In a drug rehabilitation clinic several patients appeared to be intoxicated. Urine specimens were collected and tested for drug abuse, but no substances were detected. Later, one of the patients admitted to having smoked something he referred to as «chemical hashish», and handed the clinic staff a small bag containing green, herbal-looking leaves. We received these for chromatographic-mass spectrometric analysis and found that they contained pentyl-naphthoylindole, also called JWH-018.

    JWH-018 is a synthetic cannabinoid. It stimulates cannabinoid receptors in the brain, inducing an intoxicating effect similar to that of cannabis. During the last five years, JWH-018 and other cannabinoids have been offered for sale on the Internet, packed in small metal sachets and labelled as incense products or bath salts, with product names such as Spice, Aroma, K2 and Silver. Originally these products were believed to contain psychoactive plant fragments, but this was later shown to be incorrect. The intoxicating effect is caused by high-potency synthetic substances – in our case JWH-018 – which are sprayed onto the dried leaves.

    The synthetic cannabinoids represent a new and worrisome trend in substance abuse (1). Psychosis, heart infarction and addiction have been described among users. The long-term effects are unknown. These substances have achieved an unfortunate popularity among groups of substance abusers, since the products are easily available, inexpensive and undetectable by regular drug testing methods. They are claimed to be natural, safe and legal. The truth is that they are synthetic, dangerous and in most cases illegal.

    The patient has consented to publication of the article.


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