Prevalence of Synthetic Cannabinoids in the Workplace David J. - - PDF document

▶
prevalence of synthetic cannabinoids in the workplace
SMART_READER_LITE
LIVE PREVIEW

Prevalence of Synthetic Cannabinoids in the Workplace David J. - - PDF document

Jan 05, 2023 22 likes •263 views

6/11/2014 Prevalence of Synthetic Cannabinoids in the Workplace David J. Kuntz, PhD, DABFT Executive Director of Analytical Toxicology Clinical Reference Laboratory Lenexa, KS 66215 email | kuntzd@crlcorp.com 1 6/11/2014 Webinar Objectives

slide-1
SLIDE 1

6/11/2014 1

Prevalence of Synthetic Cannabinoids in the Workplace

David J. Kuntz, PhD, DABFT Executive Director of Analytical Toxicology Clinical Reference Laboratory Lenexa, KS 66215 email | kuntzd@crlcorp.com

slide-2
SLIDE 2

6/11/2014 2

Webinar Objectives

  • 1. Brief history of the emergence synthetic

cannabinoids

  • 2. Effects of synthetic cannabinoids on the body
  • 3. Testing for synthetic cannabinoids at CRL
  • 4. Results of testing 90,000 workplace samples
  • 5. Governmental steps to control their

distribution

slide-3
SLIDE 3

6/11/2014 3

Spice History

  • The synthetic cannabinoids were created by Dr. John W.

Huffman in 1995 who was synthesizing chemicals to imitate THC on CB1 (brain) & CB2 (immune system) receptors to develop new medicines.

  • Other pharmaceutical companies and scientists have also

been involved in research and has led to some of the other unique alpha-numeric naming conventions.

  • One compound was the 18th compound created and

became JWH-018. The list of compounds numbered to 450.

  • JWH-018 and JWH-073 became the most popular as they

had high potency but have been largely replaced with different compounds.

slide-4
SLIDE 4

6/11/2014 4

Cannabinoid Receptor Effects

  • Reported as useful in the treatment of pain,

vomiting, epilepsy, multiple sclerosis, Parkinson’s, anxiety, and other claims

– CB1 receptors when stimulated in the CNS results in the mood changes, memory, time perception, auditory and visual changes with increasing dose – CB2 receptors are mainly located in immune-cells and are responsible in reducing inflammation

  • Toxic effects with increasing dose to include seizures,

psychosis, tachycardia, hyperactivity and suicidal thoughts

slide-5
SLIDE 5

6/11/2014 5

Spice Effects Reported in Humans

Psychological Physiological

Mild euphoria Hyperventilation Hyperactivity Anxiety Paranoia Hallucinations Vomiting Seizures Suicidal

  • Slurred speech
  • Poor coordination
  • Light-headedness
  • Red eyes
  • Pupil dilation
  • Elevated Pulse/BP
  • Flank pain (kidney injury)
  • Chest pain

D O S E

slide-6
SLIDE 6

6/11/2014 6

Packaging of Spice

  • The synthetic cannabinoids are either liquids or crystalline

which are dissolved in a solvent sprayed onto or mixed with potpourri of different fragrances and is often reflected in the name of the product.

  • The packaging is typically plastic bags or small packet with

very unique pictures and names. The internet is filled with purchase sites along with purchase prices by the gram or kilogram.

  • All are labeled “Not for Human Consumption” as an attempt

to eliminate the FDA/DEA from investigating the product.

slide-7
SLIDE 7

6/11/2014 7

Synthetic Cannabinoid Products

slide-8
SLIDE 8

6/11/2014 8

slide-9
SLIDE 9

6/11/2014 9

Spice Testing at CRL

  • The synthetic cannabinoids quickly became a popular alternative to

plant marijuana due to its similar psychological and physiological effects.

  • The use appeared to be widespread in the Midwest of the United

States with a major supplier only 30 miles from Kansas City

  • Clients of Clinical Reference Laboratory (CRL) were requesting that a

workplace drug testing panel be developed to detect the use of these compounds by their employees

  • In July 2011, the first panel of JWH-018 and JWH-073 was developed

to detect use. The panel was expanded several times to now include twelve compounds.

  • Screening is performed by LC/MS/MS with a separate LC/MS/MS

analysis for confirmation using a different type of analytical column.

  • Panel expansion/updates are based on the reported prevalence of new

compounds and availability of the reference standards.

slide-10
SLIDE 10

6/11/2014 10

Synthetic Cannabinoids

Generic terms to the herbal mixtures (incense, potpourri) which are sprayed with synthetic cannabinoids dissolved in acetone and smoked to get a “legal high” similar to marijuana. Typically packaged in foil-type packets and sold as “Not for Human Consumption”. Sold in convenience stores, gas stations, or head shops.

CRL is currently testing for metabolites of the following 21-compounds:

JWH-018 JWH-019 BB-22 JWH-073 JWH-081 PB-22 JWH-122 JWH-210 5-F-PB-22 JWH-250 AM-2201 AB-PINACA UR-144 MAM-2201 ADB-PINACA XLR-11 RCS-4 5-F-AB-PINACA AKB-48 5-F-AKB-48 ADBICA

slide-11
SLIDE 11

6/11/2014 11

Compound Similarities

  • Many compounds have minor modifications

that can enhance their pharmacologic effects by adding a Fluorine to the molecule

  • Examples of modifications:

