İşılay BALCI, Ali YILMAZ, Yeşim YETİŞ, Emrah EMİRAL, Kenan KARBEYAZ

Analysis of Deaths Related to Synthetic Cannabinoid (“Bonsai”) in Eskişehir, Turkey

Introduction, Objective; In literature, there are studies reporting that SC affects many systems such as cardiac, respiratory, urogenital, digestive system and cause death even in the first use. In this study, it is aimed to determine frequency of death resulting from use of SC and also the rate of forensic deaths in Eskisehir province. Method: In this study, cases in which cause of death is related to the use of SC and which are included in forensic deaths that occurred between 1 January 2011 and 31 December 2016, are going to be included in this study. The rate of cases in which deaths result from SC to the rate of all forensic deaths is going to be detected. Also, demographic data of the cases such as age, gender, educational status, marital status, working status and residence are going to be examined. Findings: Within 6 years-period the study includes, it was determined that 33 people died because of SC. In 2011, the first year that the study includes, the rate of deaths resulting from SC to forensic deaths was 0,3%, and this rate reached up to 3,1% in 2016. It was noted that SC named AM-2201 and JWH-018 (totally n=22, 66,7%) were mostly related to the death. Discussion: In our study, it was observed that the deaths associated with SC increased until 2016. It is known that the use of other synthetic drugs or stimulants has increased in the last 2 years instead of SC. Hence, need for examination, equipment and experience required for identifying and reporting these synthetic substances will increase day by day.

Anahtar Kelimeler:

