UMEM Educational Pearls

Designer drugs are structural or functional analogs of controlled substances produced to mimic pharmacological effects of the original compound while circumventing legal restrictions and detection on drug screens. Considered "legal highs" by the public, these highly potent drugs are produced in clandestine laboratories with no regulations for quality control or clinical testing for phamacological effects and thus present major threat to public health. Examples include synthetic hallucinogens (DOM: STP), opiates ( methylfentanyl:china white), stimulants (methamphetamine:crank, MDMA: ecstasy, cathinones:bath salts) and synthetic cannabinoids (spice).

The synthetic cannabinoids are the newest designer drugs and numerous cases of intoxication are being reported including some fatalties.Cannabinoids fall into 3 classes: endocannabinoids, phytocannabinoids, synthetic. Marijuana, the best known cannabinoid is plant derived and its psychoactive effects are mainly due to delta-9-tetrahydrocannabinol (THC) which binds with the endocannabinoid receptors CB1 and CB2 found throughout the central and peripheral nervous system and peripheral organs. The CB receptors interact with opiate receptors which is likely responsible for the analgesic effect.

Since 1984, the John Huffman research group at Clemenson University synthesized over 450 cannabinoid compounds for biomedical reseach known as "JWH compounds". These compounds hold great promise in the investigation of multiple diseases and development of new novel therapies. Over the last several years, these cannabinoid compounds began cropping up sprayed onto herbs marketed in colorful packets and sold on the internet, convienence stores, and head shops. Although clearly labeled as "not for human consumption" considered on the street as a legal alternative to marijuana.

Key Points:

• Common names: Spice, K2, Smoke, Skunk, Purple Haze, Scooby snax, Crazy Monkey.
• JWH 018 (4-5 fold greater affinity for CB receptor than THC), JWH 081,122, 210
• Exact composition of products unknown and ever changing to avoid legal restrictions.
• Cannabinoid dose can vary greatly between products and even within same package "hot spots" are found where the drug is more concentrated.
• Often shown to be contaminated with impurities like beta agonists clenbulterol
• No clinical human studies on effects or any routine detection assays available.
• Clinical effects can vary from commonly described anxiety agitation, tachycardia to sedation and somulence.

References

Seely KA, Lapoint , et al. Spice drugs are more than harmless herbal blends: a review of pharmacology and toxicology of synthetic cannabinoids. Progress in Neuropharmacology & Biological Psychiatry (2012), doi:10.1016/j.pnpbp.2012.04.017

Wiley JL. Marusich JA. et al. Hijacking of basic research: the case of synthetic cannabinoids. Methods Rep RTI Press. 2011 November; 2011; .doi: 10.3768/rtipress.2011.op.0007.1111