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Ricci V, Maina G. Clinical and Public Health Challenge of Handling Synthetic Cathinone and Cannabinoid Abuse in Pediatric Care: A Narrative Review. Pediatr Rep 2025; 17:19. [PMID: 39997626 PMCID: PMC11857941 DOI: 10.3390/pediatric17010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2024] [Revised: 01/22/2025] [Accepted: 02/05/2025] [Indexed: 02/26/2025] Open
Abstract
BACKGROUND Synthetic cathinones and cannabinoids have emerged as significant public health concerns, particularly in pediatric populations. Marketed under deceptive names such as "bath salts" and "K2/Spice", these substances pose unique challenges due to their accessibility, potency, and unpredictable effects. This narrative review synthesizes evidence on the toxicological effects of synthetic cathinones and cannabinoids in pediatric patients, emphasizing clinical presentations, management challenges, and public health implications. METHODS A structured narrative review was conducted using PubMed and Scopus databases to identify peer-reviewed studies published between January 2010 and September 2024. The selected articles focus on neuropsychiatric, systemic, and management outcomes associated with these substances in individuals aged 0-18 years. RESULTS Five studies demonstrate that synthetic cathinones frequently cause seizures, sympathomimetic toxidrome (tachycardia, hypertension), and neuropsychiatric effects like paranoia and catatonia. Seven studies show synthetic cannabinoids induce psychosis, respiratory depression requiring ventilation in 12% of cases, and cardiovascular complications like myocardial ischemia. One study highlighted severe outcomes in pediatric accidental exposures, emphasizing the unpredictable and life-threatening effects of these substances, often exacerbated by co-ingestion with alcohol or THC. CONCLUSIONS Pediatric exposure to synthetic cathinones and cannabinoids results in severe and unpredictable toxicological effects, necessitating tailored clinical management strategies and enhanced diagnostic capabilities. Public health measures, including stringent regulatory controls, targeted education initiatives, and robust surveillance systems, are critical to mitigating these risks. A multidisciplinary approach is essential to safeguard vulnerable pediatric populations from the escalating dangers posed by synthetic drugs, and future research must address the long-term impacts and mechanisms of toxicity.
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Affiliation(s)
- Valerio Ricci
- Psychiatry Department, San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, Italy;
- Department of Neurosciences “Rita Levi Montalcini”, University of Turin, Via Cherasco n. 15, 10126 Torino, Italy
| | - Giuseppe Maina
- Psychiatry Department, San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, Italy;
- Department of Neurosciences “Rita Levi Montalcini”, University of Turin, Via Cherasco n. 15, 10126 Torino, Italy
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Kutzler J, Polettini AE, Bleicher S, Sauer C, Schultis W, Neukamm MA, Auwärter V. Synthetic cannabinoids in hair-Prevalence of use in abstinence control programs for driver's license regranting in Germany. Drug Test Anal 2024; 16:518-531. [PMID: 37731292 DOI: 10.1002/dta.3578] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
Although the use, structural variety, and prevalence of synthetic cannabinoids (SCs) have steadily increased on the drug market, they are rarely analyzed in abstinence control programs for driver's license regranting. The aim of this study was to determine the SC prevalence in these programs by analyzing hair samples collected between March 2020 and March 2021 from various regions in Germany, mainly Bavaria (40%). Specimens were analyzed quantitatively for drugs of abuse and qualitatively for 107 SCs. Hair samples were screened by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and to search for unknown SC analogs, positive samples were additionally screened by liquid chromatography-high resolution time of flight mass spectrometry (LC-qTOF/MS). The analysis of 5097 hair samples resulted in 181 SC detections (3.6%), showing a wide range of 44 SCs, with up to 13 different compounds found in a single sample. The most prevalent compounds were 5F-MDMB-PICA and MDMB-4en-PINACA; furthermore, 10 new substances not initially covered by LC-MS/MS analysis were detected by LC-qTOF/MS. The SC positivity rate was comparable to cocaine (5.4%) and amphetamine (2.6%). Only in 35 cases (0.7%), SC analysis was requested by the clients, highlighting the insufficient coverage of SC consumption in the studied collective. In summary, hair sample analysis proved to be a valuable tool to monitor the use of SCs. In order to keep pace with newly emerging SC analogs, an up-to-date analytical method is essential. Prospectively, SCs should be more routinely screened in hair analysis for abstinence control to avoid cannabis substitution by SCs.
