Non-Medical Use of Synthetic Marijuana (Cannabinoids)

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Non-Medical Use of Synthetic Marijuana
(Cannabinoids)

• We will be starting shortly.

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Non-Medical Use of Synthetic Marijuana
(Cannabinoids) April 20, 2011

• Presenter
• Rick Moldenhauer
• MS, LADC, ICADC, LPCC

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Introduction to Connect Pro

• Welcome to this Connect Pro Virtual Meeting.
• We will be using the following windows
• PowerPoint Window
• Attendee List
• Chat
• Note
• We will also use the Raise your Hand feature

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Introduction to Connect Pro

• Two Ways to Ask Questions
• 1. In Writing
• Write question in Chat window
• Press Enter
• Only the moderator will see your question

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Introduction to Connect Pro

• 2. By Raising Your Hand
• Raise your hand by clicking
• You will see your status change
• in attendees list
• Un-mute your phone (press ) when called upon
• Remember to mute your phone again once you have
  finished speaking (press )
• Lower your hand by again clicking

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Regional Introductions
Jan Hofmann Associate Coordinator, Central Region
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Learning Objectives

• By the end of this webinar, participants will
  have
• Learned about various forms of synthetic
  cannabinoids and current developments with these
  substances
• Identified the signs of intoxication, withdrawal
  symptoms, and medical problems associated with
  synthetic marijuana
• Discussed actions taken by the DEA as they impact
  states
• Identified potential local- and State-level
  policy strategies for addressing use

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Rick Moldenhauer

• Treatment Services Consultant at the Alcohol and
  Drug Abuse Division, Department of Health
  Services
• More than 25 years of direct care experience in a
  wealth of settings involving chemical dependency
  treatment.
• On a variety of State and Federal initiatives
  involving best practices and committees for
  various purposes.
• Author, frequent speaker, and technical assistant
  in quality delivery of chemical dependency
  services.

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Rick Moldenhauer
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Poll
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Examples of Brand Names

• SPICE
• Spice Silver
• Spice Gold
• Spice Diamond
• Spice Tropical Synergy
• Spice Arctic Synergy
• Smoke Plus
• K2

• Buddha Melt
• Budda Blend
• Smoke X. XX and XXX
• Chillin XXX
• Spicey XXX
• ZoHai SX
• Eclipse
• Bonzai fertilizer

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Synthetic Cannabinoids in Herbal Blends

• HU-210 (6aR,10aR)-9-(hydroxymethyl)-6,6-dimethyl-
  3 -(2-methyloctan-2-yl)-6a,7,10,10a-tetrahydrobenz
  oc chromen-1-ol
• CP 47,497 2-(1R,3S)-3-hydroxycyclohexyl-5-(2-me
  thyloctan-2-yl)phenol)
• Cannabicyclohexanol (CP 47,497 C8 homologue)
  2-(1R,3S)-3-hydroxycyclohexyl-5-(2-methylnonan-
  2-yl)phenol)

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Synthetic Cannabinoids in Herbal Blends (contd)
We will be talking about these two, as they are
primary

• JWH-018 1-pentyl-3-(1-naphthoyl)indole
• JWH-073 1-butyl-3-(1-naphthoyl)indole
• JWH-200 1-2-(4-morpholinyl)ethyl-3-(1-naphthoyl
  )indole
• JWH-250 1-pentyl-3-(2-methoxyphenylacetyl)indole
  
• JWH-081 1-pentyl-3-1-(4-methoxy)naphthoylindole
  

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JWH-018/073 - SPICE

• JWH-018 / 073 are analgesic chemicals from the
  naphthoylindole family, which acts as a full
  agonist at both the CB1 and CB2 cannabinoid
  receptors, with some selectivity for CB2.
• Synthetic cannabinoids
• Sold as incense

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Packaged as Incense Implying Safety
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Sample Adfor Incense
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JWH-018

• Created in 1995 for experimental purposes in
  animal and cell cultures, not humans, by Dr. John
  Huffman, PhD at Clemson University

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JWH-018

• 1-pentyl-3-naphthoylindole
• An analgesic chemical from the aminoalkylindole
  family.
• 40.00 per gram

http//www.researchchemicalz.com
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JWH-018 as Agonist to CB1

• Mainly found in the brain (CNS), also in lungs
  liver and kidneys
• Increase formation of fatty acids (lipogenesis)
• Inhibit the motor activity of the
  gastrointestinal tract (gastrointestinal
  motility)
• Low blood pressure (hypotension)
• Reduced pain sensitivity (hypoanalgesia)

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JWH-018 as Agonist to CB1

• Mainly found in the immune system and
  hematopoietic cells
• Plays a role in the autoimmune system and
  response
• Dosage varies per individual
• Testing issues

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JWH-018 Route of Administration