AM-2201 is 5-fluoro-JWH-018 (10-fold stronger than JWH-018) XLR-11 is 5-F-UR-144 AB-PINACA vs. 5-F-AB-PINACA

slide-12
SLIDE 12

6/11/2014 12

Synthetic Cannabinoid Products

  • K2
  • K2 Blond
  • K2 Blue
  • K2 Blueberry
  • K2 Cherry
  • K2 Citron
  • K2 Cloud 9
  • K2 Melon
  • K2 Pink
  • K2 Rasta
  • K2 Sex
  • K2 Summit
  • K2 Ultra
  • K2 Watermelon
  • K3
  • K3 Ultimate
  • Lava Red
  • Mr. Happy
  • Armageddon
  • Astral Blast
  • Black Mamba
  • Blue Fire
  • Bonzai
  • Cloud 10
  • Coma
  • Demon Ritual Botanical
  • Fake Weed
  • Funky Green Stuff
  • Genie
  • Head Trip
  • Herbal Incense
  • Smoke
  • Super Kush
  • Texas Kush
  • Voodoo Spice
  • Zombie Twilight
slide-13
SLIDE 13

6/11/2014 13

Year One Data Summary

(July 2011-September 2012) Total Number of Samples – 15,995 Total Number of Positives – 1,116 Overall Positive Rate - 7.0%

slide-14
SLIDE 14

6/11/2014 14

Year Two Data Summary

(October 2012- September 2013) Total Number of Samples – 40,857 Total Number of Positives – 886 Overall Positive Rate – 2.2%

slide-15
SLIDE 15

6/11/2014 15

Cumulative Data Summary

(July 2011 – April 2014) Total Number of Samples – 89,051 Total Number of Positives – 2630 Overall Positive Rate – 2.9%

slide-16
SLIDE 16

6/11/2014 16

Jan 2013 Feb 2013 Mar 2013 Apr 2013 May 2013 Jun 2013 Jul 2013 Aug 2013 Sep 2013 Oct 2013 Nov 2013 Dec 2013 Jan 2014 Feb 2014 May2 014 Apr 2014 Total Positive Samples 19 5 156 207 136 97 62 60 42 93 83 38 72 84 79 169

JWH-018 11 5 35 19 22 5 6 7 4 10 17 7 5 6 6 JWH-073 10 13 1 10 2 2 6 1 5 10 2 1 5 2 JWH-081 JWH-210 JWH-250 1 2 RCS-4 3 1 JWH-122 1 AM2201 JWH-019 MAM2201 2 1 2 2 1 UR-144 131 193 135 95 60 55 39 87 72 38 58 74 74 145 XLR11 21 30 1 2 1 1 2 1 2 1 5 AKB48 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 1 2 1 5-F-AKB48 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a BB-22 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a PB-22 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 13 10 6 34 5-F-PB n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 8 14 7 14 AB-PINACA n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 24 ADB-PINACA n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 5-F-AB-PINACA n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 5 ADBICA n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a

slide-17
SLIDE 17

6/11/2014 17

0.0% 1.0% 2.0% 3.0% 4.0% 5.0% 6.0% 7.0% 8.0% 9.0%

Follow Up Not Specified Other Post Accident Preemployment Random Reasonable Cause Return to Duty

Percent Positive by Reason for Testing

July 2012 thru June 2013 July 2013 thru April 2014

slide-18
SLIDE 18

6/11/2014 18

slide-19
SLIDE 19

6/11/2014 19

THC AMP/MAMP

K2 Positives K2 vs. Multi-drug Positive Jan 2013 - Apr 2014

K2 86.9% THC 5.6% AMP/MAMP 2.4% Methadone <1% HC/HM <1% COCAINE <1% BENZO <1% OC/OM <1% Morphine <1% Tramadol <1% BUTALBITAL <1% ETG <1% Bath Salts <1% 6-AM <1% Fentanyl <1%

slide-20
SLIDE 20

6/11/2014 20

slide-21
SLIDE 21

6/11/2014 21

Requirements to Schedule New Chemicals

The Comprehensive Crime Control Act of 1984 gives the Attorney General authority to emergency schedule a drug or drug class but must satisfy three of eight factors:

  • 1. History and current pattern of use
  • 2. Scope of abuse
  • 3. Duration
  • 4. Significance of abuse
  • 5. Risk to public health
  • 6. Actual abuse
  • 7. Diversion from legitimate channels
  • 8. Clandestine importation, manufacture or distribution
slide-22
SLIDE 22

6/11/2014 22

Synthetic Drug Control Act of 2012

  • Signed by President Obama in July 2012
  • Expanded wording to include cannabimimetic Agents

– Any substance that is a cannabinoid receptor Type I (CB1 receptor agonist as demonstrated by binding studies and function assays) – Amends Schedule I of the Controlled Substances Act to include many additional “Bath Salt” compounds

  • Expands time for temporary scheduling to avoid imminent

hazards to Public Safety

– Extends from 1 to 2 years for emergency temporary scheduling – Extends 6 month period to 12 months for additional information before a final ruling on status

slide-23
SLIDE 23

6/11/2014 23

What is the Future of Designer Drugs?

  • As new synthetic cannabinoid products are identified, the government will be

placing many of these into Schedule I status due to their health risks and abuse.

  • Examples of new compounds on the horizon:

AM1220 AM-694 AM-1235 AM-223 UR-597 EAM-2201 STS-135 BAY-38-7271

  • The labs will continue to develop new methods to look for hundreds of different

known compounds covering multiple chemical families of structures. The future will be full of new chemicals that were never envisioned and the drug testing industry and legal review will be ongoing for many years to come.

  • The penalties for the production must be very high to control their expansion

since the profits are so very high. But with synthesis in overseas countries controlling their proliferation will be very hard.

slide-24
SLIDE 24

6/11/2014 24

Questions ?