Bimpisidis, Z., Melis, M., et al. (2015). Stimulation of in vivo dopamine transmission and intravenous self-administration in rats and mice by JWH-018, a Spice cannabinoid. Neuropharmacology, 99, 705–714.Google Scholar
De Luca, M. A., and Fattore, L. (2018). Therapeutic use of synthetic cannabinoids: Still an open issue? Clin Ther, 40, 1457–1466.Google Scholar
Dresen, S., Ferreirós, N., Pütz, M., et al. (2010). Monitoring of herbal mixtures potentially containing synthetic cannabinoids as psychoactive compounds. J Mass Spectrom, 45, 1095–1232.CrossRefGoogle ScholarPubMed
Egan, K. L., Suerken, C. K., Reboussin, B. A., et al. (2015). K2 and spice use among a cohort of college students in southeast region of the USA. Am J Drug Alcohol Abuse, 41, 317–322.CrossRefGoogle ScholarPubMed
Elmore, J. S., and Baumann, M. H. (2018). Repeated exposure to the ‘spice’ cannabinoid JWH-018 induces tolerance and enhances responsiveness to 5-HT1A receptor stimulation in male rats. Front Psychiatry, 9, 55.Google Scholar
Escelsior, A., Belvederi Murri, M., Corsini, G. P., et al. (2021). Cannabinoid use and self-injurious behaviours: A systematic review and meta-analysis. J Affect Disord, 278, 85–98.CrossRefGoogle ScholarPubMed
Fasih, A. (2021). Lethal coagulopathy resulting from the consumption of contaminated synthetic cannabinoids: The story of a public health crisis. J Public Health (Oxf), 43, e1–e6.Google Scholar
Fattore, L. (2013). Considering gender in cannabinoid research: A step towards personalized treatment of marijuana addicts. Drug Test Anal, 5, 57–61.Google Scholar
Fattore, L. (2016). Synthetic cannabinoids: Further evidence supporting the relationship between cannabinoids and psychosis. Biol Psychiatry, 79, 539–548.Google Scholar
Fattore, L., and Fratta, W. (2010). How important are sex differences in cannabinoid action? Br J Pharmacol, 160, 544–548.Google Scholar
Fattore, L., and Fratta, W. (2011). Beyond THC: The new generation of cannabinoid designer drugs. Front Behav Neurosci, 5, 60.Google Scholar
Fattore, L., Marti, M., Mostallino, R., et al. (2020). Sex and gender differences in the effects of novel psychoactive substances. Brain Sci, 10, 606.Google Scholar
Ferk, F., Gminski, R., Al-Serori, H., et al. (2016). Genotoxic properties of XLR-11, a widely consumed synthetic cannabinoid, and of the benzoyl indole RCS-4. Arch Toxicol, 90, 3111–3123.Google Scholar
Forrester, M. B., Kleinschmidt, K., Schwarz, E., et al. (2011). Synthetic cannabinoid exposures reported to Texas poison centers. J Addict Dis, 30, 351–358.Google Scholar
Gampfer, T. M., Wagmann, L., Belkacemi, A., et al. (2021). Cytotoxicity, metabolism, and isozyme mapping of the synthetic cannabinoids JWH-200, A-796260, and 5F-EMB-PINACA studied by means of in vitro systems. Arch Toxicol, 95, 3539–3557.Google Scholar
Grafinger, K. E., Cannaert, A., Ametovski, A., et al. (2021a). Systematic evaluation of a panel of 30 synthetic cannabinoid receptor agonists structurally related to MMB-4en-PICA, MDMB-4en-PINACA, ADB-4en-PINACA, and MMB-4CN-BUTINACA using a combination of binding and different CB1 receptor activation assays-Part II: Structure activity relationship assessment via a β-arrestin recruitment assay. Drug Test Anal, 13, 1402–1411.Google Scholar
