The impact of Australian legislative changes on synthetic cannabinoid exposures reported to the New South Wales Poisons Information Centre.
The emergence of new psychoactive substances (NPS), including synthetic cannabinoid receptor agonists (SCRAs) poses novel challenges for drug regulation and public health. Misconceptions of safety and legality, coupled with the fact that NPS are undetectable on routine drugs screens contributes to their popularity. Concerns over the unpredictable toxicity and abuse potential of NPS has led to a variety of legislative responses worldwide. We wish to describe Australian trends in SCRA use, examining the effects of legislative changes on calls to Australia's largest poisons centre.



A retrospective review of calls to the New South Wales Poisons Information Centre (NSWPIC). Cases occurring between 1 January 2010 and 30 June 2015 with documented use of SCRAs were included.



There were 146 exposures to SCRAs recorded in the NSWPIC database. Federal bans of specific SCRA compounds in 2011/2012 had little impact on call volumes. State-based legislation introduced in 2013 banning specific brand names of SCRA products was followed by a dramatic, sustained decrease in exposures. The most common symptoms reported with SCRA use were tachycardia, vomiting, drowsiness, anxiety/panic, decreased level of consciousness, chest pain, agitation, hallucinations, confusion, seizures and hypertension.



Banning of specific brand names of SCRA (timed with raids and social media campaigns) appears effective at reducing SCRA exposures. We postulate that this raised awareness within the community of the illegality of these substances while also reducing supply through bricks-and-mortar shops. These results could help inform future legislative responses.
New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia; Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, Sydney Medical School, Blackburn Building (DO6), The University of Sydney, NSW, 2006, Australia. Electronic address: rose.cairns@health.nsw.gov.au.
Rose
R
Cairns
New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia.
Jared A
JA
Brown
New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia; Discipline of Emergency Medicine, Sydney Medical School, The University of Sydney, NSW, 2006, Australia.
Naren
N
Gunja
New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia; Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, Sydney Medical School, Blackburn Building (DO6), The University of Sydney, NSW, 2006, Australia.
Nicholas A
NA
Buckley
D000293:Adolescent; D000328:Adult; D063386:Cannabinoid Receptor Agonists / Q000506:poisoning*; D002186:Cannabinoids / Q000506:poisoning*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000331:legislation & jurisprudence / Q000506:poisoning*; D007880:Legislation, Drug; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D011039:Poison Control Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015813:Substance Abuse Detection / Q000379:methods; D055815:Young Adult
D063386:Cannabinoid Receptor Agonists; D002186:Cannabinoids; D013287:Illicit Drugs
Designer drugs; Legislative changes; New psychoactive substances; Recreational poisoning; Synthetic cannabinoid; Toxicology