Figure 1: Samples Screened by Reason for Testing 2014 2013 2012 0% 20%
■ Random ■ Not Specified/Other ■ Preemployment
40%
■ Reasonable Cause ■ Post Accident
60% 80%
■ Follow Up ■ Return to Duty
100%
Figure 2: Positive Specimens by Analyte
900 850 800 750 700 650 600 550 500 450 400 350 300 250 200 150 100 50 0
■ 2012 ■ 2013 ■ 2014
Synthetic Cannabinoid Effects Marijuana exerts its effects on two recep- tor types known as CB1 (brain) and CB2 (immune system, brain, and GI system). Synthetic cannabinoids are designed to have similar interactions with similar actions with a combination of effects on the CB1 and CB2 receptors in the body. Self-reported effects range from mild euphoria to hyperventila- tion, paranoia, hallucinogens, vomiting and seizures. Te physiological effects include: slurred speech, poor motor coordination, lightheadedness, red eyes, pupil dilation, elevated pulse and blood pressure. Tese effects can last up to 12 hours with some subjects claiming several days are needed to recover from their use. Te long-lasting effects are caused by the synthetics ability to bind to the CB1 receptor at a rate of 10-fold or higher than THC. Synthetic cannabinoid adverse effects were reported in a Colorado emergency room study1
and found elevated JWH-018 JWH-073 UR-144 XLR11 AB- PINACA 5-F- PB-22 PB22
Additional Analytes
blood pressure of greater than 120 mmHg (64 percent), heart rate of greater than 100 beats per minute (57 percent), somnolence (35 percent), aggressive or violent behavior (32 percent), agitation (32 percent) and confusion (25 percent). A 2014 SAMHSA Advisory2
provides a summary entitled
“Spice, Bath Salts, and Behavioral Health” for additional review of the synthetics and their implications for abuse.
Figure 3: Percent Positive by Reason for Testing
10.0% 8.0% 6.0% 4.0% 2.0% 0.0%
■ 2012 ■ 2013 ■ 2014
Follow Up
Not Specified Other Post Accident Pre- employment
Random Reasonable Cause Return
60 datia focus to Duty
Laboratory Study Various laboratories developed LC/MS/ MS screening and confirmation methods for the detection of synthetic cannabinoids in 2011 due to the prevalence of the drug in the workplace. Employers requested the testing of synthetics especially with reason- able suspicion and post-accident (reasons for testing) within their workforce. Based on the early positive rates, the testing was quickly expanded (to other reasons for testing) with random and pre-employment leading the testing categories. Te results for the first year of the testing were published in
spring 2015
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