Synthetic cannabinoids (SC)

Since 2008 dozens of new synthetic cannabinoid receptor agonist compounds have emerged as additives in so-called ‘Spice’ or ‘K2' products. These SC have become a significant challenge for clinicians, forensic scientists, analytical toxicologists and legislative authorities. These products are often used as a cannabis substitute, particularly where individuals want to avoid detection in routine drug screening, which often do not include these compounds. Relatively little is known about the pharmacological properties of these drugs, particularly in humans. Most of the SC act as potent and efficacious agonists at the cannabinoid receptor type 1 (CB₁) and hence elicit cannabis-like effects even after doses in the low milligram range. In addition to cannabis-like toxicity, these compounds are associated with stimulant effects (e.g. tachycardia, hypertension, agitation, convulsions) and other effects including hypokalaemia. There have been some studies and early case reports which suggest the potential for dependence associated with the use of SC.