1. Analysis of Synthetic Cannabinoids

    Was the substance that this patient was found with sent to an analytic organic chemist to identify the specific chemical moeties present? Synthesis of cannabinoids can result in a product that has radically different pharmacologic properties than the desired compound. The classic example is Ecstacy. Distillation at the wrong temperature, just a few degrees off, results in a total body paralysis drug. In the presented case it may be anything from an impure drug to co-synthesis of the Dextro and Levo forms of the active agent. For instance Levo-methadone is an opiate effective against nociceptive pain while Dextro-methadone is an NMDA antagonist effective against neuropathic pain.

    We really need to identify the specific agent that causes the cardiovascular effects. If street chemists are manufacturing synthetic cannabinoids we need to identify the specifics in order to identify the product (urine drug screen?), look for the specific pathologic effects in patients presenting with atypical symptoms, and hopefully develope a treatment protocol to minimize any damage.

    Conflict of Interest:

    None declared

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