First large study links synthetic cannabinoid blood levels to consciousness impairment in 71 patients

Serum concentrations of 5F-MDMB-PICA correlated with ex vivo CB1 receptor activation in a sigmoidal relationship. The Glasgow Coma Scale showed a significant decreasing trend with increasing cannabinoid activity, meaning higher drug levels corresponded with greater impairment of consciousness. In vitro testing of five metabolites revealed two theoretically active metabolites, but in vivo their contribution to overall cannabinoid activity was negligible.

Evaluation of 71 patients presenting with recreational drug toxicity from 5F-MDMB-PICA. LC-HRMS confirmed and quantified the drug in serum. A CB1 bioassay measured ex vivo cannabinoid activity. Clinical features including Glasgow Coma Scale were correlated with drug levels.

Synthetic cannabinoids are far more dangerous than natural cannabis, and this is the first large patient cohort study to link 5F-MDMB-PICA blood levels to clinical outcomes. The dose-response relationship between drug levels and consciousness impairment provides crucial toxicological data.

The ability to predict clinical severity from blood levels and in vitro pharmacological data represents a step toward rapid risk assessment for synthetic cannabinoid poisonings, which are becoming more common.

Single synthetic cannabinoid studied. Patients may have used other substances not detected. GCS is a crude measure of impairment. The correlation between blood levels and clinical effects may not hold for other synthetic cannabinoids with different pharmacology.