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Affiliation(s)
- Johannes Kutzler
- Department of Forensic Toxicology & Drug Analysis, SYNLAB MVZ Weiden GmbH, Weiden, Germany
- Institute of Forensic Medicine, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Postgraduate Course for Toxicology and Environmental Toxicology, Institute for Legal Medicine, University of Leipzig, Leipzig, Germany
| | - Aldo Eliano Polettini
- Department of Forensic Toxicology & Drug Analysis, SYNLAB MVZ Weiden GmbH, Weiden, Germany
- Department of Diagnostics & Public Health, University of Verona, Verona, Italy
| | - Sergej Bleicher
- Department of Forensic Toxicology & Drug Analysis, SYNLAB MVZ Weiden GmbH, Weiden, Germany
| | - Christoph Sauer
- Department of Forensic Toxicology & Drug Analysis, SYNLAB MVZ Weiden GmbH, Weiden, Germany
| | - Wolfgang Schultis
- Department of Forensic Toxicology & Drug Analysis, SYNLAB MVZ Weiden GmbH, Weiden, Germany
| | - Merja A Neukamm
- Institute of Forensic Medicine, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Volker Auwärter
- Institute of Forensic Medicine, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Bilel S, Zamberletti E, Caffino L, Tirri M, Mottarlini F, Arfè R, Barbieri M, Beggiato S, Boccuto F, Bernardi T, Casati S, Brini AT, Parolaro D, Rubino T, Ferraro L, Fumagalli F, Marti M. Cognitive dysfunction and impaired neuroplasticity following repeated exposure to the synthetic cannabinoid JWH-018 in male mice. Br J Pharmacol 2023; 180:2777-2801. [PMID: 37311647 DOI: 10.1111/bph.16164] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND AND PURPOSE Psychotic disorders have been reported in long-term users of synthetic cannabinoids. This study aims at investigating the long-lasting effects of repeated JWH-018 exposure. EXPERIMENTAL APPROACH Male CD-1 mice were injected with vehicle, JWH-018 (6 mg·kg-1 ), the CB1 -antagonist NESS-0327 (1 mg·kg-1 ) or co-administration of NESS-0327 and JWH-018, every day for 7 days. After 15 or 16 days washout, we investigated the effects of JWH-018 on motor function, memory, social dominance and prepulse inhibition (PPI). We also evaluated glutamate levels in dialysates from dorsal striatum, striatal dopamine content and striatal/hippocampal neuroplasticity focusing on the NMDA receptor complex and the neurotrophin BDNF. These measurements were accompanied by in vitro electrophysiological evaluations in hippocampal preparations. Finally, we investigated the density of CB1 receptors and levels of the endocannabinoid anandamide (AEA) and 2-arachidonoylglycerol (2-AG) and their main synthetic and degrading enzymes in the striatum and hippocampus. KEY RESULTS The repeated treatment with JWH-018 induced psychomotor agitation while reducing social dominance, recognition memory and PPI in mice. JWH-018 disrupted hippocampal LTP and decreased BDNF expression, reduced the synaptic levels of NMDA receptor subunits and decreased the expression of PSD95. Repeated exposure to JWH-018, reduced hippocampal CB1 receptor density and induced a long-term alteration in AEA and 2-AG levels and their degrading enzymes, FAAH and MAGL, in the striatum. CONCLUSION AND IMPLICATIONS Our findings suggest that repeated administration of a high dose of JWH-018 leads to the manifestation of psychotic-like symptoms accompanied by alterations in neuroplasticity and change in the endocannabinoid system.
