not your mother’s drugs: synthetic cannabinoids
DESCRIPTION
Not Your Mother’s Drugs: Synthetic Cannabinoids. Diane A. Tennies, Ph.D., LADC Lead TEAP Health Specialist. Learning Objectives. Describe the synthetic cannabinoids and why they are increasing in popularity Articulate the physiologic effects associated with synthetic cannabinoids use - PowerPoint PPT PresentationTRANSCRIPT
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NOT YOUR MOTHER’S DRUGS: SYNTHETIC CANNABINOIDS
Diane A. Tennies, Ph.D., LADC
Lead TEAP Health Specialist 1
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LEARNING OBJECTIVES
Describe the synthetic cannabinoids and why they are increasing in popularity
Articulate the physiologic effects associated with synthetic cannabinoids use
Discuss the current status of federal and state laws as applied to synthetic cannabinoids
Develop center-specific interventions to assist students identified as using synthetic cannabinoids
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REMEMBER WHEN?SIMPLER AND EASIER TIMES
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Opiates Cocaine Phencyclidine (PCP)
Extensive scientific literature (clinical and experimental)
Kinetics (the chemical process) Toxicological effects (on humans)
‘THE GOOD OLE DAYS’
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MARIJUANA
Listed in US Pharmacopea until 1944 when removed due to political pressure to ban social use in USA
Cannabis preparations have been used for psychotomimetic effects for 4000 to 6000 years
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PSYCHOTOMIMETIC??
Mimics the symptoms of psychosis (delusions and hallucinations)
Carl Sagan used ‘psychotomimetic’ (in his anonymous article “Mr.X”) to describe the effects of marijuana
Cannabinoids are psychotomimetic, especially delta-9-tetrahydrocannabinol (THC)
Psychotomimetic drugs affect: thought, perception and mood, without causing marked psychomotor stimulation or depression
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CANNABINOIDS 101
Occurs naturally in dried flowering/fruiting tops of Cannabis Sativa plant
Cannabinoids active compounds extracted from cannabis
Renewed interest in using cannabinoids for medicinal purposes
Discovery of cannabinoids receptors and endocannabinoids opened new era in research on pharmaceutical applications of cannabinoids
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HUMAN CHEMISTRY
Human body produces endogenous cannabinoids and the cannabis plant produced exogenous cannabinoids
We have complex cannabinoids receptor systems
Marijuana contains a variety of unique cannabinoids that bind with these receptors
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DELTA-9-TETRAHYDROCANNABINOL (THC)
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WHAT IS THIS EMINENT PROFESSOR BEST KNOWN FOR?
Dr. John W. Huffman, (JWH) professor of organic chemistry at Clemson University in South Carolina for 50 years
Ph.D. from Harvard and the National Institutes of Health's Senior Scientist Award
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DUBIOUS HONOR OF BEING CREATOR OF SYNTHETIC CANNABINOIDS
Researching the effects of cannabinoids on the brain (For NIDA in 1990’s)
Developed chemical compounds to mimic effects of marijuana (like JWH-018)
1995 paper contained the method/ingredients and was published 11
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The Spread of K2/Spice K2/Spice is unintended result of scientific
research on marijuana's effects
2008 - German pharmaceutical company THC Pharm developed three versions of the herbal incense brand Spice with JWH-018 as primary ingredient
By summer of 2009, packets of dried herbs sprayed with JWH compounds were sold throughout the world as "herbal incense" products
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DR. HOFFMAN SAYS: The materials to make JWH-018 are available from
laboratory chemical suppliers. A good college senior chemistry major could probably make them with some supervision and decent lab equipment. JWH-018 was made by a summer undergraduate research student, with supervision
There are no valid, peer-reviewed studies of the effects of this compound in humans, nor are there any data regarding its toxicity…it’s like playing Russian Roulette
I emphasize that this compound was not designed to be a super-THC. It should absolutely not be used as a recreational drug
I’ve lived around the world a long time [78 years old] and come to the conclusion that if an enterprising person wants to find a new way to get high, they’re going to do it
People who use it are idiots13
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LEGITIMATE USES FOR SYNTHETIC CANNABINOIDS
Nabilone – derivative of THC and in proprietary preparation Cesamet used for nausea in chemotherapy
Dronabinol/Marinol – used for nausea, vomiting
Rimonabant (Acomplia, Zimulti) – initially used for weight loss but pulled because of side-effects. NIDA investigating because it blocks the effects of THC in marijuana
Sativex – semi-synth used in Europe and Canada for pain
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SYNTHETIC CANNABINOIDS – LATEST IN A LONG HISTORY OF DESIGNER DRUGS
Morphine and Heroin illegal in 1925
Synthetic hallucinogen LSD
MDMA (Ecstasy)
Every illegal drug has an unregulated "research chemical" that reputedly does the same thing
For instance, can buy MDAI, said to have similar effects to ecstasy, and mephedrone, a synthetic cousin of crystal methamphetamine
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THE MANY VERSIONS
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SPICE (FROM THE FRANK DUNE BOOKS)
AKA:
Spice gold Spice silver Spice diamond Yucatan fire Sence Chill X Genie Algerian blend
K2 Solar flare K2 summit PEP Spice Fire n’ Ice Zombie World Bad to the Bone Black Mamba Dark Night G-Force
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MORE SPICE
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PHYSICAL FORM OF K2/SPICE
Pure state – either solids or oils
Smoking mixtures – usually sold in metal-foil sachets
Solution of the cannabinoids sprayed onto herbal mixture
Contain 3 g dried ‘vegetable matter’
Enough for 8 joints
Price comparable to marijuana19
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“HERBAL INCENSE” PRODUCTS CONTAIN A VARIETY OF HERBS AND
OTHER BOTANICALS Canavalia rosea: commonly known as beach bean or
bay bean - vine found in tropical and subtropical beach dunes
Nymphaea caerulea: also known as Blue Egyptian water lily
Scutellaria nana: perennial herb also known as Dwarf Skullcap
Pedicularis densiflora: known commonly as Indian Warrior - a perennial herb
Leonotis leonurus: also known as Lion's Tail and Wild Dagga - a perennial shrub native to southern Africa
Zornia latifolia: a perennial herb Nelumbo nucifera: known by a number of names
including Indian Lotus, or simply Lotus - aquatic perennial commonly found in China
Leonurus sibiricus: commonly called Honeyweed or Siberian Motherwort, herbaceous plant native to Asia
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EFFECTS OF SYNTHETIC CANNABINOIDS: RESEARCH
SAYS…
Behavioral pharmacology studies show JWH-018 has Δ9-THC-like activity in animals
In mice, it decreases overall activity, produces analgesia, decreases body temperature and produces catalepsy
A search in the literature found no published studies of the effects of JWH-018 in humans
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PHARMACOLOGY
Cannabinoids receptor agonists mimic effects of THC by interacting with CB1 receptors in brain
Synthetic compounds bind more strongly than THC (up to 100 x’s more tightly)
Little known about pharmacology and toxicology
Long half-lives = prolonged psychoactive effect
Considerable batch variability = highly potential for overdose 22
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SAME OR DIFFERENT CHEMICAL STRUCTURES?
