• Noah Shopan, Dennis Scolnik, Eyal Hassoun, Anastasia Firsow, Ilan Volkov, and Miguel Glatstein.
• Department of Emergency Medicine, Tel Aviv Medical Center, Faculty of Medicine, Tel Aviv University, Israel.
• Am J Emerg Med. 2023 Nov 1; 73: 7107-10.

BackgroundSynthetic cannabinoids (SC) are chemical substances, which activate cannabinoid receptors in a similar fashion to tetrahydrocannabinol, but with increased efficacy, and are used as illicit recreational drugs.ObjectiveOur objective was to characterize the clinical manifestations and management of three specific, common SC exposures in a cohort of patients presenting to the emergency department of our institution.MethodsRetrospective case series of patients admitted to an urban tertiary care center between August 1, 2018 and December 31, 2021, with confirmed SC use and positive urinary immunoassay testing for AB-FUBINACA, 4F-MDMB-BUTINACA and ACHMINACA.Results58 patients met inclusion criteria during the 3-year study period; median age was 35 years, 60% were male, 31% patients were exposed to >1 substance, and 31% needed hospital addition. The most common physical signs were cardiovascular (54%) and neuropsychiatric (45%). Severe outcomes included coma and seizures, necessitating intubation in 4 patients, and acute renal injury in 7 patients.ConclusionSC are potentially harmful drugs of abuse which can lead to life-threatening complications. Acute care personnel should be aware of the broad range of signs and symptoms of SC use. Testing with short turn around times is available to assess SC use.Copyright © 2023 Elsevier Inc. All rights reserved.

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