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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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  • 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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