La Mano Negra

PNP-08147; No of Pages 10
Progress in Neuro-Psychopharmacology & Biological Psychiatry xxx (2012) xxx–xxx

Contents lists available at SciVerse ScienceDirect

Progress in Neuro-Psychopharmacology & Biological Psychiatry
journal homepage: www.elsevier.com/locate/pnp

Spice drugs are more than harmless herbal blends: A review of the pharmacology and toxicology of synthetic cannabinoidsKathryn A. Seely a, Jeff Lapoint b, Jeffery H. Moran a, c, Liana Fattore d,⁎
a

Arkansas Department of Health, Public Health Laboratory, Little Rock, AR, United States New York City Poison Control Center, 455 First Ave, NY 10016, United States Department of Pharmacology & Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States d NeuroscienceInstitute—Cagliari, CNR National Research Council of Italy, Italy
b c

a r t i c l e

i n f o

a b s t r a c t
“K2” and “Spice” drugs (collectively hereafter referred to as Spice) represent a relatively new class of designer drugs that have recently emerged as popular alternatives to marijuana, otherwise characterized as “legal highs”. These drugs are readily available on the Internet andsold in many head shops and convenience stores under the disguise of innocuous products like herbal blends, incense, or air fresheners. Although package labels indicate “not for human consumption”, the number of intoxicated people presenting to emergency departments is dramatically increasing. The lack of validated and standardized human testing procedures and an endless supply of potential drugs ofabuse are primary reasons why researchers find it difficult to fully characterize clinical consequences associated with Spice. While the exact chemical composition and toxicology of Spice remains to be determined, there is mounting evidence identifying several synthetic cannabinoids as causative agents responsible for psychoactive and adverse physical effects. This review provides updates of thelegal status of common synthetic cannabinoids detected in Spice and analytical procedures used to test Spice products and human specimens collected under a variety of clinical circumstances. The pharmacological and toxicological consequences of synthetic cannabinoid abuse are also reviewed to provide a future perspective on potential short- and long-term implications. © 2012 Elsevier Inc. All rightsreserved.

Article history: Received 8 March 2012 Received in revised form 18 April 2012 Accepted 19 April 2012 Available online xxxx Keywords: Intoxication K2 ‘Legal highs’ Marijuana alternative Spice Synthetic cannabinoid

Contents 1. 2. 3. 4. 5. Introduction . . . . . . . . . . . . . . . . . Synthetic cannabinoids available on the market . Legislation . . . . . . . . . . . . . . . . . .Detection and identification of Spice . . . . . . Pharmacology and toxicology . . . . . . . . . 5.1. Pharmacokinetics and pharmacodynamics 5.2. Acute effects . . . . . . . . . . . . . . 5.2.1. Psychoactive effects . . . . . . 5.2.2. Physical effects . . . . . . . . 5.3. Long term effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....