Synthetic Cannabinoid Receptor Agonists (SCRAs), also known as synthetic cannabinoids or colloquially as spice, mamba or K2 are a group of drugs with some structural and functional similarity to the active ingredients in cannabis (e.g. THC and CBD). These synthetic cannabinoids are typically sprayed onto dried plant matter so they can be smoked or sold as liquids to be vaporised or inhaled in e-cigarettes or similar.
Effects of synthetic cannabinoid use are similar, but more pronounced, than cannabis with effects such as relaxation, euphoria, lethargy, confusion, anxiety, fear hallucinations, paranoia, tachycardia, nausea and vomiting reported.
Symptoms of synthetic cannabinoid overdose include cardiovascular toxicity (including sudden death), central nervous system and respiratory depression, seizures, convulsions, hyperemesis, psychosis and aggressive behaviour. These compounds are extensively used in certain populations (e.g. prisons, homeless) and due to their physiochemical properties a specific screening method has been developed.
At UHB, SCRAs are screened for using solid phase extraction followed by high resolution mass spectrometry (LC-QTof MS). Over 40 synthetic cannabinoids and their metabolites are included. The scope of the analysis is being constantly updated to reflect changing trends in synthetic cannabinoid use amongst the population.
As of 1st of March 2020, the current screen includes, but is not limited, to the following drugs plus relevant metabolites:
5F-APICA (STS-135), 5F-APINACA (5F-AKB-48), 5F-CUMYL-PINACA, 5F-MDMB-PINACA (5F-ADB), 5F-PB-22 (5F-QUPIC), AB-CHMNACA, AB-FUBINACA, AB-PINACA, ADB-PINACA, AM-2201, APICA, APINACA (AKB-48), BB-22 (QUCHIC), JWH-018 (AM-678), JWH-122, JWH-73, MAM-2201, MDMB-CHMICA, MDMB-CHMINACA, PB-22 (QUPIC), THJ-018, THJ-2201, UR-144, XLR-11, 5F-MDMB-PICA, 4F-MDMB-BINACA & MDMB-4en-PINACA*
*Current drugs in circulation are given in bold
Should you have any questions regarding a Synthetic Cannabinoid Receptor Agonist (SCRA) Screen - please contact the laboratory on 0121 424 3707.
Screening for synthetic cannabinoid use is rarely clinically indicated as treatment of suspected use or overdose would be supportive. If screening is required, please collect samples while patient is symptomatic or as soon as possible following symptoms. Unlike traditional drugs of abuse, the approximate detection window of these compounds is not well defined.
The test is currently non-accredited but is being considered by UKAS as part of our application for flexible scope.
This is a screening test. Drugs detected in specimens will be stated on the report.
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The Trust Laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital were awarded UKAS (United Kingdom Accreditation Service) accreditation to the internationally recognised ISO 15189 standard in May 2015. For a list of accredited tests and other information please visit the test database http://www.heftpathology.com/frontpage/test-database.html.
Tests not appearing on this scope are either under consideration or in the process of accreditation and so currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.
For further information contact Louise Fallon, Quality Manager, 0121 424 1235