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Affiliation(s)
- Sabrine Bilel
- Department of Translational Medicine, Section of Legal Medicine and LTTA Center, University of Ferrara, Ferrara, Italy
| | - Erica Zamberletti
- Department of Biotechnology and Life Sciences (DBSV) and Neuroscience Center, University of Insubria, Busto Arsizio, Italy
| | - Lucia Caffino
- Department of Pharmacological and Biomolecular Sciences, 'Rodolfo Paoletti', Università degli Studi di Milano, Milan, Italy
| | - Micaela Tirri
- Department of Translational Medicine, Section of Legal Medicine and LTTA Center, University of Ferrara, Ferrara, Italy
| | - Francesca Mottarlini
- Department of Pharmacological and Biomolecular Sciences, 'Rodolfo Paoletti', Università degli Studi di Milano, Milan, Italy
| | - Raffaella Arfè
- Department of Translational Medicine, Section of Legal Medicine and LTTA Center, University of Ferrara, Ferrara, Italy
| | - Mario Barbieri
- Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Sarah Beggiato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy
| | - Federica Boccuto
- Department of Translational Medicine, Section of Legal Medicine and LTTA Center, University of Ferrara, Ferrara, Italy
| | - Tatiana Bernardi
- Department of Environmental Sciences and Prevention, University of Ferrara, Ferrara, Italy
| | - Sara Casati
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Anna T Brini
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
- IRCCS Galeazzi Orthopedic Institute, Milan, Italy
| | - Daniela Parolaro
- Department of Biotechnology and Life Sciences (DBSV) and Neuroscience Center, University of Insubria, Busto Arsizio, Italy
- Zardi-Gori Foundation, Milan, Italy
| | - Tiziana Rubino
- Department of Biotechnology and Life Sciences (DBSV) and Neuroscience Center, University of Insubria, Busto Arsizio, Italy
| | - Luca Ferraro
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy
- Laboratory for the Technology of Advanced Therapies (LTTA Centre), University of Ferrara, Ferrara, Italy
| | - Fabio Fumagalli
- Department of Pharmacological and Biomolecular Sciences, 'Rodolfo Paoletti', Università degli Studi di Milano, Milan, Italy
| | - Matteo Marti
- Department of Translational Medicine, Section of Legal Medicine and LTTA Center, University of Ferrara, Ferrara, Italy
- Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, Rome, Italy
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Corli G, Tirri M, Bilel S, Arfè R, Coccini T, Roda E, Marchetti B, Vincenzi F, Zauli G, Borea PA, Locatelli CA, Varani K, Marti M. MAM-2201 acute administration impairs motor, sensorimotor, prepulse inhibition, and memory functions in mice: a comparison with its analogue AM-2201. Psychopharmacology (Berl) 2023:10.1007/s00213-023-06378-8. [PMID: 37233813 DOI: 10.1007/s00213-023-06378-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/02/2023] [Indexed: 05/27/2023]
Abstract
RATIONALE 1-[(5-fluoropentyl)-1H-indol-3-yl](4-methyl-1-naphthalenyl) methanone (MAM-2201) is a potent synthetic cannabinoid receptor agonist illegally marketed in "spice" products and as "synthacaine" for its psychoactive effects. It is a naphthoyl-indole derivative which differs from its analogue 1-[(5-Fluoropentyl)-1H-indol-3-yl](1-naphthylenyl) methanone (AM-2201) by the presence of a methyl substituent on carbon 4 (C-4) of the naphthoyl moiety. Multiple cases of intoxication and impaired driving have been linked to AM-2201 and MAM-2201 consumption. OBJECTIVES This study aims to investigate the in vitro (murine and human cannabinoid receptors) and in vivo (CD-1 male mice) pharmacodynamic activity of MAM-2201 and compare its effects with those induced by its desmethylated analogue, AM-2201. RESULTS In vitro competition binding studies confirmed that MAM-2201 and AM-2201 possess nanomolar affinity for both CD-1 murine and human CB1 and CB2 receptors, with preference for the CB1 receptor. In agreement with the in vitro binding data, in vivo studies showed that MAM-2201 induces visual, acoustic, and tactile impairments that were fully prevented by pretreatment with CB1 receptor antagonist/partial agonist AM-251, indicating a CB1 receptor mediated mechanism of action. Administration of MAM-2201 also altered locomotor activity and PPI responses of mice, pointing out its detrimental effect on motor and sensory gating functions and confirming its potential use liability. MAM-2201 and AM-2201 also caused deficits in short- and long-term working memory. CONCLUSION These findings point to the potential public health burden that these synthetic cannabinoids may pose, with particular emphasis on impaired driving and workplace performance.