Grafinger, K. E., Vandeputte, M. M., Cannaert, A., et al. (2021b). Systematic evaluation of a panel of 30 synthetic cannabinoid receptor agonists structurally related to MMB-4en-PICA, MDMB-4en-PINACA, ADB-4en-PINACA, and MMB-4CN-BUTINACA using a combination of binding and different CB1 receptor activation assays. Part III: The G protein pathway and critical comparison of different assays. Drug Test Anal, 13, 1412–1429.Google Scholar
Guler, E. M., Bektay, M. Y., Akyildiz, A. G., et al. (2020). Investigation of DNA damage, oxidative stress, and inflammation in synthetic cannabinoid users. Hum Exp Toxicol, 39, 1454–1462.Google Scholar
Gunderson, E. W., Haughey, H. M., Ait-Daoud, N., et al. (2012). ‘Spice’ and ‘K2’ herbal highs: A case series and systematic review of the clinical effects and biopsychosocial implications of synthetic cannabinoid use in humans. Am J Addict, 21, 320–326.CrossRefGoogle ScholarPubMed
Gutierrez, K. M., and Cooper, T. V. (2014). Investigating correlates of synthetic marijuana and salvia use in light and intermittent smokers and college students in a predominantly Hispanic sample. Exp Clin Psychopharmacol, 22, 524–529.Google Scholar
Haden, M., Archer, J. R., Dargan, P. I., et al. (2017). MDMB-CHMICA: Availability, patterns of use, and toxicity associated with this novel psychoactive substance. Subst Use Misuse, 52, 223–232.Google Scholar
Hermanns-Clausen, M., Kneisel, S., Szabo, B., et al. (2013). Acute toxicity due to the confirmed consumption of synthetic cannabinoids: Clinical and laboratory findings. Addiction, 108, 534–544.Google Scholar
Hiranita, T. (2015). Self-administration of JWH-018 a synthetic cannabinoid in experimentally naïve rats. J Alcohol Drug Depend, 3, e128.Google Scholar
Hobbs, M., Kalk, N. J., Morrison, P. D., et al. (2018). Spicing it up: Synthetic cannabinoid receptor agonists and psychosis: A systematic review. Eur Neuropsychopharmacol, 28, 1289–1304.Google Scholar
Hurst, D., Loeffler, G., and McLay, R. (2011). Psychosis associated with synthetic cannabinoid agonists: A case series. Am J Psychiatry, 168, 1119.Google Scholar
Joseph, A. M., Manseau, M. W., Lalane, M., et al. (2017). Characteristics associated with synthetic cannabinoid use among patients treated in a public psychiatric emergency setting. Am J Drug Alcohol Abuse, 43, 117–122.Google Scholar
Kaneko, S. (2017). Motor vehicle collisions caused by the ‘super-strength’ synthetic cannabinoids, MAM-2201, 5F-PB-22, 5F-AB-PINACA, 5F-AMB and 5F-ADB in Japan experienced from 2012 to 2014. Forensic Toxicol, 35, 244–251.Google Scholar
Karinen, R., Tuv, S. S., Øiestad, E. L., et al. (2015). Concentrations of APINACA, 5F-APINACA, UR-144 and its degradant product in blood samples from six impaired drivers compared to previous reported concentrations of other synthetic cannabinoids. Forensic Sci Int, 246, 98–103.Google Scholar
Koller, V. J., Auwärter, V., Grummt, T., et al. (2014). Investigation of the in vitro toxicological properties of the synthetic cannabimimetic drug CP-47,497-C8. Toxicol Appl Pharmacol, 277, 164–171.Google Scholar
Koller, V. J., Ferk, F., Al-Serori, H., et al. (2015). Genotoxic properties of representatives of alkylindazoles and aminoalkyl-indoles which are consumed as synthetic cannabinoids. Food Chem Toxicol, 80, 130–136.Google Scholar
Langer, N., Lindigkeit, R., Schiebel, H. M., et al. (2016). Identification and quantification of synthetic cannabinoids in ‘spice-like’ herbal mixtures: Update of the German situation for the spring of 2016. Forensic Sci Int, 269, 31–41.Google Scholar
Lapoint, J., James, L. P., Moran, C. L., et al. (2011). Severe toxicity following synthetic cannabinoid ingestion. Clin Toxicol, 49, 760–764.Google Scholar
