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

The takeaway

Seven patients, mostly adolescents, presented with agitation and psychotic features after unknowingly vaping a synthetic cannabinoid (MDMB-4en-PINACA) through contaminated e-cigarettes.

Emergency physicians, parents, school health officials, vaping product regulators.

Median age 17 years

What the researchers found

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.

Why it matters

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 numbers in context

7 patients. Median age 17 years (range 14-37). 85.7% male. 71.4% presented with behavioral changes. 85.7% agitated. 57.1% had psychotic features. 3 cases: MDMB-4en-PINACA was the only substance detected. Period: Feb 2022-Feb 2025.

How the study worked

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.

What this study cannot tell us

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.

How to read the evidence

Preliminary: small case series providing important clinical alert but limited generalizability.

When this study was published

2025 study (cases from 2022-2025)

The bigger picture

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.

Questions still open

How widespread is synthetic cannabinoid contamination of vaping products? Should routine drug screening in young patients presenting with acute psychosis include synthetic cannabinoids? What supply chain interventions could prevent contamination?

Common questions

Can vaping devices contain synthetic cannabinoids?

Yes. This case series documented seven patients poisoned by MDMB-4en-PINACA found in vaping products. In three cases, it was the only drug detected, confirming the vape as the source.

What happened to the patients?

Most presented with agitation and behavioral changes, with over half experiencing psychotic features including hallucinations and delusions. The patients were mostly teenagers.

Read the original research

Seven patients with analytically confirmed MDMB-4en-PINACA toxicity associated with the use of electronic vaping devices.

Clinical toxicology (Philadelphia, Pa.), 63(5), 360-362

View on PubMed ↗Publisher’s paper ↗

Citation

Pucci, Mark; Moyns, Emma; Welby-Everard, Peter; Starbrook, Lauren. (2025). Seven patients with analytically confirmed MDMB-4en-PINACA toxicity associated with the use of electronic vaping devices.. Clinical toxicology (Philadelphia, Pa.), 63(5), 360-362. https://doi.org/10.1080/15563650.2025.2489079