Volker Auwärter

Bio: Volker Auwärter is an academic researcher from University of Freiburg. The author has contributed to research in topics: Synthetic cannabinoids & Metabolite. The author has an hindex of 42, co-authored 178 publications receiving 6167 citations. Previous affiliations of Volker Auwärter include American Board of Legal Medicine & Humboldt State University.

Acute toxicity due to the confirmed consumption of synthetic cannabinoids: clinical and laboratory findings

Abstract: Aims Recently, several synthetic cannabinoids were identified in herbal mixtures consumed as recreational drugs alternative to cannabis products. The aim was to characterize the acute toxicity of synthetic cannabinoids as experienced by emergency patients. Design This was a retrospective study targeting patients seeking emergency treatment after recreational use of synthetic cannabinoids. Setting and participants Patients were selected from the database of the Poisons Information Center Freiburg between September 2008 and February 2011. The inclusion criteria were: hospitalization, available clinical reports and analytical verification of synthetic cannabinoid uptake. In total, 29 patients were included (age 14–30 years, median 19; 25 males, four females). Measurements Clinical reports were evaluated and synthetic cannabinoids and other drugs were determined analytically. Findings CP-47,497-C8 (one), JWH-015 (one), JWH-018 (eight), JWH-073 (one), JWH-081 (seven), JWH-122 (11), JWH-210 (11), JWH-250 (four) and AM 694 (one) were quantified in blood samples. JWH-018 was most common in 2008–9, JWH-122 in 2010, and JWH-210 in 2011. Tachycardia, agitation, hallucination, hypertension, minor elevation of blood glucose, hypokalaemia and vomiting were reported most frequently. Chest pain, seizures, myoclonia and acute psychosis were also noted. Conclusions There appears to have been an increase in use of the extremely potent synthetic cannabinoids JWH-122 and JWH-210. Acute toxic symptoms associated with their use are also reported after intake of high doses of cannabis, but agitation, seizures, hypertension, emesis and hypokalaemia seem to be characteristic to the synthetic cannabinoids, which are high-affinity and high-efficacy agonists of the CB1 receptor. Thus, these effects are due probably to a strong CB1 receptor stimulation.

Monitoring of herbal mixtures potentially containing synthetic cannabinoids as psychoactive compounds

Abstract: Herbal mixtures like 'Spice' with potentially bioactive ingredients were available in many European countries since 2004 and are still widely used as a substitute for cannabis, although merchandized as 'herbal incense'. After gaining a high degree of popularity in 2008, big quantities of these drugs were sold. In December 2008, synthetic cannabinoids were identified in the mixtures which were not declared as ingredients: the C(8) homolog of the non-classical cannabinoid CP-47,497 (CP-47,497-C8) and a cannabimimetic aminoalkylindole called JWH-018. In February 2009, a few weeks after the German legislation put these compounds and further pharmacologically active homologs of CP-47,497 under control, another cannabinoid appeared in 'incense' products: the aminoalkylindole JWH-073. In this paper, the results of monitoring of commercially available 'incense' products from June 2008 to September 2009 are presented. In this period of time, more than 140 samples of herbal mixtures were analyzed for bioactive ingredients and synthetic cannabimimetic substances in particular. The results show that the composition of many products changed repeatedly over time as a reaction to prohibition and prosecution of resellers. Therefore neither the reseller nor the consumer of these mixtures can predict the actual content of the 'incense' products. As long as there is no possibility of generic definitions in the controlled substances legislation, further designer cannabinoids will appear on the market as soon as the next legal step has been taken. This is affirmed by the recent identification of the aminoalkylindoles JWH-250 and JWH-398. As further cannabinoids can be expected to occur in the near future, a continuous monitoring of these herbal mixtures is required. The identification of the synthetic opioid O-desmethyltramadol in a herbal mixture declared to contain 'kratom' proves that the concept of selling apparently natural products spiked with potentially dangerous synthetic chemicals/pharmaceuticals is a continuing trend on the market of 'legal highs'.

Detection and Activity Profiling of Synthetic Cannabinoids and Their Metabolites with a Newly Developed Bioassay.

Abstract: Synthetic cannabinoids (SCs) are the largest group of compounds currently monitored in Europe by the EU Early Warning System on new psychoactive substances. Emerging recreational use of these products has led to multiple cases of adverse health effects and even death. In contrast to marijuana, where Δ9-tetrahydrocannabinol (Δ9THC) is metabolized to only one major active metabolite, it has been reported that several major phase I metabolites of SCs remain biologically active, exerting cannabinoid (CB) receptor affinity, potency, and efficacy greater than those of Δ9THC. It is therefore reasonable that more SCs can also be biotransformed into molecules with various levels of CB activity. Here, we developed and applied a new G-protein coupled receptor (GPCR) activation assay based on NanoLuc binary technology (Promega). More specifically, by demonstrating CB1 and CB2 receptor activation by JWH-018 and a selection of its metabolites, we are the first to show the suitability of the newly developed bioassay for...

Trends and Geographic Patterns in Drug and Synthetic Opioid Overdose Deaths — United States, 2013–2019

Abstract: Deaths involving synthetic opioids other than methadone (synthetic opioids), which largely consist of illicitly manufactured fentanyl; psychostimulants with abuse potential (eg, methamphetamine); and cocaine have increased in recent years, particularly since 2013 (1,2) In 2019, a total of 70,630 drug overdose deaths occurred, corresponding to an age-adjusted rate of 216 per 100,000 population and a 43% increase from the 2018 rate (207) (3) CDC analyzed trends in age-adjusted overdose death rates involving synthetic opioids, psychostimulants, cocaine, heroin, and prescription opioids during 2013-2019, as well as geographic patterns in synthetic opioid- and psychostimulant-involved deaths during 2018-2019 From 2013 to 2019, the synthetic opioid-involved death rate increased 1,040%, from 10 to 114 per 100,000 age-adjusted (3,105 to 36,359) The psychostimulant-involved death rate increased 317%, from 12 (3,627) in 2013 to 50 (16,167) in 2019 In the presence of synthetic opioid coinvolvement, death rates for prescription opioids, heroin, psychostimulants, and cocaine increased In the absence of synthetic opioid coinvolvement, death rates increased only for psychostimulants and cocaine From 2018 to 2019, the largest relative increase in the synthetic opioid-involved death rate occurred in the West (679%), and the largest relative increase in the psychostimulant-involved death rate occurred in the Northeast (438%); these increases represent important changes in the geographic distribution of drug overdose deaths Evidence-based prevention and response strategies including substance use disorder treatment and overdose prevention and response efforts focused on polysubstance use must be adapted to address the evolving drug overdose epidemic