Lemos, N. P. (2014). Driving under the influence of synthetic cannabinoid receptor agonist XLR-11. J Forensic Sci, 59, 1679–1683.CrossRefGoogle ScholarPubMed
Lenzi, M., Cocchi, V., Cavazza, L., et al. (2020). Genotoxic properties of synthetic cannabinoids on TK6 human cells by flow cytometry. Int J Mol Sci, 21, 1150.Google Scholar
Louis, A., Peterson, B. L., and Couper, F. J. (2014). XLR-11 and UR-144 in Washington state and state of Alaska driving cases. J Anal Toxicol, 38, 563–568.CrossRefGoogle ScholarPubMed
Martinotti, G., Santacroce, R., Papanti, D., et al. (2017). Synthetic cannabinoids: Psychopharmacology, clinical aspects, psychotic onset. CNS Neurol Disord Drug Targets, 16, 567–575.Google Scholar
McCain, K. R., Jones, J. O., Chilbert, K. T., et al. (2018). Impaired driving associated with the synthetic cannabinoid 5F-Adb. J Forensic Sci Criminol, 6, 10.15744/2348-9804.6.105.Google Scholar
Meijer, K. A., Russo, R. R., and Adhvaryu, D. V. (2014). Smoking synthetic marijuana leads to self-mutilation requiring bilateral amputations. Orthopedics, 37, 391–394.Google Scholar
Miliano, C., Margiani, G., Fattore, L., et al. (2018). Sales and advertising channels of new psychoactive substances (NPS): Internet, social networks, and smartphone apps. Brain Sci, 8, 123.Google Scholar
Morbiato, E., Bilel, S., Tirri, M., et al. (2020). Potential of the zebrafish model for the forensic toxicology screening of NPS: A comparative study of the effects of APINAC and methiopropamine on the behavior of zebrafish larvae and mice. Neurotoxicology, 78, 36–46.Google Scholar
Münster-Müller, S., Matzenbach, I., Knepper, T., et al. (2020). Profiling of synthesis-related impurities of the synthetic cannabinoid Cumyl-5F-PINACA in seized samples of e-liquids via multivariate analysis of UHPLC-MSn data. Drug Test Anal, 12, 119–126.Google Scholar
Musshoff, F., Madea, B., Kernbach-Wighton, G., et al. (2014). Driving under the influence of synthetic cannabinoids (‘Spice’): A case series. Int J Legal Med, 128, 59–64.Google Scholar
Nia, A. B., Mann, C., Kaur, H., et al. (2018). Cannabis use: Neurobiological, behavioral, and sex/gender considerations. Curr Behav Neurosci Rep, 5, 271–280.Google Scholar
Nia, A. B., Mann, C. L., Spriggs, S., et al. (2019). The relevance of sex in the association of synthetic cannabinoid use with psychosis and agitation in an inpatient population. J Clin Psychiatry, 80, 18m12539.Google Scholar
Ossato, A., Canazza, I., Trapella, C., et al. (2016). Effect of JWH-250, JWH-073 and their interaction on ‘tetrad’, sensorimotor, neurological and neurochemical responses in mice. Prog Neuropsychopharmacol Biol Psychiatry, 67, 31–50.Google Scholar
Ossato, A., Uccelli, L., Bilel, S., et al. (2017). Psychostimulant effect of the synthetic cannabinoid JWH-018 and AKB48: Behavioral, neurochemical, and dopamine transporter scan imaging studies in mice. Front Psychiatry, 8, 130.Google Scholar
Ossato, A., Vigolo, A., Trapella, C., et al. (2015). JWH-018 impairs sensorimotor functions in mice. Neuroscience, 300, 174–188.Google Scholar
Palamar, J. J., Acosta, P., Calderón, F. F., et al. (2017). Assessing self-reported use of new psychoactive substances: The impact of gate questions. Am J Drug Alcohol Abuse, 43, 609–617.Google Scholar
Palamar, J. J., Martins, S. S., Su, M. K., et al. (2015). Self-reported use of novel psychoactive substances in a US nationally representative survey: Prevalence, correlates, and a call for new survey methods to prevent underreporting. Drug Alcohol Depend, 156, 112–119.CrossRefGoogle Scholar
