Clinical Characteristics of Synthetic Cannabinoid Use in a Large Urban Psychiatric Emergency Setting.
Increasing reports of synthetic cannabinoid (SC)-related adverse events have largely comprised case reports and analyses of calls to poison control centers. Existing studies have also mostly involved white male populations.



The purpose of this study is to systematically describe clinical characteristics of SC use in a relatively large, diverse, urban sample presenting to a psychiatric emergency setting.



SC users (n = 110) were identified by reviewing charts (n = 948) from the psychiatric emergency service of a large, urban public hospital in the United States for November 2014, which was randomly selected from the 12 months of that year. Sociodemographic data were collected from administrative databases and clinical data were collected from the electronic medical record.



SC users were mostly non-white (90.0%) males (95.5%), who were likely to be police-involved (34.5%) and homeless (84.5%). SC users also had significant and often pre-existing psychiatric and substance use comorbidity, including acute psychotic symptoms (70.0%), more than one comorbid psychiatric diagnosis (31.8%) and primary psychotic disorder diagnosis (40.0%), past psychiatric visits to the hospital (70.9%), comorbid substance use (62.7%), agitation requiring intervention (22.7%), and the need for extended psychiatric observation (15.5%) and inpatient admission (34.5%). Relatively limited medical complications were identified. Conclusions/Importance: In this sample, SC use affected a sociodemographically disadvantaged and mentally ill population, likely exacerbating existing psychiatric problems. This is one of the only studies to systematically examine the clinical effects of SC use in a significant clinical sample, and the first study in an urban, racial/ethnic minority, and vulnerable sample.
a Department of Psychiatry , New York University School of Medicine , New York , New York, USA.|b Department of Psychiatry , Bellevue Hospital Center , New York , New York, USA.
Marc W
MW
Manseau
a Department of Psychiatry , New York University School of Medicine , New York , New York, USA.|b Department of Psychiatry , Bellevue Hospital Center , New York , New York, USA.
Amit
A
Rajparia
c The Nathan Kline Institute, Research Foundation for Mental Hygiene , Orangeburg , New York , USA.
Adriana
A
Joseph
a Department of Psychiatry , New York University School of Medicine , New York , New York, USA.
Sarah
S
Azarchi
a Department of Psychiatry , New York University School of Medicine , New York , New York, USA.|c The Nathan Kline Institute, Research Foundation for Mental Hygiene , Orangeburg , New York , USA.
Donald
D
Goff
a Department of Psychiatry , New York University School of Medicine , New York , New York, USA.
Ritvij
R
Satodiya
a Department of Psychiatry , New York University School of Medicine , New York , New York, USA.|b Department of Psychiatry , Bellevue Hospital Center , New York , New York, USA.|c The Nathan Kline Institute, Research Foundation for Mental Hygiene , Orangeburg , New York , USA.
Crystal Fuller
CF
Lewis
D000328:Adult; D002186:Cannabinoids / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D009519:New York City / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014505:Urban Population / Q000706:statistics & numerical data; D035862:Vulnerable Populations / Q000706:statistics & numerical data
D002186:Cannabinoids
Synthetic cannabinoids; acute intoxication; drug-induced psychosis; homelessness; psychiatric emergency