Abstract
The emergence of smokable herbal products containing synthetic cannabinoids (SCs) is becoming increasingly popular in the new psychoactive substance use landscape. These compounds are mainly sold online (darknet) as an alternative to controlled and regulated psychoactive substances such as cocaine, MDMA and opiates. In the early 2000s, SCs became popular under brand names such as Spice in Europe and K2 in the USA. Substantial variations may exist in content and concentration of SC compounds in many available products, even within the same brand or batch. Clinical effects of SCs, as with other new psychoactive substances (NPSs), depend on the individual, the dose and the route of administration. The majority of their psychoactive effects are comparable to those of cannabis. Distinct pharmacological properties and the metabolism of SCs relative to Δ9-THC may contribute to the observed toxicity. Early evidence suggests that adverse somatic and psychiatric outcomes associated with the use of SCs may be more prevalent and more severe than those arising from cannabis use. The aim of the current chapter is to review the available data regarding the effects and consequences of SC use in humans. A literature search was performed on two representative databases, PubMed and Science Direct, and various websites as mentioned above. The terms used for the database search were “synthetic cannabinoids”, “spice”, “K2”, “synthetic cannabis”, “legal highs”, “new psychoactive substances”, “harmful use”, “adverse effects” and “fatalities”. The search was limited to the years 2005 to 2017. The literature search conducted led to the identification of potentially 122 relevant articles. All articles were screened from their abstracts to determine their relevance in the framework of the current review.
Published Version
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