Date

12-30-2011

UMMS Affiliation

Graduate School of Biomedical Sciences, Master of Science in Clinical Investigation (MSCI) program

Document Type

Thesis, Master's

Subjects

Theses, UMMS; Marijuana Abuse; Receptors, Cannabinoid; Street Drugs; Designer Drugs

Disciplines

Life Sciences | Medical Toxicology | Medicine and Health Sciences

Abstract

Background

Herbal marijuana alternatives (HMA), legal plant products adulterated with synthetic cannabinoid receptor agonists, represent a growing public health concern. Only a few case reports describe HMA and synthetic cannabinoid’s clinical toxicity. We describe an outbreak of HMA abuse primarily in the Midwest, the clinical presentation of HMA toxicity, and clinical and forensic testing.

Methods

During the course of ongoing surveillance for emerging drugs of abuse between November 2009 and August 2010, we retrospectively and prospectively identified a convenience sample comprising 81 cases of abuse of HMA products. Subject demographics, vital signs, lab results and urine were obtained (when available) and tested via gas chromatography mass spectrometry (GCMS) analysis. Samples of HMAs and synthetic cannabinoids were also analyzed via GCMS.

Results

HMA users were predominantly young males who inhaled HMAs. Analysis of their urine detected synthetic cannabinoid parent compound in one subject. GCMS analysis of synthetic cannabinoids established a reference library that confirmed the presence of synthetic cannabinoids in sampled HMA products.

Conclusion

HMA products were available in head shops, gas stations, and via the Internet. We have confirmed the presence of synthetic cannabinoids in these HMA products. The tachycardia, hypertension, agitation, anxiety, vomiting and hallucinations observed in this convenience sample are not readily explained by the presence of synthetic cannabinoids acting on CB1 and CB2 receptors. Further research must be done on HMA products and their abusers.