A Long Way from Woodstock: Synthetic Cannabinoids

Abstract

Abstract: Since their first appearance in the United States’ recreational drug supply, synthetic cannabinoids (SCs) have become an increasingly common substance of abuse and have been linked to mass-overdose outbreaks in multiple states. The term “synthetic cannabinoids” includes dozens of structurally distinct chemicals that share a common site of action on the CB1 and CB2 cannabinoid receptors, the same target as delta-9-tetrahydrocannabinol found in marijuana. While not living up to their marketing as a “safe and legal” recreational drug, SCs are often used by those looking to avoid testing positive on immunoassay-based urine drug screens. Clinical effects are unpredictable, ranging from mild agitation or delirium up to lethal cardiac arrythmias, and they can be difficult to distinguish from other substances of abuse or nonpharmacological medical illness. Fortunately, most patients recover with minimal long-term consequences.