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Expert peer review No.2 Agenda item 4.11: JWH‐250

Expert Committee on Dependence Thirty‐sixth Meeting Geneva, 16‐20 June 2014

1. Comments based on the review report attached a. Evidence on dependence and abuse potential

JWH‐250 is one of several hundred synthetic , which have become available in the recreational market over recent years. It has been identified in various herbal products. No data on the dependence or abuse potential of JWH‐250 are available in human or experimental animal studies. The risk of dependence may be assumed by analogy with its analog δ‐9 (δ‐9 THC). b. Risks to individual and society because of misuse

It is very difficult to ascribe health risks to JWH‐250 specifically because it appears to be one of several cannabinoid constituents in various herbal preparations sold variably as “spice” or under brand names such as “Legal Eagle” or “Happy Tiger.” There are no data reported in scientific publications on the effects of JWH‐250 on the physical and mental health of human beings. There appear to be no animal data either. The effects on individuals and society may be argued by analogy with other synthetic . Adverse effects have been reported from 21 WHO member countries of JWH‐250 which include vomiting but mostly psychiatric effects such as , panic attacks, and . c. Magnitude of the problem in countries (misuse, illicit production, smuggling etc)

Numerous reports have been made about the presence of JWH‐250, both as a pure substance and as a substance found on herbal products from forensic laboratory reporting systems. of JWH‐250 have been made mainly from European countries. d. Need of the substance for medical (including veterinary) practice

There are no known therapeutic applications of JWH‐250 and no veterinary indications. e. Need of the substance for other purposes (e.g. industrial)

There is no known industrial use.

36th ECDD (2014), page 1 Expert peer review No.2 Agenda item 4.11: JWH‐250

f. Measures taken by countries to curb misuse

Of 72 WHO member states, 22 reported that JWH‐250 was controlled under national legislation. It is not clear to what extent it is covered in this legislation as a specific substance or generically as one of many . g. Impact if this substance if scheduled

Scheduling would be one method of limiting the use of JWH‐250 in that it would provide a basis for countries which are signatories to the international conventions taking steps to interrupt manufacture, importation and trafficking on the basis of its illegal status.

2. Additional information to the review report

A recent examination of emerging drugs in Europe by Torrens and her colleagues has identified JWH‐250 as being one of several cannabinoids of the JWH series available in European countries (Papaseit et al., 2014).

3. Other comments or opinions

In my practice as a physician in I have seen 16 patients hospitalized with acute psychiatric syndromes occurring when they had been taking synthetic cannabinoids, in some cases exclusively (i.e. to the exclusion of cultivated . The most common presentation has been with acute , the syndrome typically lasting in its florid for 2‐4 days, but with continuing psychotic symptoms for up to six weeks.

The impact of the psychoses was that several patients put themselves at considerable risk of additional harm and death by, for example, running in front of passing motor vehicles, experiencing command hallucinations, and attacking people or property and also becoming isolative and self‐neglecting. All these patients had previously smoked cultivated marijuana (grown naturally in soil or hydroponically). They made a clear distinction between the effects of naturally or hydroponically grown on the one hand and the effect of the synthetic cannabinoid on the other hand. The synthetic cannabinoids were sold using a variety of commercial names, which bear no relationship to the chemical names or code numbers employed in the scientific literature.

4. Expert reviewer’s view on scheduling with rationale

Because of the limited amount of information specifically on the dependence and abuse potential of, and the harms associated with, JWH‐250, it is difficult to offer advice about scheduling in the Conventions. By analogy with the effects of synthetic cannabinoids in general and my clinical of the effects of these drugs, I would suggest that APINACA is placed in Schedule I of the 1961 Convention on Drugs, in which cannabis and cannabis are placed.

36th ECDD (2014), page 2