New report highlights public health and social risks posed by synthetic cannabinoids in Europe

Synthetic cannabinoids come under the spotlight today in a new report released by the EU drugs agency (EMCDDA). Widely available across Europe and highly potent, these substances are placing some users at a ‘high risk of poisoning’, the agency warns.

Synthetic cannabinoids are the largest group of new psychoactive substances (NPS) monitored by the EMCDDA through the EU Early Warning System, with 209 detected between 2008 and 2020. They began to appear in Europe in the mid-2000s, in smoking mixtures such as ‘Spice’, and sold as ‘legal’ replacements for cannabis. But it was soon discovered that these potent substances could poison users, who were often inadvertently exposed to high doses (1). In such cases, this led to outbreaks of mass poisonings in parts of Europe, Canada, Russia and the United States.

Today’s report describes how synthetic cannabinoids are still used recreationally as ‘legal’ cannabis replacements, but that their low cost and powerful intoxicating effects have led to the availability of a wider range of products (e.g. vaping liquids) and to use by marginalised groups (e.g. high-risk drug users, people in prison or homeless). It also shows how the market in, and use of, synthetic cannabinoids have been linked to social problems, such as violence, bullying and debt.

Recent EMCDDA risk assessments of two synthetic cannabinoids — 4F-MDMB-BICA and MDMB-4en-PINACA — reveal how these drugs are increasingly found in prisons, smuggled in via letters, photographs and clothing impregnated with the substances.

The new report highlights concerns over these substances being mis-sold as, or used to adulterate, other drugs or products. In particular, it cites synthetic cannabinoids being mis-sold as THC and CBD vaping liquids or being used to adulterate low-THC cannabis products. Users unaware that a product contains synthetic cannabinoids are exposed to higher health risks. 

Similar to other NPS, synthetic cannabinoids are shipped as bulk powders from companies in China to Europe, where they are processed into finished products.

Reviewing the current body of knowledge on the chemistry, pharmacology and toxicology of synthetic cannabinoids in Europe, the report aims to support early-warning and risk-assessment activities and strengthen situational awareness of this group of substances.

‘In the future, it can be expected that synthetic cannabinoids with high potency, and that are easy to synthesise, will continue to be introduced into the market’, states the report.

It concludes that, in order to reduce the public health and social threats posed by synthetic cannabinoids, strong early-warning systems are needed in order to detect, assess and respond to emerging threats in a timely manner.

Seven synthetic cannabinoids have been the focus of EMCDDA risk assessments and brought under control in the EU since 2016.