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Prevalence of Synthetic Cannabinoids in

the Workplace

David J. Kuntz, PhD, DABFTExecutive Director of Analytical Toxicology

Clinical Reference Laboratory

Lenexa, KS 66215

email | kuntzd@crlcorp.com

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Webinar Objectives

1. Brief history of the emergence synthetic

cannabinoids

2. Effects of synthetic cannabinoids on the body

3. Testing for synthetic cannabinoids at CRL

4. Results of testing 90,000 workplace samples

5. Governmental steps to control their

distribution

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Spice History• The synthetic cannabinoids were created by Dr. John W. Huffman in 1995 who was synthesizing chemicals to imitate THC on CB1 (brain) & CB2 (immune system) receptors to develop new medicines.

• Other pharmaceutical companies and scientists have also been involved in research and has led to some of the other unique alpha-numeric naming conventions.

• One compound was the 18th compound created and became JWH-018. The list of compounds numbered to 450.

• JWH-018 and JWH-073 became the most popular as they had high potency but have been largely replaced with different compounds.

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Cannabinoid Receptor Effects• Reported as useful in the treatment of pain,

vomiting, epilepsy, multiple sclerosis, Parkinson’s,

anxiety, and other claims

– CB1 receptors when stimulated in the CNS results in the

mood changes, memory, time perception, auditory and

visual changes with increasing dose

– CB2 receptors are mainly located in immune-cells and are

responsible in reducing inflammation

• Toxic effects with increasing dose to include seizures,

psychosis, tachycardia, hyperactivity and suicidal

thoughts

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Spice Effects Reported in Humans

Psychological Physiological

Mild euphoria

Hyperventilation

Hyperactivity

Anxiety

Paranoia

Hallucinations

Vomiting

Seizures

Suicidal

• Slurred speech

• Poor coordination

• Light-headedness

• Red eyes

• Pupil dilation

• Elevated Pulse/BP

• Flank pain (kidney injury)

• Chest pain

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Packaging of Spice• The synthetic cannabinoids are either liquids or crystalline

which are dissolved in a solvent sprayed onto or mixed with

potpourri of different fragrances and is often reflected in the

name of the product.

• The packaging is typically plastic bags or small packet with

very unique pictures and names. The internet is filled with

purchase sites along with purchase prices by the gram or

kilogram.

• All are labeled “Not for Human Consumption” as an attempt

to eliminate the FDA/DEA from investigating the product.

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Synthetic Cannabinoid Products

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Spice Testing at CRL• The synthetic cannabinoids quickly became a popular alternative to plant marijuana due to its similar psychological and physiological effects.

• The use appeared to be widespread in the Midwest of the United States with a major supplier only 30 miles from Kansas City

• Clients of Clinical Reference Laboratory (CRL) were requesting that a workplace drug testing panel be developed to detect the use of these compounds by their employees

• In July 2011, the first panel of JWH-018 and JWH-073 was developed to detect use. The panel was expanded several times to now include twelve compounds.

• Screening is performed by LC/MS/MS with a separate LC/MS/MS analysis for confirmation using a different type of analytical column.

• Panel expansion/updates are based on the reported prevalence of new compounds and availability of the reference standards.

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Synthetic Cannabinoids

Generic terms to the herbal mixtures (incense, potpourri) which are sprayed with synthetic cannabinoids dissolved in acetone and smoked to get a “legal high” similar to marijuana. Typically packaged in foil-type packets and sold as “Not for Human Consumption”. Sold in convenience stores, gas stations, or head shops.

CRL is currently testing for metabolites of the following

21-compounds:

JWH-018 JWH-019 BB-22

JWH-073 JWH-081 PB-22

JWH-122 JWH-210 5-F-PB-22JWH-250 AM-2201 AB-PINACA

UR-144 MAM-2201 ADB-PINACA

XLR-11 RCS-4 5-F-AB-PINACAAKB-48 5-F-AKB-48 ADBICA

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Compound Similarities

• Many compounds have minor modifications

that can enhance their pharmacologic effects

by adding a Fluorine to the molecule

• Examples of modifications:

�AM-2201 is 5-fluoro-JWH-018 (10-fold stronger

than JWH-018)

�XLR-11 is 5-F-UR-144

�AB-PINACA vs. 5-F-AB-PINACA

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Synthetic Cannabinoid Products

• K2• K2 Blond• K2 Blue• K2 Blueberry• K2 Cherry• K2 Citron• K2 Cloud 9• K2 Melon • K2 Pink• K2 Rasta• K2 Sex• K2 Summit• K2 Ultra• K2 Watermelon• K3• K3 Ultimate• Lava Red• Mr. Happy

