This is an overview of a presentation in Symposium 491. Scientists versus Street Chemists: The Toxicity of Designer Marijuana presented Wed, Apr 30, 9:30 AM - 12:00 PM at the 2014 Experimental Biology meeting.
Jeffrey Moran (PubMed) of the Arkansas Department of Public Health opened with an overview of synthetic cannabinoid products being sold and consumed by individuals seeking a marijuana-like high. The state of Arkansas has established a response to the emergence of synthetic cannabimimetic and stimulant drugs which includes government, academic, clinical and private resources. It is currently called the Center for Drug Detection and Response. He specifically mentioned his own analytic laboratory in the Department of Public Health, academic scientists at the University of Arkansas for Medical Sciences and Cayman Chemicals. The latter company has been essential in preparing analytical standards for their assessment of parent drugs and, in particular, the metabolites that might be found in human samples.
An analytical chemist’s approach to public health problems by J. H. Moran
Dr. Moran briefly overviewed the history of the appearance of 3 gram packets of dried plant material selling for $20-$50 each. Rather than boutique potporri, such packets are laced with synthetic cannabinoid drugs. They started appearing in the US around 2008 or 2009 and Arkansas identified their first item in 2010.
From 2010 until the present (2014), Moran's laboratory in the Department of Health has assessed over 4,300 synthetic drug items and 1,823 human samples. From this they have identified 47 different synthetic cannabinoids, 17 designer stimulants and 9 designer hallucinogens. From this diversity, how to triage? How to decide what to focus on? Well, Dr. Moran said that a half dozen cannabinoid compounds (of the 47) amounted to about 80-90% of the samples they've analyzed to date. If I had it right, his summary slide of top suspects included JWH-018, AM2201, UR-144, XLR-11, AB-PINACA, AB-FUBINACA and PB-22. (I may have missed a couple). Interestingly, although Dr. Moran mentioned some compounds dropping off the radar following specific DEA Scheduling actions, and new entities arising to replace them, JWH-018 has been making a comeback. This points, in my view, to an important reminder. Despite the fact that the diversity in designer cannabinoids and cathinones appears to be driven by legal status, it is good to remember there are plenty of highly popular recreational drugs which are clearly illegal and have been so for many decades. I would predict a winnowing process whereby a few highly attractive exemplars of the cannabinoid and cathinone classes of drugs remain with us, even when they have been placed under control by the DEA (or act of Congress).
Dr. Moran when on to mention that the preparations available on the street are not exclusively predictive when it comes to appearances. That is, you might suspect that anything made of dried plant matter might contain cannabinoids where as tablets, capsules and loose powder or crystalline substances might be the cathinones. Although generally true, a few herbal material samples contained synthetic cathinones and a few "pills and powders" were found to contain synthetic cannabinoids.
Dr. Moran also described his role as a public health official by depicting statewide tracking data. The different streams of information can be synthesized and direct him / his office to the right population. If he sees a lot of activity through poison control lines with no corresponding alerts from the law enforcement, then maybe he needs to reach out to local police jurisdictions. Likewise, a flurry of law enforcement without any activity from Emergency Departments may indicate a need to educate health care professionals on what to look for in that community.
One cannot help but walk away from this presentation with an appreciation for two things. One, we are fortunate that the Arkansas folks have taken a lead in generating a wealth of information on the use of cannabimimetic drugs. Second, it is always a pleasure to learn more about how someone with a job mandate that isn't strictly academic responds to an emerging recreational drug situation like we have been experiencing of late.
Dr. Moran disclosed his participation in Pin Point Testing, LLC.