Synthetic Cannabinoids: A New Frontier of Designer Drugs

During the past decade, synthetic cannabinoids (SCs)emerged as a major designer drug class (1, 2). De-signer drugs include chemicals with slight molecular struc-ture modification of controlled substances to circumvent drug laws. Synthetic cannabinoid consumption was first recognized during the mid-2000s in Europe (1) and gained attention in the United States by 2009 after increasing calls to national poison control centers (3). During 2010, SC products contributed to 11 406 U.S. emergency depart-ment visits, primarily by teens and young adults (4). Con-cern about increasing use and consequences led to initial national regulation on 1 March 2011, when the Drug En-forcement Administration placed 5 common SCs under Schedule 1 control, which prohibited compound manufac-ture, sale, and possession (5). However, SC product con-sumption persisted. Nationwide during 2011 and 2012,