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Driving under the influence of synthetic cannabinoids (“Spice”): a case series

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Abstract

Recreational use of synthetic cannabinoid receptor agonists—so-called “Spice” products—became very popular during the last few years. Several reports on clinical symptoms and poisonings were published. Unfortunately, most of these reports do not contain any analytical data on synthetic cannabinoids in body fluids, and no or only a limited number of cases were reported concerning driving under the influence (DUI) of this kind of drugs. In this article, several cases of DUI of synthetic cannabinoids (AM-2201, JWH-018, JWH-019, JWH-122, JWH-210, JWH-307, MAM-2201 (JWH-122 5-fluoropentyl derivative), and UR-144) are presented, focusing on analytical results and signs of impairment documented by the police or the physicians who had taken the blood sample from the suspects. Consumption of synthetic cannabinoids can lead to impairment similar to typical performance deficits caused by cannabis use which are not compatible with safe driving. These deficits include centrally sedating effects and impairment of fine motor skills necessary for keeping the vehicle on track. Police as well as forensic toxicologists and other groups should become familiar with the effects of synthetic cannabinoid use, and be aware of the fact that drug users may shift to these “legal” alternatives due to their nondetectability by commonly used drug screening tests based on antibodies. Sophisticated screening procedures covering the complete range of available compounds or their metabolites have to be developed for both blood/serum and urine testing.

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References

  1. Pertwee R (2005) Cannabinoids. Handb. Exp. Pharm, 168. Springer, Heidelberg, Germany

    Google Scholar 

  2. Auwärter V, Kneisel S, Hutter M, Thierauf A (2012) Synthetische Cannabinoide - Forensische Relevanz und Interpretation analytischer Befunde. Rechtsmed 22:259–271

    Article  Google Scholar 

  3. Werse B, Müller O, Schell C, Morgenstern C (2011) Jahresbericht MoSyD. Drogentrends in Frankfurt am Main 2010. Centre for Drug Research.

  4. Ashton JC, Wright JL, Mc Partland JM, Tyndall JD (2008) Cannabinoid CB1 and CB2 receptor ligand specificity and the development of CB2-selective agonists. Curr Med Chem 15:1428–1443

    Article  CAS  PubMed  Google Scholar 

  5. Pertwee RG (1999) Pharmacology of cannabinoid receptor ligands. Curr Med Chem 6:635–664

    CAS  PubMed  Google Scholar 

  6. Pertwee RG (2000) Cannabinoid receptor ligands: clinical and neuropharmacological considerations, relevant to future drug discovery, and development. Expert Opin Investig Drugs 9:1553–1571

    Article  CAS  PubMed  Google Scholar 

  7. Pertwee RG, Ross RA (2002) Cannabinoid receptors and their ligands. Prostaglandins Leukot. Essent Fat Acids 66:101–121

    Article  CAS  Google Scholar 

  8. Pertwee RG (2006) The pharmacology of cannabinoid receptors and their ligands: an overview. Int J Obes (Lond) 30(Suppl 1):S13–S18

    Article  CAS  Google Scholar 

  9. Pertwee RG (2008) The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol, and delta9-tetrahydrocannabivarin. Br J Pharmacol 153:199–215

    Article  CAS  PubMed  Google Scholar 

  10. McCarberg BH, Barkin RL (2007) The future of cannabinoids as analgesic agents: a pharmacologic, pharmacokinetic, and pharmacodynamic overview. Am J Ther 14:475–483

    Article  PubMed  Google Scholar 

  11. Auwärter V, Dresen S, Weinmann W, Müller M, Pütz M, Ferreiros N (2009) “Spice” and other herbal blends: harmless incense or cannabinoid designer drugs? J Mass Spectrom 44:832–837

    Article  PubMed  Google Scholar 

  12. Lindigkeit R, Boehme A, Eiserloh I, Luebbecke M, Wiggermann M, Ernst L, Beuerle T (2009) Spice: a never ending story? Forensic Sci Int 191:58–63

    Article  CAS  PubMed  Google Scholar 

  13. Dresen S, Ferreiros N, Pütz M, Westphal F, Zimmermann R, Auwärter V (2010) Monitoring of herbal mixtures potentially containing synthetic cannabinoids as psychoactive compounds. J Mass Spectrom 45:1186–1194

    Article  CAS  PubMed  Google Scholar 

  14. Hudson S, Ramsey J (2011) The emergence and analysis of synthetic cannabinoids. Drug Test Anal 3:466–478

    Article  CAS  PubMed  Google Scholar 

  15. Simolka K, Lindigkeit R, Schiebel HM, Papke U, Ernst L, Beuerle T (2012) Analysis of synthetic cannabinoids in "spice-like" herbal highs: snapshot of the German market in summer 2011. Anal Bioanal Chem 404:157–171

