Brandt, SD (2017) 5F-PB-22. Critical Review Report. Technical Report. World Health Organization.

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Abstract

5F-PB-22 (quinolin-8-yl 1-(5-fluoropentyl)-1H-indole-3-carboxylate) is a synthetic cannabinoid receptor agonist (SCRA) that had no history in the scientific literature until its detection emerged in 2013. This substance has been encountered as a synthetic constituent found in herbal smoking mixtures that are sold under a variety of brand names. It is common for retailers to purchase bulk quantities of the synthetic substance and add the synthetic material to plant matter that is then distributed onto the market. However, 5F-PB-22 is also available in powdered form as a “research chemical”. Various UN Member States reported the identification of 5F-PB-22 first in 2013 and data obtained from law enforcement suggest that 5F-PB-22 emerged and peaked in 2013 and 2014 in the United States of America, which then dropped in the following years. A small number of in vitro and in vivo studies are currently available but the data indicate that 5F- PB-22 binds to and activates human CB1 and CB2 receptors at low nanomolar concentrations, and that it induces a number of biological responses also triggered by the naturally occurring phytocannabinoid Δ9-THC. In some in vitro assays, 5F-PB-22 acted as a full at both cannabinoid receptors. 5F-PB-22 also fully substituted for Δ9-THC in the drug discrimination paradigm and was ~22 times more potent than the training drug, which suggests that 5F-PB-22 may have abuse liability similar to Δ9-THC and/or other internationally controlled synthetic cannabinoid receptor agonists. Reports indicate an increasing trend for SCRAs being implicated in mini epidemics that have been associated with severe adverse drug effects including deaths. Reported adverse drug reactions associated with a range of SCRAs frequently include gastrointestinal (e.g. nausea/hyperemesis), neurological (e.g. hallucination, agitation, anxiety, paranoia, confusion, delusions, catatonia, lethargy, psychosis (including susceptible individuals)), cardiovascular (e.g. tachycardia, hypertension) and renal (e.g. acute kidney failure) features. The total number of cases reported in the scientific literature that make a causal link with 5F-PB- 22 is very small. Intoxications and deaths associated with 5F-PB-22 have been reported but very few details are available. ‘Driving Under the Influence’ cases linked to 5F-PB-22 intoxication revealed significant impairment. Although not specific to 5F-PB-22, there are indications that socially vulnerable and stigmatized drug users for example found in homeless and prison populations, are increasingly associated with problematic use of SCRA products. Heavy use of SCRAs has been associated with problematic withdrawal symptoms and further research is needed to investigate the underlying mechanisms. Epidemiological data, such as prevalence of use, abuse and dependence information specifically related to 5F-PB-22 could not be identified.

Item Type:	Monograph (Technical Report)
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RM Therapeutics. Pharmacology
Divisions:	Pharmacy & Biomolecular Sciences
Publisher:	World Health Organization
Date Deposited:	20 Oct 2017 10:04
Last Modified:	21 Jan 2022 16:16
URI:	https://researchonline.ljmu.ac.uk/id/eprint/7381

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