Peglow, S., Buchner, J., and Briscoe, G. (2012). Synthetic cannabinoid induced psychosis in a previously nonpsychotic patient. Am J Addict, 21, 287–288.Google Scholar
Peterson, B. L., and Couper, F. J. (2015). Concentrations of AB-CHMINACA and AB-PINACA and driving behavior in suspected impaired driving cases. J Anal Toxicol, 39, 642–647.Google Scholar
Rajasekaran, M., Brents, L. K., Franks, L. N., et al. (2013). Human metabolites of synthetic cannabinoids JWH-018 and JWH-073 bind with high affinity and act as potent agonists at cannabinoid type-2 receptors. Toxicol Appl Pharmacol, 269, 100–108.Google Scholar
Riley, S. B., Sochat, M., Moser, K., et al. (2019). Case of brodifacoum-contaminated synthetic cannabinoid. Clin Toxicol, 57, 143–144.Google Scholar
Roberto, A. J., Lorenzo, A., Li, K. J., et al. (2016). First-episode of synthetic cannabinoid-induced psychosis in a young adult, successfully managed with hospitalization and risperidone. Case Rep Psychiatry, 2016, 7257489.Google Scholar
Schifano, F., Corazza, O., Deluca, P., et al. (2009). Psychoactive drug or mystical incense? Overview of the online available information on spice products. Int J Cult Ment Health, 2, 137–144.Google Scholar
Seely, K. A., Lapoint, J., Moran, J. H., et al. (2012). Spice drugs are more than harmless herbal blends: A review of the pharmacology and toxicology of synthetic cannabinoids. Prog Neuropsychopharmacol Biol Psychiatry, 39, 234–243.Google Scholar
Sevinc, M. M., Kinaci, E., Bayrak, S., et al. (2015). Extraordinary cause of acute gastric dilatation and hepatic portal venous gas: Chronic use of synthetic cannabinoid. World J Gastroenterol, 21, 10704–10708.Google Scholar
Sezer, Y., Jannuzzi, A. T., Huestis, M. A., et al. (2020). In vitro assessment of the cytotoxic, genotoxic and oxidative stress effects of the synthetic cannabinoid JWH-018 in human SH-SY5Y neuronal cells. Toxicol Res, 9, 734–740.Google Scholar
Solimini, R., Busardò, F. P., Rotolo, M. C., et al. (2017). Hepatotoxicity associated to synthetic cannabinoids use. Eur Rev Med Pharmacol Sci, 21, 1–6.Google Scholar
Sud, P., Gordon, M., Tortora, L., et al. (2018). Retrospective chart review of synthetic cannabinoid intoxication with toxicologic analysis. West J Emerg Med, 19, 567–572.Google Scholar
Sweeney, B., Talebi, S., Toro, D., et al. (2016). Hyperthermia and severe rhabdomyolysis from synthetic cannabinoids. Am J Emerg Med, 34, 121.e1–2.Google Scholar
Tai, S., and Fantegrossi, W. E. (2017). Pharmacological and toxicological effects of synthetic cannabinoids and their metabolites. Curr Top Behav Neurosci, 32, 249–262.Google Scholar
Theunissen, E. L., Reckweg, J. T., Hutten, N. R. P. W., et al. (2022). Psychotomimetic symptoms after a moderate dose of a synthetic cannabinoid (JWH-018): Implications for psychosis. Psychopharmacology, 239, 1251–1261.Google Scholar
Thomas, S., Bliss, S., and Malik, M. (2012). Suicidal ideation and self-harm following K2 use. J Okla State Med Assoc, 105, 430–433.Google ScholarPubMed
Tomiyama, K. I., and Funada, M. (2021). Synthetic cannabinoid CP-55,940 induces apoptosis in a human skeletal muscle model via regulation of CB1 receptors and L-type Ca2+ channels. Arch Toxicol, 95, 617–630.Google Scholar
