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Pharmacology of New Psychoactive Substances

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Editorial09 May 2023
Editorial: Pharmacology of new psychoactive substances

Synthetic cannabinoids (SCs) are new psychoactive drugs functionally similar to delta-9tetrahydrocannabinol (THC) but with a higher binding affinity for cannabinoid CB1 and CB2 receptors and are currently used recreationally with potential health risks. JWH-122 and JWH-210 are naphthoylindole SCs and potent CB1 and CB2 receptor agonists. Clinical effects of SCs are mainly available from intoxication cases and surveys, with few human studies following controlled administration or observational studies using standardized measures of cardiovascular and subjective effects. Martinez and colleagues evaluated the acute pharmacological effects of inhaled JWH-122 (1 mg) and JWH-210 (2.25 mg) recreational consumption in a 4 h observational study and assessed their disposition in the oral fluid. JWH-122 but not JWH-210 caused significant increases in systolic and diastolic blood pressure, and heart rate. Moreover, only JWH-210 produced significant changes in subjective drug effects, similar to those induced by THC (intensity, high, good effects, and hunger). The maximal pharmacological effects and oral fluid concentrations mostly occurred 20 min after intake. The attained results demonstrate a different pattern of effects of these two SCs. In another report, Mendiguren and colleagues investigate the effect of cannabidiol (CBD) on the neuronal activity of dorsal raphe nucleus (DRN) 5-HT cells and its interaction with somatodendritic 5-HT1A autoreceptors. CBD is the main non-psychoactive cannabinoid found in the cannabis plant, evokes several pharmacological effects via the 5-HT1A receptor. The DRN is the principal serotonergic cluster in the midbrain that expresses the 5-HT1A receptor. These authors determined the effect of CBD on the firing activity of DRN 5-HT cells and the 5-HT1A autoreceptor activation by electrophysiological and calcium imaging techniques in rat brain slices. CBD did not change the firing rate of DRN 5-HT cells or the inhibitory effect of 5-HT. However, CBD reduced the inhibitory effects of selective 5-HT1A receptor agonists (8-OH-DPAT and ipsapirone) by over 50%. Although CBD failed to activate 5-HT1A autoreceptors, it hampered the inhibitory effect of selective 5-HT1A receptor agonists on the firing activity of DRN 5-HT cells through a mechanism that does not involve CB1, serotonergic 5-HT2A, or GABAA receptors. Their data suggest a negative allosteric modulation of DRN somatodendritic 5-HT1A receptor by CBD.Cathinones are another class of new psychoactive agents. Poyatos and colleagues studied the effect of methylone, the most common synthetic cathinone, and MDMA in humans with a history of psychostimulant use. The subjects reported euphoria, increased heart rate and blood pressure, and wellbeing following both compounds. However, methylone worked faster but with a shorter duration of action, suggesting that methylone has the same pharmacological profile and possibly carries the same abuse potential as the parent compound. Zul Aznal and colleagues evaluated the effects of repeated administration (for 15 days) of mitragynine, the main alkaloid of kratom, and lyophilized kratom decoction on cognitive behaviours and brain metabolite profiles in adolescent (PND31) male Sprague Dawley rats. The authors showed that neither substance affects memory recognition in the novel object test. However, both substances caused a deficit in social interaction. Mitragynine also attenuated reference memory in the water maze test, which may be related to metabolite changes in the brain and involve different pathways.These studies reveal the importance of further studying the effect of these compounds to expand our understanding of the pharmacology and toxicology of these drugs and to provide useful information regarding their deleterious effects to both clinicians and the governmental policy makers.

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Pharmacological effects of methylone and MDMA in humans
Methylone is one of the most common synthetic cathinones popularized as a substitute for 3,4-methylenedioxymethamphetamine (MDMA, midomafetamine) owing to its similar effects among users. Both psychostimulants exhibit similar chemistry (i.e., methylone is a β-keto analog of MDMA) and mechanisms of action. Currently, the pharmacology of methylone remains scarcely explored in humans. Herein, we aimed to evaluate the acute pharmacological effects of methylone and its abuse potential in humans when compared with that of MDMA following oral administration under controlled conditions. Seventeen participants of both sexes (14 males, 3 females) with a previous history of psychostimulant use completed a randomized, double-blind, placebo-controlled, crossover clinical trial. Participants received a single oral dose of 200 mg of methylone, 100 mg of MDMA, and a placebo. The variables included physiological effects (blood pressure, heart rate, oral temperature, pupil diameter), subjective effects using visual analog scales (VAS), the short form of the Addiction Research Center Inventory (ARCI), the Evaluation of Subjective Effects of Substances with Abuse Potential questionnaire (VESSPA-SSE), and the Sensitivity to Drug Reinforcement Questionnaire (SDRQ), and psychomotor performance (Maddox wing, psychomotor vigilance task). We observed that methylone could significantly increase blood pressure and heart rate and induce pleasurable effects, such as stimulation, euphoria, well-being, enhanced empathy, and altered perception. Methylone exhibited an effect profile similar to MDMA, with a faster overall onset and earlier disappearance of subjective effects. These results suggest that abuse potential of methylone is comparable to that of MDMA in humans.

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Acute Pharmacological Effects and Oral Fluid Concentrations of the Synthetic Cannabinoids JWH-122 and JWH-210 in Humans After Self-Administration: An Observational Study
ORIGINAL RESEARCH
19 August 2021
Acute Pharmacological Effects and Oral Fluid Concentrations of the Synthetic Cannabinoids JWH-122 and JWH-210 in Humans After Self-Administration: An Observational Study
Synthetic cannabinoids (SCs) are a group of new psychoactive drugs used recreationally with potential health risks. They are monitored by the EU Early Warning System since 2010 due to severe adverse effects on consumers. JWH-122 and JWH-210 are naphthoylindole SCs and potent cannabinoid receptor CB1 and CB2 agonists. Information about the effects of SCs usually is available from intoxication cases and surveys, and few studies in humans after controlled administration or observational/naturalistic studies using standardized measures of cardiovascular and subjective effects are available. The aim of this study was to evaluate the acute pharmacological effects of JWH-122 and JWH-210 recreational consumption in a 4-h observational study, and assess their disposition in oral fluid. Sixteen volunteers self-administered 1 mg dose of JWH-122 (n=8) or 2.25 mg mean dose of JWH-210 (range 2-3 mg, n=8) by inhalation (smoking). Physiological parameters including blood pressure (systolic and diastolic), heart rate and cutaneous temperature were measured. A set of Visual Analog Scales (VAS), the 49-item short form version of the Addiction Research Centre Inventory (ARCI) and the Evaluation of the Subjective Effects of Substances with Abuse Potential (VESSPA-SSE) were used for the evaluation of subjective effects. Oral fluid was collected at baseline, 10, 20 and 40 min, and 1, 2, 3 and 4 h after self-administration. Statistically significant increases in systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were observed after JWH-122 self-administration but not after JWH-210 self-administration. JWH-210 self-administration produced significant changes in subjective drug effects, similar to those induced by THC (intensity, high, positive effects and hunger). The subjective effects following JWH-122 consumption were minimal. The maximal effects were mostly observed 20 min after intake. JWH-122 and JWH 210 oral fluid concentration reached a peak 20 min after administration and were not detected after 3 h. The results demonstrated a different pattern of effects of these two SCs. Due to the limitations of our observational study, further research with a larger sample and controlled studies is needed to better define the acute pharmacological effect and health risk profile of JWH-122 and JWH-210.

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