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Affiliation(s)
- Giorgia Corli
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Via Fossato Di Mortara 17-19, 44121, Ferrara, Italy
| | - Micaela Tirri
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Via Fossato Di Mortara 17-19, 44121, Ferrara, Italy
| | - Sabrine Bilel
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Via Fossato Di Mortara 17-19, 44121, Ferrara, Italy
| | - Raffaella Arfè
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Via Fossato Di Mortara 17-19, 44121, Ferrara, Italy
| | - Teresa Coccini
- Laboratory of Clinical and Experimental Toxicology, and Poison Control Centre and National Toxicology Information Centre, Toxicology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100, Pavia, Italy
| | - Elisa Roda
- Laboratory of Clinical and Experimental Toxicology, and Poison Control Centre and National Toxicology Information Centre, Toxicology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100, Pavia, Italy
| | - Beatrice Marchetti
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Via Fossato Di Mortara 17-19, 44121, Ferrara, Italy
| | - Fabrizio Vincenzi
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Giorgio Zauli
- Research Department, King Khaled Eye Specialistic Hospital, Riyadh, Saudi Arabia
| | | | - Carlo Alessandro Locatelli
- Laboratory of Clinical and Experimental Toxicology, and Poison Control Centre and National Toxicology Information Centre, Toxicology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100, Pavia, Italy
| | - Katia Varani
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Matteo Marti
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Via Fossato Di Mortara 17-19, 44121, Ferrara, Italy.
- Department of Anti-Drug Policies, Collaborative Center for the Italian National Early Warning System, Presidency of the Council of Ministers, Ferrara, Italy.
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Corli G, Tirri M, Bilel S, Giorgetti A, Bernardi T, Boccuto F, Borsari M, Giorgetti R, Marti M. Ethanol enhances JWH-018-induced impairment of sensorimotor and memory functions in mice: From preclinical evidence to forensic implication in Driving Under the Influence of Drugs. Drug Alcohol Depend 2023; 247:109888. [PMID: 37120918 DOI: 10.1016/j.drugalcdep.2023.109888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/03/2023] [Accepted: 04/14/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Several new Synthetic Cannabinoids have appeared each year since their introduction into the illicit drug market as recreational drugs. Among these, naphtalen-1-yl-(1-pentylindol-3-yl) methanone (JWH-018) is one of the most detected compounds in biological samples from patients involved in intoxication or death cases. Furthermore, consumption of JWH-018 has been linked to several cases of Driving Under the Influence of Drugs (DUID) suggesting that effects induced by this compound can affect individuals' ability to drive. METHODS Given the high spread of polydrug consumption and the wide number of alcohol-related traffic accidents, this study aims to investigate the acute effects induced by co-administration of JWH-018 with ethanol on sensorimotor and motor responses, grip strength and memory functions in CD-1 male mice. Acute impairments induced by JWH-018 and ethanol alone have also been investigated, in order to compare their effects with that induced by their concurrent administration. RESULTS In vivo behavioral experiments revealed a worsening of the cognitive and sensorimotor disruption after the co-administration of JWH-018 with ethanol compared to single compounds. CONCLUSIONS These animal-based findings suggest a potential increased impairment on psychomotor performances which could be related to driving abilities posed by poly-drug consumption involving SCs and ethanol.
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Affiliation(s)
- Giorgia Corli
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Micaela Tirri
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Sabrine Bilel
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Arianna Giorgetti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
| | - Tatiana Bernardi
- Department of Environmental Sciences and Prevention, University of Ferrara, Ferrara, 44121, Italy
| | - Federica Boccuto
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Martina Borsari
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Raffaele Giorgetti
- Department of Excellence of Biomedical Science and Public Health, Faculty of Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Matteo Marti
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Ferrara, Italy; Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, Italy.
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Theunissen EL, Reckweg JT, Hutten NRPW, Kuypers KPC, Toennes SW, Neukamm MA, Halter S, Ramaekers JG. Psychotomimetic symptoms after a moderate dose of a synthetic cannabinoid (JWH-018): implications for psychosis. Psychopharmacology (Berl) 2022; 239:1251-1261. [PMID: 33501595 PMCID: PMC9110546 DOI: 10.1007/s00213-021-05768-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/14/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Synthetic cannabinoids (SCs) are the largest class of novel psychoactive substances (NPS) and are associated with an increased risk of overdosing and adverse events such as psychosis. JWH-018 is one of the earliest SCs and still widely available in large parts of the world. Controlled studies to assess the safety and behavioural profiles of SCs are extremely scarce. AIM The current study was designed to assess the psychotomimetic effects of a moderate dose of JWH-018. METHODS Twenty-four healthy participants (10 males, 14 females) entered a placebo-controlled, double blind, within-subjects trial and inhaled vapour of placebo or 75μg/kg bodyweight JWH-018. To ascertain a minimum level of intoxication, a booster dose of JWH-018 was administered on an as-needed basis. The average dose of JWH-018 administered was 5.52 mg. Subjective high, dissociative states (CADSS), psychedelic symptoms (Bowdle), mood (POMS) and cannabis reinforcement (SCRQ) were assessed within a 4.5-h time window after drug administration. RESULTS JWH-018 caused psychedelic effects, such as altered internal and external perception, and dissociative effects, such as amnesia, derealisation and depersonalisation and induced feelings of confusion. CONCLUSION Overall, these findings suggest that a moderate dose of JWH-018 induces pronounced psychotomimetic symptoms in healthy participants with no history of mental illness, which confirms that SCs pose a serious risk for public health.