• Armageddon• Astral Blast• Black Mamba• Blue Fire• Bonzai• Cloud 10• Coma• Demon Ritual Botanical• Fake Weed• Funky Green Stuff• Genie• Head Trip• Herbal Incense• Smoke• Super Kush• Texas Kush• Voodoo Spice• Zombie Twilight

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Year One Data Summary(July 2011-September 2012)

Total Number of Samples – 15,995

Total Number of Positives – 1,116

Overall Positive Rate - 7.0%

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Year Two Data Summary(October 2012- September 2013)

Total Number of Samples – 40,857

Total Number of Positives – 886

Overall Positive Rate – 2.2%

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Cumulative Data Summary(July 2011 – April 2014)

Total Number of Samples – 89,051

Total Number of Positives – 2630

Overall Positive Rate – 2.9%

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Jan

2013

Feb

2013

Mar

2013

Apr

2013

May

2013

Jun

2013

Jul

2013

Aug

2013

Sep

2013

Oct

2013

Nov

2013

Dec

2013

Jan

2014

Feb

2014

May2

014

Apr

2014

Total Positive

Samples 19 5 156 207 136 97 62 60 42 93 83 38 72 84 79 169

JWH-018 11 5 35 19 22 5 6 7 4 10 17 0 7 5 6 6

JWH-073 10 0 13 1 10 2 2 6 1 5 10 0 2 1 5 2

JWH-081 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

JWH-210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

JWH-250 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0

RCS-4 0 0 0 3 1 0 0 0 0 0 0 0 0 0 0 0

JWH-122 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0

AM2201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

JWH-019 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

MAM2201 0 0 2 0 0 0 0 1 0 0 0 0 2 0 2 1

UR-144 0 0 131 193 135 95 60 55 39 87 72 38 58 74 74 145

XLR11 0 0 21 30 1 2 1 1 0 2 0 1 0 2 1 5

AKB48 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 1 0 2 1

5-F-AKB48 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 0 0 0 0

BB-22 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 0 0 0 0

PB-22 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 13 10 6 34

5-F-PB n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 8 14 7 14

AB-PINACA n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 24

ADB-PINACA n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 0

5-F-AB-PINACA n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 5

ADBICA n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 0

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Percent Positive

by Reason for Testing

July 2012 thru June 2013 July 2013 thru April 2014

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THC

AMP/MAMP

K2 Positives

K2 vs. Multi-drug Positive

Jan 2013 - Apr 2014

K2 86.9% THC 5.6% AMP/MAMP 2.4% Methadone <1%

HC/HM <1% COCAINE <1% BENZO <1% OC/OM <1%

Morphine <1% Tramadol <1% BUTALBITAL <1% ETG <1%

Bath Salts <1% 6-AM <1% Fentanyl <1%

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Requirements to Schedule New

ChemicalsThe Comprehensive Crime Control Act of 1984 gives the Attorney General authority to emergency schedule a drug or drug class but

must satisfy three of eight factors:

1. History and current pattern of use

2. Scope of abuse

3. Duration4. Significance of abuse

5. Risk to public health

6. Actual abuse7. Diversion from legitimate channels

8. Clandestine importation, manufacture or distribution

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Synthetic Drug Control Act of 2012

• Signed by President Obama in July 2012

• Expanded wording to include cannabimimetic Agents– Any substance that is a cannabinoid receptor Type I (CB1 receptor

agonist as demonstrated by binding studies and function assays)

– Amends Schedule I of the Controlled Substances Act to include many additional “Bath Salt” compounds

• Expands time for temporary scheduling to avoid imminent hazards to Public Safety– Extends from 1 to 2 years for emergency temporary scheduling

– Extends 6 month period to 12 months for additional information before a final ruling on status

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What is the Future of Designer

Drugs?• As new synthetic cannabinoid products are identified, the government will be

placing many of these into Schedule I status due to their health risks and abuse.

• Examples of new compounds on the horizon:

AM1220 AM-694 AM-1235 AM-223

UR-597 EAM-2201 STS-135 BAY-38-7271

• The labs will continue to develop new methods to look for hundreds of different known compounds covering multiple chemical families of structures. The future will be full of new chemicals that were never envisioned and the drug testing industry and legal review will be ongoing for many years to come.

• The penalties for the production must be very high to control their expansion since the profits are so very high. But with synthesis in overseas countries controlling their proliferation will be very hard.

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Questions ?