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Cannabis adulterated with the synthetic cannabinoid receptor agonist MDMB-4en-PINACA and the role of European drug checking services.

Pieter E Oomen, Dominique Schori, Karsten Tögel-Lins, Dean Acreman, Sevag Chenorhokian, Anton Luf, Alexandra Karden, Carlos Paulos, Elisa Fornero, Enrico Gerace, Raoul P J Koning, Liliana Galindo, Laura Smit-Rigter, Fiona Measham, Mireia Ventura

International Journal of Drug Policy February 2022 DOI: 10.1016/j.drugpo.2021.103493 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Observational study Peer reviewed
Sample size 1,142
Population Samples sold as cannabis (herbal, resin, and e-liquid) submitted to nine drug checking services in eight European countries within the Trans European Drug Information (TEDI) network
Topics Cannabis
Keywords Adulteration Drug checking Mdmb-4en-pinaca Scras
Key findings Of 1,142 samples sold as cannabis, 270 contained the synthetic cannabinoid receptor agonist MDMB-4en-PINACA. All cannabis samples contained less than 1% THC, and e-liquids contained no phytocannabinoids. Three serious health incidents requiring hospitalization were reported after use of adulterated cannabis samples. The authors argue that adulteration of cannabis with synthetic cannabinoid receptor agonists is a new phenomenon carrying risk for people who use it, and propose that drug checking and harm reduction services could be reconfigured to include cannabis consumers.

Abstract

European drug checking services exchange information on drug trends within the Trans European Drug Information (TEDI) network, allowing monitoring and coordination of responses. Starting in Spring 2020, several services detected the synthetic cannabinoid receptor agonist MDMB-4en-PINACA in adulterated low-THC cannabis products. Cannabis products suspected of adulteration were analyzed for the presence of MDMB-4en-PINACA by 9 services in 8 countries within the TEDI network. If available, phytocannabinoid analysis was also performed. 1142 samples sold as cannabis in herbal, resin and e-liquid form were analyzed, of which 270 were found to contain MDMB-4en-PINACA. All cannabis samples contained low THC (<1%), except the e-liquids which contained no phytocannabinoids. Three serious health incidents requiring hospitalization after use of an adulterated cannabis sample were reported. Adulteration of cannabis with synthetic cannabinoid receptor agonists is a new phenomenon that carries risk for people who use it. Given that cannabis consumers are not a usual target group for drug checking services, services and associated harm reduction interventions could be reconfigured to include them.

Comparable studies

Other observational and cohort studies on cannabis, most cited first.

Study Year Design Participants
High-potency cannabis and the risk of psychosis People with first episode of psychosis and healthy controls from the local population 2009 Case-control study n = 454
Ayahuasca-Assisted Therapy for Addiction: Results from a Preliminary Observational Study in Canada Rural aboriginal population 2013 Observational study
Impaired cognitive performance in drug free users of recreational ecstasy (MDMA) Otherwise healthy young people 2000 Observational
Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study Individuals from the general population in Germany aged 14-24 at baseline 2011 Observational cohort n = 1,923
Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases Patients treated for cannabis-induced psychotic symptoms in Denmark between 1994 and... 2005 Observational cohort n = 535

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