Summary about Disease
Synthetic cannabinoid-related illnesses encompass a range of adverse health effects resulting from the use of synthetic cannabinoids (SCs), which are human-made chemicals that mimic the effects of THC, the psychoactive component of marijuana. SCs bind to the same receptors in the brain as THC but often with much greater potency, leading to unpredictable and potentially severe consequences. These substances are often marketed as "synthetic marijuana" or "herbal incense" under various brand names, but their composition and effects can vary widely and are often unknown. These illnesses can range from mild psychological effects to severe physical symptoms and even death.
Symptoms
Symptoms vary widely depending on the specific synthetic cannabinoid used, the dosage, and individual factors. Common symptoms include:
Cardiovascular: Rapid heart rate, high blood pressure, chest pain, heart attack.
Neurological: Agitation, anxiety, paranoia, hallucinations, psychosis, seizures, coma.
Gastrointestinal: Nausea, vomiting.
Renal: Acute kidney injury.
Musculoskeletal: Muscle breakdown (rhabdomyolysis).
Other: Sweating, dizziness, confusion, altered mental status, respiratory depression, stroke.
Behavioral: Violent behavior, suicidal thoughts.
Causes
The primary cause of synthetic cannabinoid-related illnesses is the consumption of synthetic cannabinoids. These substances are manufactured in laboratories and sprayed onto dried plant material to be smoked or ingested. The specific chemical compounds used vary widely, and their potency and effects are often unknown. Lack of quality control in the manufacturing process leads to variability in product contents and can result in overdoses and unexpected toxic effects. Users often purchase synthetic cannabinoids unknowingly or because they are perceived as legal alternatives to marijuana.
Medicine Used
Treatment focuses on supportive care to manage symptoms and stabilize the patient. There is no specific antidote for synthetic cannabinoid toxicity. Common treatments include:
Cardiovascular Support: Medications to control heart rate and blood pressure, treatment for heart attack.
Neurological Support: Sedatives (e.g., benzodiazepines) to manage agitation and seizures, antipsychotics for psychosis.
Respiratory Support: Oxygen supplementation, mechanical ventilation if needed.
Fluid Management: Intravenous fluids to maintain hydration and kidney function.
Treatment of Rhabdomyolysis: Intravenous fluids and supportive care to prevent kidney damage.
Activated Charcoal: May be considered if the patient presents soon after ingestion, but its effectiveness is unclear.
Is Communicable
Synthetic cannabinoid-related illnesses are not communicable. They are caused by the ingestion or inhalation of a chemical substance, not by an infectious agent.
Precautions
Avoid Use: The most important precaution is to avoid using synthetic cannabinoids altogether. Their unpredictable effects and potential for severe health consequences make them extremely dangerous.
Education: Educate yourself and others about the risks of synthetic cannabinoids.
Seek Help: If you or someone you know is using synthetic cannabinoids, seek help from a healthcare professional or substance abuse treatment program.
Be Aware: Be aware of the signs and symptoms of synthetic cannabinoid toxicity and seek immediate medical attention if they occur.
Check Ingredients: Be wary of products marketed as "herbal incense" or "synthetic marijuana," especially if the ingredients are not clearly listed.
How long does an outbreak last?
There is no definable length for an outbreak. Outbreaks are dependent on the supply and availability of contaminated or particularly potent synthetic cannabinoid products in a given area. An outbreak may last weeks, months, or even years depending on the nature and source of the substance, as well as the effectiveness of public health interventions to remove the supply and warn the public.
How is it diagnosed?
Diagnosis can be challenging as synthetic cannabinoids are often not detected by standard drug screens. Diagnosis is typically based on:
Clinical Presentation: Symptoms and signs exhibited by the patient.
History: Information about substance use obtained from the patient or witnesses.
Laboratory Tests:
Urine and blood toxicology screens (though many synthetic cannabinoids are not detectable). Specialized testing may be available but can be costly and time-consuming.
Blood tests to assess kidney function (BUN, creatinine), liver function (AST, ALT), and muscle breakdown (creatine kinase).
Differential Diagnosis: Ruling out other possible causes of the symptoms.
Timeline of Symptoms
The onset of symptoms is usually rapid, occurring within minutes to hours after using synthetic cannabinoids.
Immediate (Minutes to Hours): Agitation, anxiety, paranoia, rapid heart rate, nausea, vomiting, confusion.
Short-Term (Hours to Days): Hallucinations, psychosis, seizures, chest pain, kidney injury, muscle breakdown, respiratory depression.
Long-Term (Weeks to Months): Prolonged psychosis, cognitive impairment, dependence, withdrawal symptoms upon cessation. (Note: long term effects are still being researched).
Important Considerations
Variability: The composition and potency of synthetic cannabinoid products vary widely, making it difficult to predict their effects.
Potency: Synthetic cannabinoids can be much more potent than THC, increasing the risk of overdose and severe adverse effects.
Legality: The legal status of synthetic cannabinoids varies by jurisdiction, and new compounds are constantly being developed to circumvent regulations.
Mental Health: Synthetic cannabinoids can exacerbate pre-existing mental health conditions and trigger new psychiatric problems.
Public Health: Synthetic cannabinoid use poses a significant public health challenge due to the unpredictable nature of these substances and the potential for widespread outbreaks of illness.
Treatment: The lack of specific antidotes and the difficulty in identifying the specific compounds ingested make treatment challenging.