A 27-year-old man experienced sudden headache, nausea, vertigo, and palpitations after vaping an e-cigarette that, unbeknownst to him, contained the synthetic cannabinoid ADB-BUTINACA.
emergency medicine clinicians, toxicologists, e-cigarette users, public health regulators
What the researchers found
Standard point-of-care drug tests were negative, but advanced LC-QTOF-MS analysis detected ADB-BUTINACA in the e-cigarette liquid. The patient experienced headache, nausea, vertigo, red eyes, and palpitations after vaping. This represents involuntary intoxication from an undisclosed synthetic cannabinoid in a commercial e-cigarette product.
Why it matters
E-cigarettes can contain undisclosed psychoactive substances that standard drug tests cannot detect. This case highlights the risk of involuntary intoxication and the limitations of routine screening in emergency settings.
The numbers in context
1 patient, age 27. Symptoms: headache, nausea, vertigo, red eyes, palpitations. Point-of-care drug test: negative. LC-QTOF-MS: positive for ADB-BUTINACA in e-cigarette liquid.
How the study worked
Case report of a 27-year-old man presenting to the emergency department. Point-of-care recreational drug testing was performed, followed by liquid chromatography-quadrupole time-of-flight mass spectrometry analysis of the e-cigarette liquid.
What this study cannot tell us
Single case report. Cannot determine how widespread e-cigarette contamination is. No long-term follow-up. Unclear source of the e-cigarette liquid or how the synthetic cannabinoid was introduced.
How to read the evidence
Single case report provides limited evidence but highlights an important clinical and public health concern.
When this study was published
Recently published case report.
The bigger picture
As e-cigarette markets grow and regulation varies by jurisdiction, the risk of undisclosed additives including synthetic cannabinoids represents an emerging public health concern. Standard drug tests are not designed to detect many novel psychoactive substances.
Questions still open
- How common are undisclosed synthetic cannabinoids in commercial e-cigarette products?
- Should emergency departments routinely test for novel psychoactive substances?
Common questions
Can e-cigarettes contain drugs other than nicotine?
Would a standard drug test catch this?
Read the original research
Involuntary intoxication caused by vaping the synthetic cannabinoid ADB-BUTINACA: A case report.
Toxicology reports, 14, 101930
Citation
Slob, Elise M A; Lyousoufi, Maryam; Pasha, Sharif; Wilms, Erik B. (2025). Involuntary intoxication caused by vaping the synthetic cannabinoid ADB-BUTINACA: A case report.. Toxicology reports, 14, 101930. https://doi.org/10.1016/j.toxrep.2025.101930
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