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Affiliation(s)
- Eef L Theunissen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands.
| | - Johannes T Reckweg
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - Nadia R P W Hutten
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - Kim P C Kuypers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - Stefan W Toennes
- Department of Forensic Toxicology, Institute of Legal Medicine, Goethe University of Frankfurt, Frankfurt, Germany
| | - Merja A Neukamm
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Halter
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Hermann Staudinger Graduate School, University of Freiburg, Freiburg, Germany
| | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
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Theunissen EL, Kuypers KPC, Mason NL, Ramaekers JG. A Comparison of Acute Neurocognitive and Psychotomimetic Effects of a Synthetic Cannabinoid and Natural Cannabis at Psychotropic Dose Equivalence. Front Psychiatry 2022; 13:891811. [PMID: 35664482 PMCID: PMC9160432 DOI: 10.3389/fpsyt.2022.891811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/26/2022] [Indexed: 01/12/2023] Open
Abstract
Due to differences in potency, efficacy, and affinity for CB1 receptors, similarities and differences in psychoactive effect profiles of natural cannabis and synthetic cannabinoids (SCs) cannot reliably be derived from equipotent dose comparisons. Instead, the current study proposes to compare the intrinsic psychoactive effects of natural cannabis (THC) and an SC, JWH-018, at psychotropic dose equivalence. Participants from two placebo-controlled studies were matched for their levels of subjective high to compare neurocognitive and psychotomimetic effects of THC and JWH-018. At equal subjective intoxication levels, both drugs impaired psychomotor, divided attention, and impulse control, with no significant difference between the two drugs. Both drugs also caused significant psychotomimetic effects, but dissociative effects were considerably more pronounced for JWH-018 than THC. We conclude that psychotropic dose equivalence provides a uniform approach for comparing the neurocognitive and psychotomimetic profiles of CB1 agonists, which can also be applied to other drug classes.
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Affiliation(s)
- Eef Lien Theunissen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Kim Paula Colette Kuypers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Natasha Leigh Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Johannes Gerardus Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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Barbieri M, Tirri M, Bilel S, Arfè R, Corli G, Marchetti B, Caruso L, Soukupova M, Cristofori V, Serpelloni G, Marti M. Synthetic cannabinoid JWH-073 alters both acute behavior and in vivo/vitro electrophysiological responses in mice. Front Psychiatry 2022; 13:953909. [PMID: 36339851 PMCID: PMC9634257 DOI: 10.3389/fpsyt.2022.953909] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/04/2022] [Indexed: 11/30/2022] Open
Abstract
JWH-073 is a synthetic cannabinoid (SCB) that is illegally marketed within an "herbal blend", causing psychoactive effects more intense than those produced by Cannabis. Users report that JWH-073 causes less harmful effects than other SCBs, misrepresenting it as a "safe JWH-018 alternative", which in turn prompts its recreational use. The present study is aimed to investigate the in vivo pharmacological activity on physiological and neurobehavioral parameters in male CD-1 mice after acute 1 mg/kg JWH-073 administration. To this aim we investigate its effect on sensorimotor (visual, acoustic, and tactile), motor (spontaneous motor activity and catalepsy), and memory functions (novel object recognition; NOR) in mice coupling behavioral and EEG data. Moreover, to clarify how memory function is affected by JWH-073, we performed in vitro electrophysiological studies in hippocampal preparations using a Long-Term Potentiation (LTP) stimulation paradigm. We demonstrated that acute administration of JWH-073 transiently decreased motor activity for up to 25 min and visual sensorimotor responses for up to 105 min, with the highest effects at 25 min (~48 and ~38%, respectively), while the memory function was altered up to 24 h (~33%) in treated-mice as compared to the vehicle. EEG in the somatosensory cortex showed a maximal decrease of α (~23%) and γ (~26%) bands at 15 min, β (~26%) band at 25 min, a maximal increase of θ (~14%) band at 25 min and δ (~35%) band at 2 h, and a significant decrease of θ (~18%), α (~26%), and β (~10%) bands during 24 h. On the other hand, EEG in the hippocampus showed a significant decrease of all bands from 10 min to 2 h, with the maximal effect at 30 min for θ (~34%) and γ (~26%) bands and 2 h for α (~36%), β (~29%), and δ (~15%) bands. Notably, the δ band significant increase both at 5 min (~12%) and 24 h (~19%). Moreover, in vitro results support cognitive function impairment (~60% of decrease) by interfering with hippocampal synaptic transmission and LTP generation. Our results suggest that JWH-073 deeply alters brain electrical responsiveness with minor behavioral symptoms. Thus, it poses a subtle threat to consumers who mistakenly consider it safer than other SCBs.
