合成大麻素和半合成大麻素：了解与这些物质相关的急性毒性（危害）

IF 2.9 3区医学 Q2 TOXICOLOGY

Toxicology letters Pub Date : 2025-09-01 DOI:10.1016/j.toxlet.2025.07.036

D.M. Wood

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引用次数: 0

摘要

大麻是欧洲最常用的毒品。在欧盟药物管理局（EUDA）发布的《欧洲药物报告2024：趋势与发展》中，据报道，去年约有1510万15至34岁的欧盟居民使用大麻，370万15至64岁的成年人每天或几乎每天使用大麻。到2023年底，欧洲药品管理局监测了950多种新的精神活性物质，被监测的物质中最大的一类是合成大麻素（以前称为合成大麻素受体激动剂）。自21世纪初以来，这些物质已经在欧洲上市，尽管直到21世纪后期才开始有大量使用和急性危害的报告，当时它们开始以“香料”的名义销售。最初，这些合成大麻素在结构上与Δ9-tetrahydrocannabinol（天然存在的大麻中的主要活性化合物）相关，但随着时间的推移，它们的结构相似性已经降低，因为它们已经进化到逃避国家和国际控制机制。这些化合物的毒性最初似乎与大麻相似，并且主要是神经精神特征；然而，随着它们的进化，毒性随着兴奋剂（躁动、心动过速、高血压）和神经毒性（癫痫发作、昏迷）的增加而改变。2022年，半合成大麻素六氢大麻酚（HHC）于2022年5月在欧洲被发现，此后在欧洲又发现了许多其他半合成大麻素（例如HHC醋酸酯、六氢大麻酚和四氢大麻二酚）。目前，这些化合物中的大多数似乎是由从低thc大麻中提取的大麻二酚产生的。除了检测到这些物质外，与使用它们有关的急性毒性（危害）的报告也越来越多。本次会议将详细回顾合成大麻素的急性毒性（危害），并提供与半合成大麻素相关的潜在问题的当前信息。

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CEC06-01 Synthetic cannabinoids and semi-synthetic cannabinoids: understanding the acute toxicity (harms) related to these substances

Cannabis is the mostly commonly used drug in Europe. In the European Drug Report 2024: Trends and Developments published by the European Union Drug Agency (EUDA) it was reported that last approximately 15.1 million EU residents aged 15 to 34 years had used cannabis in the last year and that 3.7 million adults aged 15 to 64 years old use cannabis on a daily or almost daily basis.

By the end of 2023, the EUDA was monitoring over 950 new psychoactive substances, and largest group of substances being monitored are the synthetic cannabinoids (previously known as the synthetic cannabinoid receptor agonists). These substances have been available in Europe since the early 2000s, although significant reports of use and acute harms did not start until the late 2000s when they started to be marketed as “Spice”. Initially these synthetic cannabinoids were structurally related to Δ9-tetrahydrocannabinol (the primary active compound in naturally occurring cannabis), but over time they structural similarity has decreased as they have evolved to evade national and international control mechanisms. The toxicity of these compounds initially appeared to be similar to that seen with cannabis, and was largely neuropsychiatric features; however, as they have evolved the toxicity has changed with increasing stimulant (agitation, tachycardia, hypertension) and neurological (seizures, coma) toxicity.

In 2022, the semi-synthetic cannabinoid, hexahydrocannabinol (HHC), was identified in Europe in May 2022, and since then there have been a number of additional semi-synthetic cannabinoids detected in Europe (for example HHC acetate, hexahydrocannabiphorol and tetrahydrocannabidiol). The majority of these compounds at this time appear to be produced from cannabidiol extracted from low-THC cannabis. Alongside the detection of these substances, there are increasing reports of acute toxicity (harms) related to their use.

This session will review the acute toxicity (harms) of the synthetic cannabinoids in detail, and provide an insight in the current information of the potential issues related to the semi-synthetic cannabinoids.

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