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Analytical confirmation of synthetic cannabinoids in a cohort of 179 presentations with acute recreational drug toxicity to an Emergency Department in London, UK in the first half of 2015.

Abstract Synthetic cannabinoid receptor agonists are the largest group of new psychoactive substances reported in the last decade; in this study we investigated how commonly these drugs are found in patients presenting to the Emergency Department with acute recreational drug toxicity.
PMID
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Authors

Mayor MeshTerms

Emergency Service, Hospital

Keywords

Drugs of abuse

Emergency Department

acute toxicity

new psychoactive substances

synthetic cannabinoid receptor agonists

Journal Title clinical toxicology (philadelphia, pa.)
Publication Year Start




PMID- 28421836
OWN - NLM
STAT- MEDLINE
DA  - 20170419
DCOM- 20170425
LR  - 20170425
IS  - 1556-9519 (Electronic)
IS  - 1556-3650 (Linking)
VI  - 55
IP  - 5
DP  - 2017 Jun
TI  - Analytical confirmation of synthetic cannabinoids in a cohort of 179
      presentations with acute recreational drug toxicity to an Emergency Department in
      London, UK in the first half of 2015.
PG  - 338-345
LID - 10.1080/15563650.2017.1287373 [doi]
AB  - CONTEXT: Synthetic cannabinoid receptor agonists are the largest group of new
      psychoactive substances reported in the last decade; in this study we
      investigated how commonly these drugs are found in patients presenting to the
      Emergency Department with acute recreational drug toxicity. METHODS: We conducted
      an observational cohort study enrolling consecutive adult patients presenting to 
      an Emergency Department (ED) in London (UK) January-July 2015 (6 months) with
      acute recreational drug toxicity. Residual serum obtained from a serum sample
      taken as part of routine clinical care was analyzed using high-resolution
      accurate mass-spectrometry with liquid-chromatography (HRAM-LCMSMS). Minimum
      clinical data were obtained from ED medical records. RESULTS: 18 (10%) of the 179
      patient samples were positive for synthetic cannabinoid receptor agonists. The
      most common was 5F AKB-48 (13 samples, concentration 50-7600 pg/ml), followed by 
      5F PB-22 (7, 30-400 pg/mL), MDMB-CHMICA (7, 80-8000 pg/mL), AB-CHMINACA (3,
      50-1800 pg/mL), Cumyl 5F-PINACA (1, 800 pg/mL) and BB-22 (1, 60 pg/mL). Only 9/18
      (50%) in whom synthetic cannabinoid receptor agonists were detected self-reported
      synthetic cannabinoid receptor agonist use. The most common clinical features
      were seizures and agitation, both recorded in four (22%) individuals. Fourteen
      patients (78%) were discharged from the ED, one of the four admitted to hospital 
      was admitted to critical care. CONCLUSIONS: Synthetic cannabinoid receptor
      agonists were found in 10% of this cohort with acute recreational drug toxicity
      but self-reported in only half of these. This suggests that presentations to the 
      ED with acute synthetic cannabinoid receptor agonist toxicity may be more common 
      than reported.
FAU - Abouchedid, Rachelle
AU  - Abouchedid R
AD  - a Clinical Toxicology , Guy's and St Thomas' NHS Foundation Trust , London , UK.
FAU - Hudson, Simon
AU  - Hudson S
AD  - b Laboratory and Managed Services , LGC Ltd , Fordham , Cambridgeshire, UK.
FAU - Thurtle, Natalie
AU  - Thurtle N
AD  - a Clinical Toxicology , Guy's and St Thomas' NHS Foundation Trust , London , UK.
FAU - Yamamoto, Takahiro
AU  - Yamamoto T
AD  - a Clinical Toxicology , Guy's and St Thomas' NHS Foundation Trust , London , UK.
FAU - Ho, James H
AU  - Ho JH
AD  - a Clinical Toxicology , Guy's and St Thomas' NHS Foundation Trust , London , UK.
FAU - Bailey, George
AU  - Bailey G
AD  - a Clinical Toxicology , Guy's and St Thomas' NHS Foundation Trust , London , UK.
FAU - Wood, Michelle
AU  - Wood M
AD  - c Department of Health Sciences , Waters Corporation , Wilmslow , Cheshire, UK.
FAU - Sadones, Nele
AU  - Sadones N
AD  - d Laboratory of Toxicology , Ghent University , Ghent , Belgium.
FAU - Stove, Christophe P
AU  - Stove CP
AD  - d Laboratory of Toxicology , Ghent University , Ghent , Belgium.
FAU - Dines, Alison
AU  - Dines A
AD  - a Clinical Toxicology , Guy's and St Thomas' NHS Foundation Trust , London , UK.
FAU - Archer, John R H
AU  - Archer JRH
AD  - a Clinical Toxicology , Guy's and St Thomas' NHS Foundation Trust , London , UK.
AD  - e Faculty of Life Sciences and Medicine , King's College London , London , UK.
FAU - Wood, David M
AU  - Wood DM
AD  - a Clinical Toxicology , Guy's and St Thomas' NHS Foundation Trust , London , UK.
AD  - e Faculty of Life Sciences and Medicine , King's College London , London , UK.
FAU - Dargan, Paul I
AU  - Dargan PI
AD  - a Clinical Toxicology , Guy's and St Thomas' NHS Foundation Trust , London , UK.
AD  - e Faculty of Life Sciences and Medicine , King's College London , London , UK.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20170220
PL  - England
TA  - Clin Toxicol (Phila)
JT  - Clinical toxicology (Philadelphia, Pa.)
JID - 101241654
RN  - 0 (Cannabinoid Receptor Antagonists)
RN  - 0 (Indazoles)
RN  - 0 (Indoles)
RN  - 0
      (N-(1-(aminocarbonyl)-2-methylpropyl)-1-(cyclohexylmethyl)-1H-indazole-3-carboxam
      ide)
RN  - 0 (N-(1-adamantyl)-1-(5-fluoropentyl)-1H-indazole-3-carboxamide)
RN  - 0 (Street Drugs)
RN  - 0 (methyl 2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido)-3,3-dimethylbutanoate)
RN  - HG18B9YRS7 (Valine)
RN  - PJY633525U (Adamantane)
SB  - AIM
SB  - IM
MH  - Adamantane/administration & dosage/analogs & derivatives/blood
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Cannabinoid Receptor Antagonists/*adverse effects/*blood
MH  - Cohort Studies
MH  - Drug Overdose/*blood/diagnosis
MH  - *Emergency Service, Hospital
MH  - Female
MH  - Humans
MH  - Indazoles/administration & dosage/blood
MH  - Indoles/blood
MH  - London
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Street Drugs/adverse effects/blood
MH  - Substance Abuse Detection
MH  - Tandem Mass Spectrometry
MH  - Valine/analogs & derivatives/blood
MH  - Young Adult
OTO - NOTNLM
OT  - *Drugs of abuse
OT  - *Emergency Department
OT  - *acute toxicity
OT  - *new psychoactive substances
OT  - *synthetic cannabinoid receptor agonists
EDAT- 2017/04/20 06:00
MHDA- 2017/04/26 06:00
CRDT- 2017/04/20 06:00
AID - 10.1080/15563650.2017.1287373 [doi]
PST - ppublish
SO  - Clin Toxicol (Phila). 2017 Jun;55(5):338-345. doi: 10.1080/15563650.2017.1287373.
      Epub 2017 Feb 20.

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