Sunday, May 19, 2013

Driving Under the Influence of Synthetic Cannabinoids (“Spice”): a case series


            A form of a synthetic cannabinoid termed “spice” has become more popular during recent years in order to reach what users call a “legal high”. It is used to mimic the effects of delta-9-tetrahydracannabinoid (THC), which is the active chemical in marijuana. THC stimulates the CB1 receptor, ultimately leading to the impairment in motor function, sense of time, short term memory, and pain perception within peripheral organs and tissues. In addition, THC activates CB2  receptors which are responsible to immune modulating and anti-inflammatory effects. Synthesized drugs such as JWH-210, JWH-122, and CP 47 497-C8 with agonist activity with CB1 are some examples of the active ingredients in “spice” drugs, and they are suggested to be much more potent than THC. This causes them to produce potentially fatal intoxications from lower doses than that of marijuana. Seven DUI cases of juveniles found to be under the influence of spice are analyzed in this article.

Case 1 included An 18 year old who appeared to be very intoxicated,and described as unable to follow instructions, disoriented, and confused. He possessed an empty bag of 3 g of an herbal mixture, “Jamaican Extreme.” Case 2 presented two teenage girls with similar symptoms of the boy in case 1. However, they ingested herbal mixtures termed, “BooM” and “OMG.” These two mixtures were also used by the subjects in cases 3-7, and also contain JWH- 210 and JWH-122. The only case which differed from the mixture of these two chemicals was that of Case 6, in which the subject was also under the influence of alcohol.

In each of the seven cases, each juvenile portrayed similar symptoms including apparent sedation, short term memory, inability to speak, and paranoia. JWH-210 and JWH-122 are shown to have a much higher affinity for the CB1 receptor than THC, thus making them more intoxicating in smaller doses. As a result, the strongly sedating effects of these substances directly impair one’s ability to drive. In order to address this problem, law officers are being educated about the drugs and their symptoms. Also, new technologies are being developed in order to accurately screen for levels of these drugs’ metabolites in blood and urine samples.

           

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