    Article  CAS  PubMed  Google Scholar 

  16. Moosmann B, Kneisel S, Girreser U, Brecht V, Westphal F, Auwärter V (2012) Separation and structural characterization of the synthetic cannabinoids JWH-412 and 1-[(5-fluoropentyl)-1H-indol-3yl]-(4-methylnaphthalen-1-yl)methanone using GC-MS NMR analysis and a flash chromatography system. Forensic Sci Int 220:e17–e22

    Article  CAS  PubMed  Google Scholar 

  17. Kneisel S, Westphal F, Bisel P, Brecht V, Broecker S, Auwärter V (2012) Identification and structural characterization of the synthetic cannabinoid 3-(1-adamantoyl)-1-pentylindole as an additive in “herbal incense”. J Mass Spectrom 47:195–200

    Article  CAS  PubMed  Google Scholar 

  18. Kneisel S, Bisel P, Brecht V, Broecker S, Müller M, Auwärter V (2012) Identification of the cannabimimetic AM-1220 and its azepane isomer (N-methylazepan-3-yl)-3-(1-naphthoyl)indole in a research chemical and several herbal mixtures. Forensic Toxicol 30:126–134

    Article  CAS  Google Scholar 

  19. Huffman JW, Szklennik PV, Almond A, Bushell K, Selley DE, He H, Cassidy MP, Wiley JL, Martin BR (2005) 1-Pentyl-3-phenylacetylindoles, a new class of cannabimimetic indoles. Bioorg Med Chem Lett 15:4110–4113

    Article  CAS  PubMed  Google Scholar 

  20. Atwood BK, Huffman J, Straiker A, Mackie K (2010) JWH018, a common constituent of “Spice” herbal blends, is a potent and efficacious cannabinoid CB receptor agonist. Br J Pharmacol 160:585–593

    Article  CAS  PubMed  Google Scholar 

  21. Atwood BK, Lee D, Straiker A, Widlanski TS, Mackie K (2011) CP47,497-C8, and JWH073, commonly found in “Spice” herbal blends, are potent and efficacious CB(1) cannabinoid receptor agonists. Eur J Pharmacol 659:139–145

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Wiley JL, Marusich JA, Martin BR, Huffman JW (2012) 1-Pentyl-3-phenylacetylindoles and JWH-018 share in vivo cannabinoid profiles in mice. Drug Alcohol Depend 123:148–153

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Müller H, Sperling W, Köhrmann M, Huttner HB, Kornhuber J, Maler JM (2010) The synthetic cannabinoid Spice as a trigger for an acute exacerbation of cannabis induced recurrent psychotic episodes. Schizophr Res 118:309–310

    Article  PubMed  Google Scholar 

  24. Schneir AB, Cullen J, Ly BT (2011) "Spice" girls: synthetic cannabinoid intoxication. J Emerg Med 40:296–299

    Article  PubMed  Google Scholar 

  25. Simmons J, Cookman L, Kang C, Skinner C (2011) Three cases of "spice" exposure. Clin Toxicol (Phila) 49:431–433

    Article  CAS  Google Scholar 

  26. Harris CR, Brown A (2013) Synthetic Cannabinoid Intoxication: a case series and review. J Emerg Med 44(2):360–366

    Article  PubMed  Google Scholar 

  27. Schneir AB, Baumbacher T (2012) Convulsions associated with the use of a synthetic cannabinoid product. J Med Toxicol 8:62–64

    Article  PubMed Central  PubMed  Google Scholar 

  28. Tung CK, Chiang TP, Lam M (2012) Acute mental disturbance caused by synthetic cannabinoid: a potential emerging substance of abuse in Hong Kong. East Asian Arch Psychiatry 22:31–33

    CAS  PubMed  Google Scholar 

  29. McQuade D, Hudson S, Dargan PI, Wood DM (2012) First European case of convulsions related to analytically confirmed use of the synthetic cannabinoid receptor agonist AM-2201. Eur J Clin Pharmacol 69(3):373–376

    Article  PubMed  Google Scholar 

  30. Cohen J, Morrison S, Greenberg J, Saidinejad M (2012) Clinical presentation of intoxication due to synthetic cannabinoids. Pediatrics 129:e1064–e1067

    Article  PubMed  Google Scholar 

  31. Every-Palmer S (2011) Synthetic cannabinoid JWH-018 and psychosis: an explorative study. Drug Alcohol Depend 117:152–157

    Article  CAS  PubMed  Google Scholar 

  32. Benford DM, Caplan JP (2011) Psychiatric sequelae of Spice, K2, and synthetic cannabinoid receptor agonists. Psychosomatics 52:295

    Article  PubMed  Google Scholar 

  33. Gunderson EW, Haughey HM, It-Daoud N, Joshi AS, Hart CL (2012) "Spice" and "K2" herbal highs: a case series and systematic review of the clinical effects and biopsychosocial implications of synthetic cannabinoid use in humans. Am J Addict 21:320–326