• Usually dissolved from powder 10mg/ml in 95
  EtOH, mixed in 1 mg of inert material
• Smoked Most common
• Inhaled Vaporization through oil pipe or
  cigarette
• Oral As granule (onset in hours)If dissolved
  onset lt hour
• Insufflation Unknown peak effect almost
  instantly

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JWH-018

• JWH-018 produces a traditional decreasing
  (tachyphylactic) response to the drug in repeated
  dosing, notably decreasing after 3 days of
  regular dosing
• Likely result of CB1 down regulation, similar to
  tolerance developed from cannabis
• Some short-term memory loss associated with
  chronic use

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JWH-018

• THC is a partial agonist at CB1 receptors
  JWH-018 (and many of its analogues) are full
  agonists
• Users may experience far more intense effects
  compared to smoking cannabis
• THC has been shown to inhibit GABA
  neurotransmission in the brain
• Some concern about hypokalaemia, resulting in Q-T
  prolongation, but argued in research

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Questions?

• Weve just reviewed various forms of synthetic
  marijuana.
• How are we doing?
• Next, we will talk about signs of intoxication,
  withdrawal symptoms, and medical problems.

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JWH-018 Desired Psychoactive Effects

• Visual changes
• Color enhancement
• Uncontrollable laughter
• Euphoria
• Talkativeness
• Sexual stimulation

• Time dilation
• Sedation
• Sleep aid
• Analgesia
• Anti-depressant

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Intoxication
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Conjunctival Injection (Redness of the Eye)
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Xerostomia (Dry Mouth)
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Potential Withdrawal Symptoms
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Chat Box QuestionWhat is Happening With the Law
in Your State/Tribe?
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Enacted and Pending LegislationAs of April 1,
2011
H 30
Chuck Klevgaard Regional Coordinator
http//www.ncsl.org/?TabId22431
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Enacted and Pending LegislationAs of April 1,
2011 (contd)
Red Lake Nation
Oglala Sioux Tribe
H 57, S 7, S 537, S 850
Leech Lake Band of Ojibwe
Lower Brule Sioux Tribe
S 2119
Little Traverse Bay Band of Odawa Indians
Great Lakes Inter-Tribal Council
Grand Traverse Band
ND
HB 6038 (2010)
MN
WI
S 259
SD
H 64, S 57
MI
IA
HB 1015 (2011)
H 2505 S 63
IN
OH
IL HB 6459 (2010)
IL
H 33 / H 34, H 186, S 35, SSB 1016/ D 1274, S 462
WV
H 100, H1655, H 2089 H 2917, H 3042, H3486
S 152, S 5, H 1102, H 1277, S 448, S 57, H 1315
http//www.ncsl.org/?TabId22431
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Minnesota Board of Pharmacy Proposed Ruling on
Synthetic Marijuana
Handout MN Board

• 6800.4210 SCHEDULE I CONTROLLED SUBSTANCES
• Elements of the ruling
• Impact of the ruling

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Drug Enforcement AdministrationActions on
Synthetic Marijuana
Handout DEA

• November 24, 2010
• The Deputy Administrator of the Drug Enforcement
  Administration (DEA) is issuing this notice of
  intent to temporarily place five synthetic
  cannabinoids into the Controlled Substances Act
  (CSA)
• March 1, 2011
• 21 CFR Part 1308 Docket No. DEA345F Schedules
  of Controlled Substances Temporary Placement of
  Five Synthetic Cannabinoids Into Schedule I

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Minnesota House and Senate Bills on Synthetic
Marijuana
Handout HF57 and SF7

• HF 57
• Introduced Jan 10, 2011
• SF7
• Modified MS 152, Subp 2

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Implications and Limitations of Policy

• Chemical substances covered under states laws
  differ from state to state
• Capacity to enforce state and federal laws is
  limited
• Minor changes to chemicals create new substances
  not covered under policy

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How Will You Use This?
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Tracking Synthetic Cannabinoids

• National Forensic Laboratory Information System
• Annual Report presents national and regional
  findings on drug cases analyzed during the past
  year, including drug seizure information by
  location.
• First mentioned in 2008 annual report
• Update in 2009 annual report
• The Drug and Chemical Evaluation Section (ODE) of
  the DEA Office of Diversion Control continues to
  gather information on abuse, diversion, and
  trafficking of Spice and its purported
  constituents.

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Questions?
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• Treatment Services Consultant
• State Opioid Treatment Authority
• P [phone]
• F [phone]
• Alcohol and Drug Abuse Division, Department of
  Health Services
• P.O. Box 64977
• St Paul, Minnesota 55164-0977
• richard.moldenhauer_at_state.mn.us

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Thank You for Participating!
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Evaluation

• Instructions

https//www.surveymonkey.com/s.aspx?smACFIOhu_2f7
iF3ROwk4VYmsA_3d_3d