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Affiliation(s)
- Mario Barbieri
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Micaela Tirri
- Department of Translational Medicine, Section of Legal Medicine and Laboratory for Technologies of Advanced Therapies (LTTA) Centre, University of Ferrara, Ferrara, Italy
| | - Sabrine Bilel
- Department of Translational Medicine, Section of Legal Medicine and Laboratory for Technologies of Advanced Therapies (LTTA) Centre, University of Ferrara, Ferrara, Italy
| | - Raffaella Arfè
- Department of Translational Medicine, Section of Legal Medicine and Laboratory for Technologies of Advanced Therapies (LTTA) Centre, University of Ferrara, Ferrara, Italy
| | - Giorgia Corli
- Department of Translational Medicine, Section of Legal Medicine and Laboratory for Technologies of Advanced Therapies (LTTA) Centre, University of Ferrara, Ferrara, Italy
| | - Beatrice Marchetti
- Department of Translational Medicine, Section of Legal Medicine and Laboratory for Technologies of Advanced Therapies (LTTA) Centre, University of Ferrara, Ferrara, Italy
| | - Lorenzo Caruso
- Department of Environment and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Marie Soukupova
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Virginia Cristofori
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Serpelloni
- Neuroscience Clinical Center and Transcranial Magnetic Stimulation (TMS) Unit, Verona, Italy
| | - Matteo Marti
- Department of Translational Medicine, Section of Legal Medicine and Laboratory for Technologies of Advanced Therapies (LTTA) Centre, University of Ferrara, Ferrara, Italy.,Department for Anti-Drug Policies, Collaborative Center of the National Early Warning System, Presidency of the Council of Ministers, Rome, Italy
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9
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Orazietti V, Basile G, Giorgetti R, Giorgetti A. Effects of synthetic cannabinoids on psychomotor, sensory and cognitive functions relevant for safe driving. Front Psychiatry 2022; 13:998828. [PMID: 36226105 PMCID: PMC9548613 DOI: 10.3389/fpsyt.2022.998828] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022] Open
Abstract
Recreational use of Synthetic Cannabinoids (SCs), one of the largest groups of New Psychoactive Substances (NPS), has increased globally over the past few years. Driving is a structured process requiring the cooperation of several cognitive and psychomotor functions, organized in different levels of complexity. Each of these functions can be affected when Driving Under the Influence (DUI) of SCs. In order to reduce the likelihood of SC-related road accidents, it is essential to understand which areas of psychomotor performance are most affected by these substances, as well as the severity of impairment. For this purpose, a multiple database- literature review of recent experimental studies in humans and animals regarding the psychomotor effects of SCs has been performed. Despite the many limitations connected to experimental studies on humans, results showed a consistency between animal and human data. SCs appear to impair psychomotor performance in humans, affecting different domains related to safe driving even at low doses. Cases of DUI of SC have been repeatedly reported, although the exact prevalence is likely to be underestimated due to current analytical and interpretative issues. For this reason, an accurate physical examination performed by trained and experienced personnel has a primary role in recognizing signs of impairment in case of strong suspicion of SC consumption. The identification of a suspected case should be followed by reliable laboratory examination.
