VIENNA, Austria – May 2021. In recent months, concerns about the potential negative health implications for users of cannabis products have been growing as evidence on their adulteration with synthetic cannabinoid receptor agonists (SCRA) such as MDMB-4en-PINACA, accumulates.

Check-it, an Austrian drug information and advice centre that provides drug testing services, issued an alert on the detection of SCRAs in four “cannabis” samples since the end of 2020. One sample contained AB-PINACA and the other three samples MDMB-4en-PINACA (Check-it, 2021). A drug testing service in Switzerland reported that more than half (50 out of 91) of the cannabis samples submitted by users between January and August 2020 contained SCRA adulterations with 5F-MDMB-PICA (identified in 27 samples) and MDMB-4en-PINACA (identified in 20 samples) being the most often identified SCRAs (Stadt Zuerich, 2020). Moreover, the EMCDDA highlighted the adulteration of cannabis products with SCRAs in France, Germany, the Netherlands, Slovenia and Sweden. Between September and December 2020, Sweden reported 36 seizures of low-tetrahydrocannabinol (THC) cannabis products which contained SCRAs (EMCDDA, 2021).

MDMB-4en-PINACA was placed under international control at the 64th regular session of the Commission on Narcotic Drugs in April 2021 (Schedule II of the Convention on Psychotropic Substances of 1971) upon recommendation by WHO. The substance is a potent synthetic cannabinoid receptor agonist with a similar mechanism of action, and similar effects to a number of other synthetic cannabinoids that are controlled under Schedule II of the Convention on Psychotropic Substances of 1971. Use of MDMB-4en-PINACA has been associated with severe adverse effects, including fatal intoxications, and cases of impaired driving. MDMB-4en-PINACA has no therapeutic use (World Health Organization, 2020). The harmfulness of MDMB-4en-PINACA is further reflected in toxicology data from post-mortem, clinical and other casework in the UNODC Early Warning Toxicology Portal, where the substance was identified in 36 cases from North America, Asia and Europe in 2020.

MDMB-4en-PINACA was reported to the UNODC Early Warning Advisory on NPS for the first time in 2018 in three European countries. In 2019, the substance was already reported in 22 countries (mostly from Europe), and continues to be reported since then from countries in different parts of the world. In the United States, for example, MDMB-4en-PINACA was one of the most frequently identified SCRA in drug seizures during 2020 (United States Drug Enforcement Administration, 2021).

Figure: Number of countries identifying MDMB-4en-PINACA, by region, 2018-2021

Source: UNODC Early Warning Advisory on NPS, 2021.

Note: The data for the years 2020 and 2021 is preliminary and subject to change.

For more information, please see:

UNODC, newsclip: April 2021 – UNODC: Eight substances "scheduled" at the 64th Session of the Commission on Narcotic Drugs

Stadt Zuerich, Synthetische Cannabinoide: Ergebnisse aus dem Drug-Checking der Stadt Zuerich, Januar bis August 2020 (September 2020).

EMCDDA, Impact of COVID-19 on drug markets, use, harms and drug services in the community and prisons (April, 2021).

World Health Organization, Summary assessment and recommendations of the 43rd ECDD, 12-16 October 2020 (November 2020).

Checkit, Warnung: synthetische Cannabinoide in Cannabis nachgewiesen, alert (April 2021)

United States Drug Enforcement Administration, Emerging Threat Report Annual 2020 (March 2021).

UNODC, Current NPS Threats, vol. III (October 2020).

UNODC Early Warning Advisory Toxicology Portal

***The Spanish translation of this news item was made possible thanks to a collaboration with OAS/CICAD, a partner of the UNODC EWA.***