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Fortschr Neurol Psychiatr 2015; 83(04): 221-231
DOI: 10.1055/s-0034-1399307
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Synthetische Cannabinoide: Verbreitung, Suchtbiologie & aktuelle Perspektive der persönlichen Gesundheitsgefährdung

Synthetic Cannabinoids: Spread, Addiction Biology & Current Perspective of Personal Health Hazard
U. Bonnet
1   Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Evangelisches Krankenhaus Castrop-Rauxel, Akademisches Lehrkrankenhaus der Universität Duisburg-Essen, Castrop-Rauxel
,
H. Mahler
2   Kriminalwissenschaftliches und -technisches Institut, Landeskriminalamt Nordrhein-Westfalen, Düsseldorf
› Author Affiliations
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Publication History

Publication Date:
20 April 2015 (online)

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Zusammenfassung

Unter den neuartigen psychoaktiven Stoffen (NPS, engl. new psychoactive substances) werden in Europa am häufigsten synthetische Cannabinoide (SCBs) gefunden. Diese werden z. B. dotiert zu pflanzlicher Matrix in sogenannten „Kräutermischungen“ verkauft. Neben Intoxikationssymptomen, wie sie auch bei starkem Cannabiskonsum auftreten können (z. B. Tachykardie, Herzinfarkt, Verwirrtheit, Halluzinationen, Panikattacken und Paranoia), fallen nach dem Konsum solcher Mischungen weitere toxische Wirkungen auf (schwere Erregung, Koma, katatoner Stupor, Hypertension, Herzrhythmusstörungen, Atemnot, epileptische Anfälle, Myoklonien, Rhabdomyolyse, Hyperthermie, starkes Schwitzen, akutes Nierenversagen, Erbrechen, Kopfschmerzen und Hypokaliämie), die zumindest zum Teil für den Cannabiskonsum unbekannt sind. Darüber hinaus sind bereits erste Abhängigkeits- und Todesfälle in Verbindung mit SCBs beschrieben. Anhand eines Algorithmus mit zwei Hauptkriterien (Abhängigkeitspotenzial und Toxizität) und unter Berücksichtigung der neuesten medizinischen und pharmakologischen Erkenntnisse wird hier erstmals versucht, das persönliche Gesundheitsrisiko durch SCBs im Vergleich zu dem durch den Konsum von anderen psychoaktiven Substanzen einzuschätzen. Demnach wird das relative Gesundheitsrisiko durch SCBs von den Autoren höher als das durch Cannabis und etwas geringer als das durch synthetische Cathinone („Badesalze“) eingeschätzt, wobei die Toxizität von SCBs deutlich über der von Cannabis und somit in etwa auf dem Niveau von synthetischen Cathinonen und Benzodiazepinen liegt. Das Abhängigkeitspotenzial von SCBs erscheint geringer als das von synthetischen Cathinonen, Benzodiazepinen oder Cannabis. Herstellung, Vertrieb und Besitz von SCBs zu kontrollieren erweist sich als äußerst schwierig. Aufgrund der hohen Fluktuation von SCBs auf dem Drogenmarkt und der infolge des Internets neuartigen Beschaffungswege steht die Legislative vor bislang nicht gekannten Herausforderungen, die sich vor allem in einem „Hase-Igel“-Problem äußern.

Abstract

Among the new psychoactive substances (NPS), most frequently synthetic cannabinoids (SCBs) have been found in Europe. These are sold as active compounds in e. g. so-called “herbal blends”. When inhaled or ingested, besides intoxication symptoms, as they occur with heavy cannabis use (e. g., tachycardia, myocardial infarction, confusion, hallucinations, panic attacks, and paranoia), harmful effects (severe agitation, coma, catatonic stupor, hypertension, cardiac arrhythmia, dyspnoea, seizures, myoclonus, rhabdomyolysis, hyperthermia, diaphoresis, acute kidney injury, vomiting, headache, and hypokalemia) arise, which are mostly unusual about cannabis use. In addition, the first cases of addiction and death related to SCBs have been reported. Taking into account the newest literature and using an algorithm with two main criteria (addiction potential, toxicity), the authors made a first attempt to rank the personal health hazard of SCBs in comparison to that of other psychoactive drugs. Accordingly, the relative health hazard of SCBs is found to be somewhat higher than that of cannabis and lower than that of synthetic cathinones (“bath salts”). However, the toxicity of SCBs, is significantly greater than the toxicity of cannabis, thus being similar to that of synthetic cathinones and benzodiazepines. The addiction potential appears to be lower than that of synthetic cathinones, benzodiazepines, or cannabis. Due to the fluctuation of substances and the availability in internet resources, legislation is facing a serious “hare-hedgehog” problem to control the manufacture, trade and possession of SCBs.

Schlüsselwörter

synthetische Cannabinoide - Cannabis - Gesundheitsgefährdung - Einordnung - Abhängigkeitspotenzial - Toxizität

Key words

synthetic cannabinoids - cannabis - cannabis harms - ranking - dependence potential - toxicity
 

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