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Affiliation(s)
- Vasco Orazietti
- Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University of Ancona, Ancona, Italy
| | - Giuseppe Basile
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Galeazzi Orthopedics Institute, Milan, Italy
| | - Raffaele Giorgetti
- Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University of Ancona, Ancona, Italy
| | - Arianna Giorgetti
- Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University of Ancona, Ancona, Italy.,Unit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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10
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Martínez L, La Maida N, Papaseit E, Pérez-Mañá C, Poyatos L, Pellegrini M, Pichini S, Ventura M, Galindo L, Busardò FP, Farré M. Acute Pharmacological Effects and Oral Fluid Concentrations of the Synthetic Cannabinoids JWH-122 and JWH-210 in Humans After Self-Administration: An Observational Study. Front Pharmacol 2021; 12:705643. [PMID: 34489699 PMCID: PMC8417402 DOI: 10.3389/fphar.2021.705643] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Abstract
Synthetic cannabinoids (SCs) are a group of new psychoactive drugs used recreationally with potential health risks. They are monitored by the EU Early Warning System since 2010 due to severe adverse effects on consumers. JWH-122 and JWH-210 are naphthoylindole SCs and potent cannabinoid receptor CB1 and CB2 agonists. Information about the effects of SCs usually is available from intoxication cases and surveys, and few studies on humans after controlled administration or observational/naturalistic studies using standardized measures of cardiovascular and subjective effects are available. The aim of this study was to evaluate the acute pharmacological effects of JWH-122 and JWH-210 recreational consumption in a 4 h observational study and assess their disposition in oral fluid (OF). Sixteen volunteers self-administered 1 mg dose of JWH-122 (n = 8) or 2.25 mg mean dose of JWH-210 (range 2–3 mg, n = 8) by inhalation (smoking). Physiological parameters including blood pressure (systolic and diastolic), heart rate (HR), and cutaneous temperature were measured. A set of visual analog scales, the 49-item short-form version of the Addiction Research Center Inventory (ARCI), and the Evaluation of the Subjective Effects of Substances with Abuse Potential (VESSPA-SSE) were used for the evaluation of subjective effects. OF was collected at baseline and at 10, 20, and 40 min and 1, 2, 3, and 4 h after self-administration. Statistically significant increases in systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR were observed after JWH-122 self-administration but not after JWH-210 self-administration. JWH-210 self-administration produced significant changes in subjective drug effects, similar to those induced by THC (intensity, high, good effects, and hunger). The subjective effects following JWH-122 consumption were minimal. The maximal effects were mostly observed 20 min after intake. JWH-122 and JWH 210 OF concentration reached a peak 20 min after administration and could not be detected after 3 h. The results demonstrated a different pattern of effects of these two SCs. Due to the limitations of our observational study, further research with a larger sample and controlled studies are needed to better define the acute pharmacological effect and health risk profile of JWH-122 and JWH-210.
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Affiliation(s)
- Lucia Martínez
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Barcelona, Spain.,Clinical Pharmacology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Nunzia La Maida
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche", Ancona, Italy
| | - Esther Papaseit
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Clara Pérez-Mañá
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Lourdes Poyatos
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Manuela Pellegrini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Mireia Ventura
- Energy Control, Associació Benestar i Desenvolupament, Barcelona, Spain
| | - Liliana Galindo
- Energy Control, Associació Benestar i Desenvolupament, Barcelona, Spain.,Department of Psychiatry, University of Cambridge/Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche", Ancona, Italy
| | - Magí Farré
- Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
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11
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The why behind the high: determinants of neurocognition during acute cannabis exposure. Nat Rev Neurosci 2021; 22:439-454. [PMID: 34045693 DOI: 10.1038/s41583-021-00466-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 11/08/2022]
Abstract
Acute cannabis intoxication may induce neurocognitive impairment and is a possible cause of human error, injury and psychological distress. One of the major concerns raised about increasing cannabis legalization and the therapeutic use of cannabis is that it will increase cannabis-related harm. However, the impairing effect of cannabis during intoxication varies among individuals and may not occur in all users. There is evidence that the neurocognitive response to acute cannabis exposure is driven by changes in the activity of the mesocorticolimbic and salience networks, can be exacerbated or mitigated by biological and pharmacological factors, varies with product formulations and frequency of use and can differ between recreational and therapeutic use. It is argued that these determinants of the cannabis-induced neurocognitive state should be taken into account when defining and evaluating levels of cannabis impairment in the legal arena, when prescribing cannabis in therapeutic settings and when informing society about the safe and responsible use of cannabis.
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