Topical Issues of Toxicology and Laboratory Identification of Synthetic Cannabinoids (Prepared According to the European Monitoring Centre for Drugs and Drug Addiction — EMCDDA)
The emergence of new smoking herbal products laced with synthetic cannabinoids can be considered as a new development in the field of designer drugs. In many countries, where spices and similar substances are available, they have become a significant problem. Government measures to control smoking blends for the last 10 years have been actively developed and implemented in Austria, Germany, France, Luxembourg, Poland, Lithuania, Sweden and are under consideration in other member states of the European Union. Nevertheless, a huge number of available and at the same time potentially dangerous psychotropic synthetic cannabinoids means that the activities carried out by states to control are ineffective.
Currently, little is known about the pharmacology, toxicology and safety of these compounds for humans. Types and amount of added synthetic cannabinoids in products may vary considerably, and some of the compounds may be active in very low doses that forms the possibility of accidental overdose with risk of severe psychiatric complications. In addition, the emergence of full cannabinoid receptor antagonists may lead to life-threatening conditions. Increase in the number of acute poisonings with synthetic cannabinoids and high hospital mortality require immediate search for effective methods of intensive care and laboratory diagnosis, bringing today the problem of synthetic cannabinoids in priority task of clinical toxicology and intensive care.
Cases of acute poisonings with smoking blends are observed in Kyiv over the past 5 years. In the group of poisonings with psychotropic drugs, herbal mixtures comprise about 1 %. Deaths during the period of 2012–2014 were not observed. Age of victims, predominantly males, was recorded in the range of 18 to 39 years. The clinical picture is characterized by lesions of the central nervous system, hallucinations, agitation, motor activity. Intensive therapy consists of a symptomatic treatment aimed at preventing complications from respiratory and cardiovascular systems; specific antidotes and pharmacological antagonists were not used. Test systems for detecting narcotic drugs and psychotropic substances in the urine didn’t give positive results, in a few cases there was a positive test for marijuana. According to the regional departments for the treatment of poisonings, there are registered very severe cases of poisonings with lethal outcome. In severe cases, the characteristic pattern is brain edema, respiratory and circulatory failure. In the described clinical manifestations of acute central nervous system damage, an analogy with severe and irreversible damages arising in cases of poisoning with inhaled drugs (glue BF) has been noted.
Free distribution of smoking mixtures is a significant toxicological problem. Complexity of toxic-chemical identification of products does not allow timely detection of toxic components and development of appropriate therapeutic measures. Variability of the chemical composition of smoking mixtures makes them potentially dangerous to the consumer. Such effects of mixtures as carcinogenicity, the ability to form a physical dependency remain unexplored. Mass poisonings among young people, high levels of deaths require to consider the problem of the distribution of dangerous products with the participation of all interested parties. Collaborative researches of toxicologists, forensics, clinicians, state control bodies will help to create an effective system to prevent undesirable consequences which may occur as a result of the use of designer drugs.
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