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Synthetic cannabinoid JWH-018 and psychosis: an explorative study.

Abstract

BACKGROUND

Aroma, Spice, K2 and Dream are examples of a class of new and increasingly popular recreational drugs. Ostensibly branded "herbal incense", they have been intentionally adulterated with synthetic cannabinoids such as JWH-018 in order to confer on them cannabimimetic psychoactive properties while circumventing drug legislation. JWH-018 is a potent cannabinoid receptor agonist. Little is known about its pharmacology and toxicology in humans. This is the first research considering the effects of JWH-018 on a psychiatric population and exploring the relationship between JWH-018 and psychotic symptoms.

METHOD

This paper presents the results of semi-structured interviews regarding the use and effects of JWH-018 in 15 patients with serious mental illness in a New Zealand forensic and rehabilitative service.

RESULTS

All 15 subjects were familiar with a locally available JWH-018 containing product called "Aroma" and 86% reported having used it. They credited the product's potent psychoactivity, legality, ready availability and non-detection in drug testing as reasons for its popularity, with most reporting it had replaced cannabis as their drug of choice. Most patients had assumed the product was "natural" and "safe". Anxiety and psychotic symptoms were common after use, with 69% of users experiencing or exhibiting symptoms consistent with psychotic relapse after smoking JWH-018. Although psychological side effects were common, no one reported becoming physically unwell after using JWH-018. Three subjects described developing some tolerance to the product, but no one reported withdrawal symptoms.

CONCLUSION

It seems likely that JWH-018 can precipitate psychosis in vulnerable individuals. People with risk factors for psychosis should be counseled against using synthetic cannabinoids.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Te Korowai-Whāriki, A Capital and Coast District Health Board Service, Ratonga Rua O Porirua, Regional Forensic Service, Raiha Street, P O Box 50-233 Porirua, New Zealand. Susanna Every-Palmer@moh.govt.nz

    Source

    Drug and alcohol dependence 117:2-3 2011 Sep 01 pg 152-7

    MeSH

    Adult
    Cannabinoids
    Humans
    Indoles
    Interview, Psychological
    Male
    Middle Aged
    Naphthalenes
    New Zealand
    Psychoses, Substance-Induced
    Psychotic Disorders
    Receptor, Cannabinoid, CB1
    Receptor, Cannabinoid, CB2
    Street Drugs
    Substance-Related Disorders
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    21316162

    Citation

    * When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Synthetic cannabinoid JWH-018 and psychosis: an explorative study. A1 - Every-Palmer,Susanna, Y1 - 2011/02/11/ PY - 2010/07/07/received PY - 2011/01/06/revised PY - 2011/01/15/accepted PY - 2011/2/15/entrez PY - 2011/2/15/pubmed PY - 2012/2/7/medline SP - 152 EP - 7 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 117 IS - 2-3 N2 - BACKGROUND: Aroma, Spice, K2 and Dream are examples of a class of new and increasingly popular recreational drugs. Ostensibly branded "herbal incense", they have been intentionally adulterated with synthetic cannabinoids such as JWH-018 in order to confer on them cannabimimetic psychoactive properties while circumventing drug legislation. JWH-018 is a potent cannabinoid receptor agonist. Little is known about its pharmacology and toxicology in humans. This is the first research considering the effects of JWH-018 on a psychiatric population and exploring the relationship between JWH-018 and psychotic symptoms. METHOD: This paper presents the results of semi-structured interviews regarding the use and effects of JWH-018 in 15 patients with serious mental illness in a New Zealand forensic and rehabilitative service. RESULTS: All 15 subjects were familiar with a locally available JWH-018 containing product called "Aroma" and 86% reported having used it. They credited the product's potent psychoactivity, legality, ready availability and non-detection in drug testing as reasons for its popularity, with most reporting it had replaced cannabis as their drug of choice. Most patients had assumed the product was "natural" and "safe". Anxiety and psychotic symptoms were common after use, with 69% of users experiencing or exhibiting symptoms consistent with psychotic relapse after smoking JWH-018. Although psychological side effects were common, no one reported becoming physically unwell after using JWH-018. Three subjects described developing some tolerance to the product, but no one reported withdrawal symptoms. CONCLUSION: It seems likely that JWH-018 can precipitate psychosis in vulnerable individuals. People with risk factors for psychosis should be counseled against using synthetic cannabinoids. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/21316162/abstract/Synthetic_cannabinoid_JWH_018_and_psychosis:_An_explorative_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(11)00063-9 DB - PRIME DP - Unbound Medicine ER -