Based on our results, the most common synthetic cannabinoids were JWH-018 at 63.3 percent followed by JWH-073 at 31.2 percent combining for 94.5 percent of all positive tests.
brain receptors (CB1) for medical purposes. Te research led to the creation of hundreds of compounds with the publication of how to synthesize these synthetic cannabinoids. Clandestine chemists found these research papers and the production and distribution of these synthetics ensued. Other investiga- tors and pharmaceutical companies have conducted research in these areas for medi- cal purposes, and their products have also made it to the market, sometimes decades aſter their original synthesis. Te compounds are identified by inven-
tor or company. For instance Dr. John W. Huffman’s compounds are all listed as JWH with the number listed behind the JWH- as the specific compound developed in the series of analog compounds. Examples of other series of compounds are AM, HU, and RCS, with each specific compound identified with a number following. Te self reported effects range from mild
euphoria to hyperventilation, paranoia, hallucinations, vomiting, and seizures. Te physiological effects include: slurred speech, poor motor coordination, light- headedness, red eyes, pupil dilation, elevated pulse and blood pressure. Te effects are reported to last up to 12 hours with some subjects reporting multiple days are needed to fully recover from its use. Te use of synthetic cannabinoids has
been reported over the last few years with an increasing number of emergency room visits and calls to the Poison Control Centers. Based on the December 2012 Te DAWN Report that reviewed drug abuse data for 2010, there were more than 11,400 cases of synthetic cannabinoid drug-related complications in United States emergency rooms. Te report further breaks down the demographics of those individuals seeking treatment, with male patients ages 12 to 29 comprising 78 percent of the ER visits. Of the patients seeking treatment, 59 percent were not using any other drug at that time, and 36 percent had used the synthetic cannabi-
20 datia focus
noid with actual marijuana, alcohol, and/ or prescription drugs (Reference 1). Te products have received tremendous press exposure in print and television due to their misuse and addiction. It is the sub- ject of intense laboratory investigation to identify their use.
Laboratory Study Clinical Reference Laboratory (CRL)
developed an LC/MS/MS method for the detection of synthetic cannabinoids in the summer of 2011 in response to the increased prevalence of the synthetics in the workforce. Clients requested that testing be performed, especially on donors with reasonable suspi- cion and post accident as reasons for testing. Since then, clients have included other testing categories such as: pre-employment, random, etc. CRL has recently reviewed and summa- rized the results of our testing over the last 12 months (December 2011 through November 2012), which includes testing on more than 21,000 samples. The synthetic cannabinoids tested
in the panel include the following eight compounds: JWH-018, JWH 073, JWH- 081, JWH-122, JWH-210, JWH- 250, AM-2201, and RCS-4. Justification for the panel components were based on information provided by other testing laboratories in the United States and the compounds found in their analyses. Do- nor samples were reported positive based on the detection of one primary metabo- lite for each compound and reported to the limit of detection. The reporting cutoffs varied by compound but were either 0.2 ng/mL or 0.5 ng/mL. These tests were performed in addition to the standard drug testing panel as the syn- thetic cannabinoid test did not require additional specimen collection or special storage considerations. All samples were initially screened by an LC/MS/MS method and confirmed using a separate analytical LC/MS/MS method.
winter 2013
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