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JWH-018 THC
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SO IF SYNTHETIC CANNABINOIDS AND THC ARE CHEMICALLY DIFFERENT…
THAT MEANS?
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GROWING POPULARITY
First appearance sold as herbal incense on internet 2004
Europe – first target market by 2008 Escalating use in USA by late 2008 Late 2008, first article appeared in scientific
literature DEA Office of Diversion Control published
one-page update on Spice in 2008 Poison Control Centers:
2009: 13 cases with adverse reactions to Spice 2010: 833 cases from 41 states through 9/1/2010 25
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COUNTRIES THAT CONTROL SYNTHETIC CANNABINOIDS
Denmark Germany Estonia France Ireland Italy Latvia Lithuania Luxembourg Austria Poland Romania Sweden UK
Chile Finland South Korea Switzerland
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IN THE UNITED STATES No federal ban but Federal Drug Czar Gil Kerlikowske stated
substance is “on our radar” and indicates state legislatures are dealing “well” with issue
Patchwork of local and state laws
In May, the Department of Defense banned synthetic cannabinoids from all U.S. military bases
Kansas first state in 5/2010
Also Oregon, Michigan, Virginia, Idaho, Missouri, Alabama, Arkansas, Georgia, Kentucky, Louisiana, North Dakota, Mississippi, Illinois, Michigan, and Tennessee
Found reference to bans being considered in Indiana, New York, Florida, Iowa, Ohio, and New Jersey
As of 12/24/2010 the DEA made possession and sale of five of the Synthetic Cannabinoids illegal (including JWH018)
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PHARMACOLOGICAL EFFECTS OF SMOKED SYNTHETIC
CANNABINOIDS Increased heart rate
and blood pressure Altered state of
consciousness Mild euphoria and
relaxation Perceptual alterations
(time distortions) Intensification of
sensory experiences Impaired short-term
memory Increase in reaction
times
Panic attacks Agitation Numbness and
tingling Vomiting (severe
requiring sedation) Hallucinations Tremors and seizures
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“THIS ISN’T JERRY GARCIA’S MARIJUANA”
(STATE REP. JEFF ROORDA, DEM – MISSOURI)
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SYNTHETIC CANNABINOIDS
Users report effects last between 30 minutes and two hours
2009 – first scientific publication documenting a Dependence syndrome corresponding with DSM-IV
Physical withdrawal syndrome similar to MJ
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SO WHAT DOES ALL THIS MEAN?
Ideas about intervening with students using synthetic cannabinoids?
What are the options?
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SO THE ANSWER IS…DRUG TESTING?
Which of the 450+ synthetic cannabinoids would be detected?
Appropriate detection cutoff levels? Cost for testing? Reliability and validity concerns
Dominion Diagnostics: Detection of metabolites through urine or blood
On the horizon: As of June, California-based Redwood Toxicology
Laboratories made test available to detect metabolites from JWH-018 and JWH-073 up to 72 hours after use
Another drug-testing company, Drug Free Sport, (handles testing for the NFL and NCAA) announced developing test for JWH metabolites by 12/2010 34
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BUT WAIT… IF WE JUST DO DRUG TESTING THEN WHAT ABOUT OTHER DESIGNER
DRUGS?
Bromo-Dragonfly – phenethylamine derivative sold as ‘plant food’ and is potent hallucinogen with delayed onset to peak (six hours) and prolonged duration (up to several days)
Nexus (Bees, Venus, Toonies) – synthetic phenothylamine can be sold as Ecstasy (white power/tablet), causes euphoria, and hallucinations
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WHAT ABOUT OTHER DESIGNER DRUGS?(continued)
Mephedrone (Meow, Drone, Bubble, M-Cat) – structure similar to Cathinone (Khat) with symptoms including anxiety, panic and paranoia, as well as severe hallucinations (analog to Crystal Meth)
Salvia – perennial plant in mint family, causes vivid hallucinations and spinal anesthesia
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COMMENTS, QUESTIONS AND CONCERNS
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