Dangers of synthetic cannabinoids (bonzai): A case report

A male patient who had abused synthetic cannabinoids (Bonzai) for three months experienced convulsions and chest pain followed by loss of consciousness immediately after using the substance. Toxicological screening detected no illicit drugs. An EEG showed paroxysmal slow waves with sharp characteristics in both hemispheres. The report suggests that mortality from synthetic cannabinoids may result from sudden cardiac death in the acute phase due to sympathetic nervous system stimulation, and epileptic abnormalities may stem from inhibition of GABA neurotransmission. New-onset generalized seizures and chest pain in young people should alert clinicians to possible synthetic cannabinoid abuse.

Study at a glance

Abstract

Cannabis has become the most widely consumed illicit substance worldwide. Synthetic cannabinoids (SCs), known mostly as JWH agents, were found to have 2-100 times more potent than THC. These are obtained with very minor modifications on the original cannabinoid compound with varying chances to be detected in routine toxicological screens. Recently the use of SCs known as Bonzai has increased considerably and SC-related deaths have increased a lot. We present a male patient who was hospitalized with the history of SC (bonzai) abuse for 3 months and started to have convulsions after using SC and brought to emergency department with chest pain and loosing consciousness immediately after using SC 1 month ago. His toxicological analysis revealed no sign of illicit drugs. EEG showed paroxysmal slow waves with sharp characteristics in both hemispheres. Mortality due to SCs may be related to sudden cardiac death in the acute phase which may result from the stimulation of sympathetic nervous system and epileptic abnormalities may be due to inhibition of γ-aminobutyric acid (GABA) neurotransmission. Novel generalized seizures and chest pain especially in young people should be warning for neurologists and cardiologists in terms of potential SC abuse.