Seven Patients Including Teens Were Poisoned by Synthetic Cannabinoid in Vape Devices

Seven patients (median age 17, range 14-37) presented to UK hospitals after using vaping products contaminated with MDMB-4en-PINACA. Six were male (85.7%). Five presented with unusual behavior changes; six were agitated; four displayed psychotic features including hallucinations and delusions. In three cases, MDMB-4en-PINACA was the only substance detected, confirming the vape as the sole source.

Observational case series from two UK acute hospitals (February 2022-February 2025). Patients self-reported vaping product use and were found positive for MDMB-4en-PINACA on routine toxicological urine screening. Clinical presentations were documented.

Vaping devices are increasingly being contaminated with synthetic cannabinoids, creating a hidden danger for users who believe they are vaping nicotine or standard cannabis products. The predominance of adolescent patients in this series highlights the vulnerability of young people to this emerging threat.

The contamination of legal vaping products with potent synthetic cannabinoids represents an emerging public health concern. Unlike intentional synthetic cannabinoid use, these patients may not have known what they were consuming, making this a product safety issue as much as a substance use issue.

Very small case series (N=7). Observational without controls. Cannot determine prevalence of contaminated vaping products. Limited to two hospitals in one country. Routine screening may miss cases where clinicians do not test for synthetic cannabinoids.