Acute kidney damage and even kidney failure have been reported following use of synthetic cannabinoids (Davidson, et al., 2017). One recent study has looked at other mechanisms of action in some of the older synthetic cannabinoids and reported that some produced varying amounts of activity at sites which are related to cardiotoxicity and heart disease (Wiley et al., 2016). It is not known whether the increased toxicity is due only to activation of CB1 cannabinoid receptors more strongly than Δ9-THC or whether these "super-strength" cannabinoids produce effects at other receptors. A major cause of concern is that some of the more recently seen synthetic cannabinoids are more likely to produce extremely toxic effects than the older synthetics (Tai and Fantegrossi, 2017
Tremors were observed in mice 30 minutes following 1 mg/kg AMB-FUBINACA in the present study. Pretreatment times and dose ranges for the drug discrimination assay were selected based on the time of peak depression in the locomotor activity assay in mice. Average potency of the discriminative stimulus effects of early compounds was 0.81±0.17 mg/kg (Gatch et al., 2014), whereas the potency of a recent set was 0.09±0.03 mg/kg (Gatch et al., 2018), and the potency of the current set is 0.05±0.01 mg/kg. Short-onset, short-acting compounds have a greater abuse liability, and long-acting compounds pose problems of long-acting adverse effects and interactions with other drugs. The duration of action of the synthetic cannabinoids tested using the 8-h protocol have varied widely, with some producing a duration of action no longer than 1 h, others producing a duration of action between 1–2 h, and others lasting more than 2 h. There seems to be a trend of newer synthetic cannabinoids being more potent than earlier compound
The chemical structures of the recent synthetic cannabinoids are unlike that of Δ9-THC, but are largely based on the structure of older synthetic cannabinoids that are known to have substantial abuse liability (Fig. 1
High resolution mass spectrometry such as LC-QTOF-MS allows the detection and identification of a broad spectrum of recreational drugs, including new psychoactive substances. A point-of-care drugs of abuse (DOA) test was initially performed on the urine of the patient. He confirmed drinking 750 ml energy drink without any further consumption of food and using an e-cigarette from Gaziantep, Turkey 10 seconds before the onset of his first symptoms. He usually smokes a pack of cigarettes a day and sometimes smokes e-cigarettes. Combined with non-specific, transient symptoms, clinical recognition of SCRA intoxication is challenging .
Data availability
The intensity is plotted against the retention time for both chromatograms, demonstrating the
adb butinaca presence and elution profiles of nicotine and ADB-BUTINACA in the analysed vape liquid sample. LC-QTOF-MS Chromatograms of Nicotine (Top) and ADB-BUTINACA (Bottom) in the Vape Liquid used by the patient. The LC-QTOF-MS analysis showed that the e-liquid contained nicotine and ADB-BUTINACA (Fig. 1). Because the point-of-care DOA test is generally not able to detect synthetic recreational drug substances, the liquid of the e-cigarette was thereafter screened using liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) on the Waters™ Xevo G3 QTOF MS system. After eating a light meal and drinking caffeinated sports drinks at the ER, the nausea complaints of the patient were reduced and the patient was discharged hom
A 30-min period, beginning when maximal depression of locomotor activity first appeared as a function of dose, was used for analysis of dose-response data and calculation of ED50 values. During test sessions, both levers were active, such that ten consecutive responses on either lever led to adb butinaca reinforcement. The substitution tests occurred only if the rats had achieved 85% injection-appropriate responding on the two prior training sessions.
The locomotor activity assay was used to identify approximate time courses and dose ranges of psychoactive effects, which is useful for identifying parameters for drug discrimination experiments and are also predictive of the time course of the psychoactive effects in human users. The purpose of the present study was to assess the abuse liability of 5F-MDMB-PINACA, MDMB-CHIMICA, MDMB-FUBINACA, ADB-FUBINACA, and AMB-FUBINACA. Since there is currently no robust measure of the reinforcing/rewarding effects of cannabinoids, drug discrimination is currently the best model for assessing abuse liability of cannabinoids. The findings produce an apparent paradox, since CPP and self-administration predict with high reliability the likelihood that a compound will be abused by humans, and cannabinoids are well-known to produce active drug-seeking in human
LC-QTOF-MS represents a significant advancement in the field of drug detection, offering higher sensitivity, specificity, and a broader spectrum of detectable substances. Despite all negative results in the point-of-care test for recreational drugs, the liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) analysis showed that the liquid of the e-cigarette contained ADB-BUTINACA, a synthetic cannabinoid. We report a 27-year-old man who was admitted to the emergency room because of sudden adb butinaca headache, nausea, vertigo, red eyes and palpitations. Synthetic cannabinoids are gaining popularity globally and detection is not commonly available.
Data availability
When clinical presentation and/or initial DOA testing results are inconclusive, additional testing with LC-QTOF-MS can be valuable and is recommended. SCRAs and other NPS may not be detected by point-of-care DOA tests. In this case, the point-of-care DOA urine screening was not able to detect the synthetic cannabinoid ADB-BUTINAC