Synthetic Cannabinoids Associated With Specific Severe Neuropsychiatric Outcomes in Adolescents

Toxicity from synthetic cannabinoid use can lead to severe illness requiring intensive care. This report analyzed multi-center toxicology data on adolescents aged 13–19 (N=348) who presented to an emergency department between January 2010 and October 2018 for treatment of symptoms related to either cannabis or synthetic cannabinoid use.

• Teens who had used only synthetic cannabinoids had greater odds of coma and/or central nervous system depression (odds ratio [OR], 3.42) and seizures (OR, 3.89), compared with those who had used only cannabis.
• Teens who had used only synthetic cannabinoids had significantly lower odds of agitation compared with those who had used only cannabis (OR, 0.18).
• Polydrug exposure was more common and involved more substances among individuals who used cannabis compared with those who used synthetic cannabinoids.

Comments: While both synthetic cannabinoids and cannabis bind to cannabinoid receptors 1 and 2, their physiological effects differ. These findings are an important reminder that different compounds in a psychoactive class can lead to vastly differing physiological effects and toxicities. This general principle underscores the need for a regulatory framework for addictive substances to protect public health.

Sharon Levy, MD, MPH

Reference: Anderson SAR, Oprescu AM, Calello DP, et al. Neuropsychiatric sequelae in adolescents with acute synthetic cannabinoid toxicity. Pediatrics. 2019;144(2).