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Background
Around 2004, a number of herbal incense products, first sold under the brand name ‘Spice’, appeared in Europe. Herbal incense or herbal blends were gaining a high degree of popularity by mid-2008 in many countries such as Germany, Poland or the UK. In December 2008, German labs identified synthetic cannabinoids in these products.
Most of the respective cannabinoids were first synthesised in the context of pharmaceutical research projects carried out in the 1980s and 1990s. They had never shown up in any commercially available product before and no human studies with these cannabinoids have been carried out, so these substances must be regarded as not safe.
The JWH series, created by the chemist John W. Huffman at Clemson University, is the most common group of synthetic cannabinoids (e.g., JWH-018, JWH-073, or JWH-210). Other names of cannabinomimetics include e.g. HU-210 (HU stands for ‘Hebrew University’), AM-694 (AM stands for Alexandros Makriyannis, another cannabinoid researcher) or CP 47,497. There are hundreds of synthetic cannabinoids that may function as active compounds of herbal mixtures.
Prevalence/ motivation for use
In context of the above mentioned media attention for ‘Spice’ products, where they were called a ‘legal alternative’ to cannabis, these products were initially found to be popular among users of different ages and socioeconomic status. It appears to be the case that media interest and the prevalence of synthetic cannabinoids are strongly related.
Representative data on Spice use are sparse. An annual local representative students’ survey in Frankfurt, Germany, shows that the number of 15- to 18-year-olds who had ever used ‘herbal incense’ increased from 6% in 2008 to 9% in 2010, followed by a decrease to 7% in 2011. Similar proportions could be observed among the same age group in a survey conducted 2009 in Hamburg, Germany, with 6% reporting lifetime use of Spice products. Among the German adult population (18-64 years) surveyed in 2009, the lifetime prevalence of Spice was 0.8% and the last year rate 0.4%. Results from the British Crime Survey (2010/11) show that among young adults (16-24 years) in England and Wales the last year prevalence of ‘Spice’ products was 0.4% . It should be emphasized that there are very few regular users of such substances.
Little is known about characteristics, types and motivations of users. An online survey in Germany showed that the largest group of users are experimental users and their primary reason for using ‘Spice’products is curiosity. Since synthetic cannabinoids are used as a substitute for cannabis, the availability and quality of cannabis also seems to play a major role for the prevalence of ‘Spice’ products. A considerable percentage of herbal incense users regarded the non-detectability as an important motive. So far, it is known about user groups that most of the current and frequent herbal incense users currently smoke cannabis as well; just a small group has completely replaced the use of illicit drugs with herbal incense. It still remains to be seen if there is a new trend emerging and if there is the development of a stable group of regular herbal incense users.
Legal status
One particularity of the ‘Spice’ product phenomenon is that substances are quickly replaced by other substances when they are listed in the annexes of the Narcotics acts. The frequent change of compositions and substances by manufacturers and traders makes it difficult to assess, monitor and control the supply of these products. But specialised laboratories are now able to identify all commercially available synthetic cannabinoids. To date, almost all European countries have implemented legal control measures on the first synthetic cannabinoids that came to prominence (e.g. JWH-018). But none of the synthetic cannabinoids found so far in ‘Spice’ and ‘Spice’-like products are internationally controlled under UN drug control conventions.
At present, the control status of these compounds differs significantly from country to country. In countries like the UK and Switzerland, a generic definition was chosen to cover not only substances already present in herbal products, but also structurally similar compounds. Austria introduced a new law with specific generic approach on cannabinomimetic ingredients, which aims to inhibit the supply of these substances and to prevent the criminalisation of users. Italy, Luxembourg and Cyprus have added a group definition of synthetic cannabinoids to their drug laws. In Poland, a new law prohibits the manufacture, advertising and introduction of ‘substitute drugs’ into circulation. Sweden has introduced a new legislation on the destruction of hazardous substances assumed to be used for intoxication and not yet regulated under the drug law. Some countries use medicines laws as a tool to control legal highs. (For more information about the legal status of synthetic cannabinoids in Europe: www.emcdda.europa.eu)
Most of the European countries try to speed up their response to new psychoactive substances and to protect public health with new legislations.
Risks
Although the psychotropic effects are similar to those of cannabis, the health related problems differ substantially, but so far, the knowledge of acute toxicity and long-term toxicity of synthetic cannabinoids is limited. Synthetic cannabinoids can cause e.g psychotic episodes, panic attacks, increased heart rates, raised blood pressure, vomiting, convulsions and may damage organs.