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Non-Medical Use of Synthetic Marijuana ( Cannabinoids )

Non-Medical Use of Synthetic Marijuana ( Cannabinoids ) . We will be starting shortly. . Non-Medical Use of Synthetic Marijuana ( Cannabinoids ) April 20, 2011 . Presenter Rick Moldenhauer MS, LADC, ICADC, LPCC. Introduction to Connect Pro. Welcome to this Connect Pro Virtual Meeting.

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Non-Medical Use of Synthetic Marijuana ( Cannabinoids )

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  1. Non-Medical Use of Synthetic Marijuana (Cannabinoids) We will be starting shortly.

  2. Non-Medical Use of Synthetic Marijuana (Cannabinoids) April 20, 2011 Presenter Rick Moldenhauer MS, LADC, ICADC, LPCC

  3. 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 Consie English Senior Administrative Assistant

  4. 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 Consie English Senior Administrative Assistant

  5. 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 Consie English Senior Administrative Assistant

  6. Regional Introductions Red Lake Nation Oglala Sioux Tribe Leech Lake Band of Ojibwe Little Traverse Bay Band of Odawa Indians Lower Brule Sioux Tribe Great Lakes Inter-Tribal Council ME Grand Traverse Band ND VT NH NY MN MA WI CT RI SD PA NJ MI DE MD IA IN OH IL WV Jan Hofmann Associate Coordinator, Central Region Chuck Klevgaard Coordinator, Northeast Region

  7. 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 Chuck Klevgaard Regional Coordinator

  8. 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.

  9. Rick Moldenhauer

  10. Poll

  11. 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

  12. Synthetic Cannabinoids in Herbal Blends • HU-210 [(6aR,10aR)-9-(hydroxymethyl)-6,6-dimethyl-3 -(2-methyloctan-2-yl)-6a,7,10,10a-tetrahydrobenzo[c] chromen-1-ol] • CP 47,497 [2-[(1R,3S)-3-hydroxycyclohexyl]-5-(2-methyloctan-2-yl)phenol)] • Cannabicyclohexanol (CP 47,497 C8 homologue) [2-[(1R,3S)-3-hydroxycyclohexyl]-5-(2-methylnonan-2-yl)phenol)]

  13. Synthetic Cannabinoids in Herbal Blends (cont’d) • 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)naphthoyl]indole] We will be talking about these two, as they are primary

  14. 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

  15. Packaged as Incense: Implying Safety

  16. Sample Adfor Incense

  17. JWH-018 Created in 1995 for experimental purposes in animal and cell cultures, not humans, by Dr. John Huffman, PhD at Clemson University

  18. JWH-018 1-pentyl-3-naphthoylindole An analgesic chemical from the aminoalkylindole family. $40.00 per gram http://www.researchchemicalz.com

  19. 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)

  20. 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

  21. 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 < hour • Insufflation: Unknown; peak effect almost instantly

  22. 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

  23. 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

  24. We’ve just reviewed various forms of synthetic marijuana. How are we doing? Next, we will talk about signs of intoxication, withdrawal symptoms, and medical problems. Questions?

  25. JWH-018 Desired Psychoactive Effects • Visual changes • Color enhancement • Uncontrollable laughter • Euphoria • Talkativeness • Sexual stimulation • Time dilation • Sedation • Sleep aid • Analgesia • Anti-depressant

  26. Intoxication

  27. Conjunctival Injection (Redness of the Eye)

  28. Xerostomia (Dry Mouth)

  29. Potential Withdrawal Symptoms

  30. Chat Box QuestionWhat is Happening With the Law in Your State/Tribe? Red Lake Nation Oglala Sioux Tribe Leech Lake Band of Ojibwe Little Traverse Bay Band of Odawa Indians Lower Brule Sioux Tribe Great Lakes Inter-Tribal Council ME Grand Traverse Band ND VT NH NY MN MA WI CT RI SD PA NJ MI DE MD IA IN OH IL WV Jan Hofmann Associate Coordinator Chuck Klevgaard Regional Coordinator

  31. Enacted and Pending LegislationAs of April 1, 2011 NORTHEAST REGION LSR 178 (H 448) ME H673 S 1834 and A 5008 VT NH NY MA S 164, H 176 and H365 CT RI PA H1383 NJ DE MD H 5066 Enacted S761 and S1098 Pending A 2644 (2010) and S 2606 H 30 Chuck Klevgaard Regional Coordinator http://www.ncsl.org/?TabId=22431

  32. Enacted and Pending LegislationAs of April 1, 2011 (cont’d) CENTRAL REGION 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 Enacted IA HB 1015 (2011) H 2505 S 63 IN IL HB 6459 (2010) OH IL Pending H 33 / H 34, H 186, S 35, SSB 1016/ D 1274, S 462 WV Jan Hofmann Associate Coordinator 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/?TabId=22431

  33. 6800.4210 SCHEDULE I CONTROLLED SUBSTANCES Elements of the ruling Impact of the ruling Minnesota Board of Pharmacy Proposed Ruling on Synthetic Marijuana Handout MN Board Rick Molderhauer

  34. 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. DEA–345F] Schedules of Controlled Substances: Temporary Placement of Five Synthetic Cannabinoids Into Schedule I

  35. Minnesota House and Senate Bills on Synthetic Marijuana Handout HF57 and SF7 • HF 57 • Introduced Jan 10, 2011 • SF7 • Modified MS 152, Subp 2

  36. 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

  37. How Will You Use This? Whiteboard

  38. 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.

  39. Questions?

  40. Treatment Services Consultant State Opioid Treatment Authority P: (651) 431 2474 F: (651) 431 7449 Alcohol and Drug Abuse Division, Department of Health Services P.O. Box 64977 St Paul, Minnesota 55164-0977 richard.moldenhauer@state.mn.us 40

  41. Thank You for Participating! Jan Hofmann Associate Coordinator

  42. Evaluation Instructions https://www.surveymonkey.com/s.aspx?sm=ACFIOhu_2f7iF3ROwk4VYmsA_3d_3d Consie English Senior Administrative Assistant

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