Adverse effects after the use of JWH‐210 – a case series from the EU Spice II plus project. Issue 10 (15th January 2016)

• Record Type: Journal Article
• Authors: Hermanns‐Clausen, Maren; Kithinji, Josephine; Spehl, Marco; Angerer, Verena; Franz, Florian; Eyer, Florian; Auwärter, Volker
• Is Part Of: Drug testing and analysis. Volume 8:Issue 10(2016:Oct.)
• Page Start: 1030
• Page End: 1038
• Publication Date: 2016-01-15
• Subjects: JWH‐210 -- synthetic cannabinoids -- CB1 receptor agonist -- poisoning -- synthetic marijuana -- cannabimimetics; Drugs -- Analysis -- Periodicals; Drug testing -- Periodicals; Chemistry, Forensic -- Periodicals; 615.1901
• DOI: 10.1002/dta.1936
• Languages: English
• ISSNs: 1942-7603

Abstract

Abstract : Since 2009, more than 140 different synthetic cannabinoids (SC) have been identified in herbal mixtures consumed as recreational drugs. Knowledge of the acute toxicity of each individual compound remains sparse. Here we present a retrospective observational case series of patients presenting to emergency departments with analytically confirmed intake of JWH‐210 as the only SC detected in serum samples. Cases were selected from a poison centre database from March 2011 to June 2014. In total, 22 patients were included (aged 12–25 years, median 17.5; 18 males 4 female). JWH‐210 was identified in the serum samples in concentrations ranging from 0.18 to 90 ng/mL. Tachycardia, nausea, somnolence, hypokalemia, hypertension, restlessness, and/or agitation were most frequently reported. Diplopia, seizures, syncope, and ECG changes such as T‐wave inversion and bradycardia were also noted. Acute adverse effects of JWH‐210 typically include central nervous system depression or cerebral seizures, but also signs of sympathomimetic toxicity. Nausea was reported in 80% and typically shows a sudden onset shortly after inhalation, suggesting a central nervous effect possibly mediated by CB1 receptors. Cardiovascular effects are reported in up to 80% of the patients and might not only include alterations in blood pressure and heart rate, but also changes in the electrocardiogram (ECG). JWH‐210 as a representative of a strong CB1 receptor agonist confirms previous reports about adverse effects of SC, but shows a distinct quantitative pattern of symptoms, compared to several other SC. Copyright © 2016 John Wiley & Sons, Ltd. Abstract : Retrospective observational case series of 22 patients presenting to hospitals with analytically confirmed intake of JWH‐210, as the only synthetic cannabinoid (SC) detected in serum samples. Nausea and cardiovascular effects dominated (80% of patients) followed by central nervous system depression, but agitation, cerebral seizures, and diplopia occurred also. JWH‐210 can be estimated as a model of a potent CB1 receptor agonist and confirms previous reports about adverse effects after inhalation of SC, although the clinical pattern of overdose is distinct compared to other cannabinoids.