Uchiyama, N., Kikura-Hanajiri, R., Ogata, J., et al. (2010). Chemical analysis of synthetic cannabinoids as designer drugs in herbal products. Forensic Sci Int, 198, 31–38.Google Scholar
Ukaigwe, A., Karmacharya, P., and Donato, A. (2014). A gut gone to pot: A case of cannabinoid hyperemesis syndrome due to K2, a synthetic cannabinoid. Case Rep Emerg Med, 167098.Google Scholar
Van der Veer, N., and Friday, J. (2011). Persistent psychosis following the use of Spice. Schizophr Res, 130, 285–286.Google Scholar
Vidourek, R. A., King, K. A., and Burbage, M. L. (2013). Reasons for synthetic THC use among college students. J Drug Educ, 43, 353–363.Google Scholar
Wang, X. F., Galaj, E., Bi, G. H., et al. (2020). Different receptor mechanisms underlying phytocannabinoid- versus synthetic cannabinoid-induced tetrad effects: Opposite roles of CB1 /CB2 versus GPR55 receptors. Br J Pharmacol, 177, 1865–1880.Google Scholar
Weinstein, A. M., Rosca, P., Fattore, L., et al. (2017). Synthetic cathinone and cannabinoid designer drugs pose a major risk for public health. Front Psychiatry, 8, 156.Google Scholar
Wells, D. L., and Ott, C. A. (2011). The ‘new’ marijuana. Ann Pharmacother, 45, 414–417.Google Scholar
Wu, N., Danoun, S., Balayssac, S., et al. (2021). Synthetic cannabinoids in e-liquids: A proton and fluorine NMR analysis from a conventional spectrometer to a compact one. Forensic Sci Int, 324, 110813.Google Scholar
Yalçın, M., Tunalı, N., Yıldız, H., et al. (2018). Sociodemographic and clinical characteristics of synthetic cannabinoid users in a large psychiatric emergency department in Turkey. J Addict Dis, 37, 259–267.Google Scholar
Zarifi, C., and Vyas, S. (2017). Spice-y kidney failure: A case report and systematic review of acute kidney injury attributable to the use of synthetic cannabis. Perm J, 21, 16–160.Google Scholar
Zimmermann, U. S., Winkelmann, P. R., Pilhatsch, M., et al. (2009). Withdrawal phenomena and dependence syndrome after the consumption of ‘spice gold’. Dtsch Artzebl Int, 106, 464–467.Google Scholar
Zorlu, N., Di Biase, A. M., Kalaycı, Ç. Ç., et al. (2016). Abnormal white matter integrity in synthetic cannabinoid users. Eur Neuropsychopharmacol, 26, 1818–1825.Google Scholar

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  • Synthetic Cannabinoids
  • Edited by Deepak Cyril D'Souza, Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine, David Castle, University of Tasmania, Australia, Sir Robin Murray, Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
  • Book: Marijuana and Madness
  • Online publication: 12 May 2023
  • Chapter DOI: https://doi.org/10.1017/9781108943246.004
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  • Synthetic Cannabinoids
  • Edited by Deepak Cyril D'Souza, Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine, David Castle, University of Tasmania, Australia, Sir Robin Murray, Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
  • Book: Marijuana and Madness
  • Online publication: 12 May 2023
  • Chapter DOI: https://doi.org/10.1017/9781108943246.004
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  • Synthetic Cannabinoids
  • Edited by Deepak Cyril D'Souza, Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine, David Castle, University of Tasmania, Australia, Sir Robin Murray, Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
  • Book: Marijuana and Madness
  • Online publication: 12 May 2023
  • Chapter DOI: https://doi.org/10.1017/9781108943246.004
Available formats
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