    Article  PubMed  Google Scholar 

  34. Forrester MB, Kleinschmidt K, Schwarz E, Young A (2011) Synthetic cannabinoid exposures reported to Texas poison centers. J Addict Dis 30:351–358

    Article  PubMed  Google Scholar 

  35. Forrester MB (2012) Adolescent synthetic cannabinoid exposures reported to Texas poison centers. Pediatr Emerg Care 28:985–989

    Article  PubMed  Google Scholar 

  36. Hermanns-Clausen M, Kneisel S, Szabo B, Auwärter V (2013) Acute toxicity due to the confirmed consumption of synthetic cannabinoids: clinical and laboratory findings. Addiction 108(3):534–544

    Article  PubMed  Google Scholar 

  37. Kneisel S, Auwärter V (2012) Analysis of 30 synthetic cannabinoids in serum by liquid chromatography-electrospray ionization tandem mass spectrometry after liquid-liquid extraction. J Mass Spectrom 47:825–835

    Article  CAS  PubMed  Google Scholar 

  38. McGuinness TM, Newell D (2012) Risky recreation: synthetic cannabinoids have dangerous effects. J Psychosoc Nurs Ment Health Serv 50:16–18

    Article  PubMed  Google Scholar 

  39. Hu X, Primack BA, Barnett TE, Cook RL (2011) College students and use of K2: an emerging drug of abuse in young persons. Subst Abuse Treat Prev Policy 6:16

    Article  PubMed Central  PubMed  Google Scholar 

  40. Vearrier D, Osterhoudt KC (2010) A teenager with agitation: higher than she should have climbed. Pediatr Emerg Care 26:462–465

    Article  PubMed  Google Scholar 

  41. Seely KA, Lapoint J, Moran JH, Fattore L (2012) Spice drugs are more than harmless herbal blends: a review of the pharmacology and toxicology of synthetic cannabinoids. Prog Neuropsychopharmacol Biol Psychiatry 39:234–243

    Article  CAS  PubMed  Google Scholar 

  42. Hoyte CO, Jacob J, Monte AA, Al-Jumaan M, Bronstein AC, Heard KJ (2012) A characterization of synthetic cannabinoid exposures reported to the national poison data system in 2010. Ann Emerg Med 60:435–438

    Article  PubMed  Google Scholar 

  43. Castellanos D, Singh S, Thornton G, Avila M, Moreno A (2011) Synthetic cannabinoid use: a case series of adolescents. J Adolesc Health 49:347–349

    Article  PubMed  Google Scholar 

  44. Hutter M, Ippisch J, Schultis H-W, Auwärter V (2012) Evaluation of an ELISA for synthetic cannabinoids applied to urine samples by comparison with a comprehensive and highly sensitive LC-MS/MS method. Rechtsmed 22(4):286–287

    Google Scholar 

  45. Elliott S (2011) Cat and mouse: the analytical toxicology of designer drugs. Bioanalysis 3:249–251

    Article  CAS  PubMed  Google Scholar 

  46. Wohlfarth A, Weinmann W (2010) Bioanalysis of new designer drugs. Bioanalysis 2:965–979

    Article  CAS  PubMed  Google Scholar 

  47. Hudson S, Ramsey J, King L, Timbers S, Maynard S, Dargan PI, Wood DM (2010) Use of high-resolution accurate mass spectrometry to detect reported and previously unreported cannabinomimetics in "herbal high" products. J Anal Toxicol 34:252–260

    Article  CAS  PubMed  Google Scholar 

  48. Hutter M, Broecker S, Kneisel S, Auwärter V (2012) Identification of the major urinary metabolites in man of seven synthetic cannabinoids of the aminoalkylindole type present as adulterants in “herbal mixtures” using LC-MS/MS techniques. J Mass Spectrom 47:54–65

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute of Forensic Medicine, University Bonn, Stiftsplatz 12, 53111, Bonn, Germany

    Frank Musshoff, Burkhard Madea & Gerhard Kernbach-Wighton

  2. FTC-Forensic-Toxicological Laboratory, Gaudenzdorfer Gürtel 43-45, 1120, Wien, Austria

    Wolfgang Bicker

  3. Institute of Forensic Medicine, University Freiburg, Albertstraße 9, 79104, Freiburg, Germany

    Stefan Kneisel, Melanie Hutter & Volker Auwärter

Authors
  1. Frank Musshoff
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  2. Burkhard Madea
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  3. Gerhard Kernbach-Wighton
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  4. Wolfgang Bicker
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  5. Stefan Kneisel
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  6. Melanie Hutter
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  7. Volker Auwärter
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Correspondence to Frank Musshoff.

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Musshoff, F., Madea, B., Kernbach-Wighton, G. et al. Driving under the influence of synthetic cannabinoids (“Spice”): a case series. Int J Legal Med 128, 59–64 (2014). https://doi.org/10.1007/s00414-013-0864-1

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  • DOI: https://doi.org/10.1007/s00414-013-0864-1

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