Transcript Synthetic cannabinoid agonists (SCRAs)

Synthetic cannabinoid
agonists (SCRAs)
Harry Shapiro
DrugScope
What are they?
• Smoking mixtures – (usually) inert herbs
plus chemicals.
• Look like natural cannabis, but high
potency varieties can be dyed in bright
colours
• Spice (original generic name) – latterly
Annihilation, Happy Joker. Exodus
Damnation; Kronic; Black Mamba,
Psyclone, Blue Cheese
Prescient?
Gary Henderson: J Forensic Science 1988:
• “In the view of this author, it is likely that the
future drugs of abuse will be synthetics rather
than plant products. They will be synthesized
from readily available chemicals, may be
derivatives of pharmaceuticals, will be very
potent, and often very selective in their action. In
addition, they will be marketed very cleverly”.
Chemistry
• EMCDDA identified seven main structural groups including : AMxxx;
HUxxx; JWHxxx; HUxxx, CPxxx
• 5F compounds (e.g Psyclone) could be classified within any of the
major structural groups
• Most of these compounds discovered by underground chemists in
the published scientific literature
• JWH = John William Huffman doing research into making a drug
that would target the brain’s natural cannabinoid receptors to aid
research into HIV/AIDS, chemotherapy and MS.
• Leaked out in Germany as K2 and Spice around 2008 where the
first street use of SCRAs was identified.
• But some compounds identified more recently not in the literature at
all – suggests chemists are examining legislation and working round
it.
Action on brain
• THC is a partial agonist – doesn’t fully engage with the
brain receptors CB1 and CB2 (because of the presence
of CBD?)
• Some SRCAs shown to be full agonists which makes
them potentially more potent than THC.
• Huffman aslo investigated retail SCRAs and discovered
that JWH-018 binds to the CB1 receptor four times
tighter than THC and ten times tighter to CB2
• We had no idea that anybody would be stupid enough to
use it”
Patterns and prevalence of use
•
Virtually no official data
•
Some data from 10/11 and 11/12 CSEW
(0.2% and 0.1% 16-59 lifetime use)
•
More data from 2015 from CSEW and ‘Smoking, drinking drugs
among school students’ survey
•
2014 Global Drug Survey, SCRAs not listed in top 20 drugs used
in the last year. But UK second only to USA in last year use,
although generally not popular among regular club drug/festival
drug users
•
Much more problematic use among vulnerable young people,
young and adult offenders, street homeless, existing service users
– often in areas of higher economic and social deprivation where
selling not restricted to head shops – whole range of outlets plus
street
•
To what extent will official data improve the picture?
Health impacts
• Impossible to gauge what brand will have what effect – not least
because any individual packet could be a SCRA blend or ‘single
estate’! Anything from dreamy euphoria to something akin to
psychedelics
• Dosage – not the same as cannabis!
• More potent varieties carry most risk: anxiety, panic, disorientation,
confusion, severely impaired short-term memory; cardio-vascular
and respiratory problems, aggression, seizures, collapse.
• Many reported incidents of A&E admissions – “Mambulance”
• Dependency (receptor binding)
Control 1
• Two rounds of MDA generic legislation
(2009 and 2012) proposed by ACMD to
mop up “first and second” generation
SCRAs
• “Third generation” advice to Home Office
in November 2014 – modifications of one
JWH compound (4 sub-structures,16
compounds??)
Control 2
• How sustainable is this
approach?
• Where does it all end?
Control 3
• Neurological approach to SCRAs
• Blanket ban on high street sales
• Local authority action – cases brought
under GPSL; bans of use in public spaces
• Internet
Neurological approach?
• Control on any drug acting on the CB1 or
CB2 receptors
• US law from 2012 – CB1. Success?
• What about licensed medicines that might
also act in this way?
• At what level of activity does law kick in?
• Expense of testing a wide range of drugs
to ascertain activity level?
Guidance and further information
• PHE Guidance to commissioners
• LGA Guidance to local authorities
• Clinical Guidance on club and other drugs
due from Project Neptune (Dr OwenBowden Jones)
• Harry Shapiro [email protected]