Synthetic cannabinoid, Death, Autopsy, Eskisehir, Turkey

PDF

___

1. Gunderson EW, Haughey HM, Ait-Daoud N, Joshi AS, Hart CL."SpiceA" and "K2" herbal highs: a case series and systematic review of the clinical effects and biopsychosocial implications of SC use in humans. Am J Addict. 2012:21:320-6.
2. Pakiş, I, Polat O. SC. ACU Magazine of Health Sciences 2016(1):6-13.
3. Urazel B, Şimşek Ü, Gündüz T, Teyin, A, Kaya Ş. Emergency Department Physicians’ Knowledge of Synthetic Cannabinoids. Journal of Turgut Ozal Medical Center, 2015;22(4):249-53
4. Szily E, Bitter I. Designer drugs in psychiatric practice - a review of the literature and the recent situation in Hungary. Neuropsychopharmacol Hung 2013;15:223-31.
5. Bretteville-Jensen AL, Tuv SS, Bilgrei OR, Fijeld B. SC and Cathinones:Prevalence and Markets. Forensic Sci Rev 2013;25:8-26.
6. Aoun EG, Christopher PP, Ingraham JW. Emerging drugs of abuse: clinical and legal considerations. R I Med J 2014;97:41-5.
7. Hudson S, Ramsey J, King L, et al. Use of high resolution accurate mass spectrometry todetect reported and previously unreported cannabinomimetics in "herbal high" products. J Anal Toxicol 2010;34:252-60.
8. Cohen J, Morrison S, Greenberg J, Saidinejad M. Clinical Presentation of Intoxication Due to SC. Pediatrics 2012;129;1064-7.
9. Gregori A, Damiano F, Bonavia M, et al. Identification of two cannabimimetic compounds WIN48098 and AM679 in illegal products. Sci Justice 2013;53:286-92.
10. Brents LK, Prather PL. The K2/Spice Phenomenon: emergence, identification, legislation and metabolic characterization of SC in herbal incense products. Drug Metab Rev 2014;46:72-85.
11. Kalyoncu, A., Ünlü B, Taştan U. Dangerous Game of Young People: Review of SC (Bonsai). Addiction Magazine. 2014; 15.3: 150-155.
12. Hermanns-Clausen, M., Kneisel, S., Hutter, M., Szabo, B., Auwärter, V. (2013) Acute intoxication by SCfour case reports. Drug Testing and Analysis. 2013;5(9-10).:790-794.
13. Hermanns-Clausen, M., Kneisel, S., Szabo, B., Auwärter, V. Acute toxicity due to the confirmed consumption of SC: clinical and laboratory findings. Addiction, 2012;108, 534-544.
14. Fantegrossi, W.E., Moran, J.H., RadominSCa-Pandya, A., Prather, P.L. Distinct pharmacology and metabolism of K2 SC compared to THC: mechanism underlying greater toxicity? Life Sciences, 2014; 97, 45-54.
15. Hruba, L., Ginsburg, B.C., McMahon, L.R. Apparent inverse relationship between cannabinoid agonist efficacy and tolerance/cross-tolerance produced by delta(9)-tetrahydrocannabinol treatment in rhesus monkeys. Journal of Pharmacology and Experimental Therapeutics, 2012;342, 843-849.
16. Alhadi S, Tiwari A, Vohra R, Gerona R, Acharya J, Bilello K. High times, low sats: diffuse pulmonary infiltrates associated with chronic SC use. J. Med. Toxicol. 2013; 9:199-206.
17. Benford DM, Caplan JP. Psychiatric sequelae of Spice, K2, and SC receptor agonists. Psychosomatics. 2011; 52:295.
18. Berry-Caban CS, Ee J, Ingram V, Berry CE, Kim E. SC overdose in a 20-year-old male US soldier. Subst. Abuse. 2013; 34:70-72.
19. Derungs A, Schwaninger A, Mansella G, Bingisser R, Kraemer T, Liechti M. Symptoms, toxicities, and analytical results for a patient after smoking herbs containing the novel SC MAM-2201. Forensic Toxicol. 2013; 31:164-171.
20. Freeman MJ, Rose DZ, Myers MA, Gooch CL, Bozeman AC, Burgin WS. Ischemic stroke after use of the synthetic marijuana "spice". Neurology. 2013; 81:209
21. Gunderson EW, Haughey HM, Ait-Daoud N, Joshi AS, Hart CL. "Spice" and "K2" herbal highs: a case series and systematic review of the clinical effects and biopsychosocial implications of SC use in humans. Am. J. Addict. 2012; 21:320-326.
22. Heath TS, Burroughs Z, Thompson AJ, Tecklenburg FW. Acute intoxication caused by a SC in two adolescents. J. Pediatr. Pharmacol. Ther. 2012; 17:177-181.
23. King LA. Legal controls on cannabimimetics: an international dilemma? Drug Test Anal. 2014;6(1-2):80-7.
24. Ergül DF, Ekemen S, Yelken BB. SC 'Bonsai' Intoxication: Six Case Series. Turk J Anaesthesiol Reanim. 2015;43(5):347-51
25. Besli GE, Ikiz M A, Yildirim S, Saltik S. SC abuse in adolescents: a case series. Journal of emergency medicine, 2015;49(5), 644-650.
26. Ezaki J, Ro A, Hasegawa M, Kibayashi K. Fatal overdose from SC and cathinones in Japan: demographics and autopsy findings. The American journal of drug and alcohol abuse, 2016;42(5), 520-529.
27. Zazoğlu S, Savaş H, Ketenci HÇ, Beyhun NE. (2017). Identifying of profiles of drugs and new generation psychoactive substances that were sent to Forensic Medicine Institute, Trabzon Group Department from 2010 to 2014 years by Forensic Authorities. Journal of Forensic Medicine, 2017;31(1):1-5.
28. Patton AL, Chimalakonda KC, Moran CL, McCain KR, RadominSCa-Pandya A, James LP, Kokes C, Moran JH. K2 toxicity: fatal case of psychiatric complications following AM2201 exposure. J Forensic Sci. 2013;58(6):1676-80.
29., Hutter M, Broecker S, Kneisel S, Franz F, Brandt SD, Auwarter V. Metabolism of SC encountered in clinical casework: major in vivo metabolites of JWH-007, JWH-019, JWH-203, JWH-307, UR-144, XLR-11, AM-2201, MAM-2201 and AM-694 in human urine using LC-MS/MS. Curr Pharm Biotechnol. 2018;19(2):144-162
30. Maciów-Głąb M, Kula K, Kłys M, Rojek SD. New psychoactive substances in substantive evidence in expert practice of the Department of Forensic Medicine, UJCM in the years 2010-2015. Arch Med Sadowej Kryminol. 2017;67(3):178-20.
31. Behonick G, Shanks KG, Firchau DJ, Mathur G, Lynch CF, NashelSCy M, JaSCierny DJ, Meroueh C. Four postmortem case reports with quantitative detection of the SC, 5F-PB-22. J Anal Toxicol. 2014;38(8):559-62.