Duccio Papanti, Laura Orsolini, Giulia Francesconi and Fabrizio Schifano
“Spice” products are synthetic cannabimimetics (SC; also called “synthetic cannabinoids”)-based designer drugs used as a legal alternative to cannabis for their very strong…
Abstract
Purpose
“Spice” products are synthetic cannabimimetics (SC; also called “synthetic cannabinoids”)-based designer drugs used as a legal alternative to cannabis for their very strong tetrahydrocannabinol (THC)-like effects. The purpose of this paper is to provide an analysis of more recent clinical and pharmacology/toxicology findings relating to SC and describe how they could impact on health, with a particular focus on mental health.
Design/methodology/approach
A systematic search and descriptive analysis of the available evidence on psychopathological issues related to misuse was performed here, whilst taking into account the Pubmed/Medline databases, a range of conference proceedings and national/international agencies’ reports.
Findings
While THC is a partial agonist, SC are full agonists on the cannabinoid receptors (CB-rs) and the administration of multiple SC can produce additive and/or synergistic agonistic interaction effects on the endocannabinoid system. These levels of strong CB-rs’ activation may be high enough to produce severe physiological and psychological disturbances. The available evidence suggests an existing relationship between SC use and psychosis (“Spiceophrenia”). The acute SC intoxication is usually characterized by tachycardia/hypertension; visual/auditory hallucinations; mydriasis; agitation/anxiety; tachypnoea; nausea/vomiting; and seizures.
Research limitations/implications
The absence of clinical trials and longitudinal studies, together with the heterogeneity of SC compounds does not facilitate a precise assessment of the health risks related to their use, with long-term effects being of particular concern.
Originality/value
Appropriate, non-judgemental, prevention campaigns with a special focus on the differences between SC and cannabis may need to be organized on a large scale. At the same time, clinicians need to be regularly updated about novel psychoactive substances, including SC, to promptly recognize signs/symptoms of intoxication.
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Charlie Place, Andy Scally, Laura Gow, Amy Wade, Rob Barrowcliff, Iram Nasim and Miriam Nyamuchiwa
Novel psychoactive substances (NPS) – often known as “legal highs” – are a varied group of substances that are causing concern due to their possible effects on mental health…
Abstract
Purpose
Novel psychoactive substances (NPS) – often known as “legal highs” – are a varied group of substances that are causing concern due to their possible effects on mental health. Particular concerns have been raised about synthetic cannabinoid receptor agonists often known as “Spice”. The purpose of this paper is to identify the prevalence of NPS use and explore any association with acute psychological disturbance.
Design/methodology/approach
The authors reviewed the case notes for 153 admissions to a male acute inpatient ward. Prevalence of reported NPS use and admissions to psychiatric intensive care unit (PICU) were recorded.
Findings
In total, 18.9 per cent of individuals admitted to acute inpatient care were reported to have used NPS. NPS users were almost ten times as likely as their non-NPS using peers to require care in PICU. This result was statistically significant (Fisher exact test: p<0.001). Although caution is required given the limitations of this study, the data and clinical experience suggest that synthetic cannabinoids may be the specific type of NPS that is being used by this group.
Practical implications
Mental health professionals can expect to care for people using NPS in acute inpatient environments, and so they need to understand the nature and effects of these substances. It is possible that NPS use may be associated with sustained acute psychological disturbance.
Originality/value
There have been few studies on the prevalence of NPS use in inpatient environments and none of them have published that explore the association with PICU admission. Despite the limitations of this study, it has significant value by identifying an urgent need for comprehensive research in this area.