Spike Max herbal incense blend via ForensicToxGuy (2013)
This blend is not associated with the outbreaks discussed here.
Here is an outbreak in Mississippi. As of today, there have been 473 reports of synthetic cannabinoid hospital visits in Mississippi.
Here is an outbreak in Alabama. From March 15 to April 20, 2015 - 462 patients were seen in the hospital for synthetic cannabinoid related matters. Of those patients, 96 were admitted to the hospital. 2 fatalities resulted.
Here is an outbreak in New York as reported by CNN. Reports were that more than 160 people visited the hospital with synthetic cannabinoid issues over the course of 9 days (as of April 18).
That equates to 1,095 people located in three states traveling to the hospital after consuming a synthetic cannabinoid product in approximately one month
All had been quiet on the specific identification of drug involved or associated with these outbreaks.
Today, the New York Times reported via Dr. Mark Ryan of the Louisiana Poison Center that "a large portion of cases appear to involve a form called mab-chminaca". I can only assume these cases that Dr. Ryan speaks of are from Louisiana and not the other states. I wouldn't doubt that MAB-CHMINACA is at play in the next states to the east as well (Mississippi and Alabama). I do know that this cannabinoid substance is out there in the wild now and has been for quite a bit of time.
MAB-CHMINACA was discussed briefly here in October 2014 when, oddly enough, the state of Louisiana moved to classify it as a Schedule I controlled substance.
As you can see from taking a quick look at the chemical structures, these new synthetic cannabinoids are all quite similar. Add in fluorinated derivatives for AB-PINACA, ABICA, ADB-PINACA, and ADBICA too.
How about some newer CHMINACA derivatives?
Want a new FUBINACA derivative or two?
The chemical diversity in structure of these compounds is amazing. Take a bit of substance A and mix it with this bit from substance B and add it all together with this group from substance C. Voila! We have new alphabet soup compound D!
As I've said before, they are a diverse chemical grab bag o' unknown pharmacological and toxicological profile. We have absolutely no pharmacological or toxicological data on most of the compounds listed above.
We do not know if they truly act on CB1 and CB2. It is surmised that they do.
We do not know if they act on other receptors or mediate other effects downstream. It is thought they don't. But who knows.
We do not know longterm (chronic) effects. And we won't for quite a while.
This guy knows more than we do...
Image courtesy of Wikipedia (2015)
All kidding aside, synthetic cannabinoids have been and will continue to be a major issue in the United States. They are public health nightmares. These recent hospitalizations are not surprising to me and should not be surprising to anyone that knows any science at all. They are the norm. The vast majority of people using these substances and products are essentially consuming substances of unknown identity with unknown pharmacological and toxicological effects in unknown combinations at unknown dosages. That is reckless. That is dangerous.
I have no answers here on what to do about these cat-and-mouse games that seem to spur on this chemical diversity over time.
Is MAB-CHMINACA really to blame for these hospitalizations? Maybe. Maybe not.
Are there other compounds out there being consumed that may be contributing to these hospitalizations? As you can see from the structures presented above, yes, there are many other compounds out there at the moment. I wouldn't be surprised to hear that some other CHMINACA or FUBINACA compounds were also associated with these outbreaks.
"And the beat goes on, the beat goes on...
Drums keep pounding a rhythm to the brain."
* Jon Snow image can be found here at Wikipedia.
*All chemical structure images were created by ForensicToxGuy in ChemDraw