Disorders due to use of synthetic cannabinoids

Disorders Due to Use of Synthetic Cannabinoids are characterized by the pattern and consequences of synthetic cannabinoid use. Synthetic cannabinoids are synthesized diverse chemical compounds that are potent agonists for endogenous cannabinoid receptors. There are several hundred such compounds. The synthetic compound is typically sprayed onto a vehicle such as cannabis or tea leaves and then smoked. The effect of these compounds is distinctly different from smoking naturally cultivated cannabis in that the euphoric effects are typically accompanied or dominated by psychotic-like symptoms (e.g., paranoia, hallucinations, and disorganized behaviour). Synthetic Cannabinoid Intoxication may therefore present more frequently with psychotic symptoms in addition to the more typical effects of cannabis. Synthetic cannabinoids are also dependence-producing and Synthetic Cannabinoid Dependence and Synthetic Cannabinoid Withdrawal are recognized. Synthetic Cannabinoid-Induced Mental Disorders also occur; in particular Synthetic Cannabinoid-Induced Psychotic Disorder is recognized. Much less is known about the effects of these drugs on other body organs and systems than is the case for naturally cultivated cannabis.

Diagnostic Categories that Apply to Synthetic Cannabinoids

Following is a list of specific diagnostic categories of that apply to synthetic cannabinoids:

• 6C42.0 Episode of Harmful Use of Synthetic Cannabinoids
• 6C42.1 Harmful Pattern of Use of Synthetic Cannabinoids
• 6C42.2 Synthetic Cannabinoid Dependence
• 6C42.3 Synthetic Cannabinoid Intoxication
• 6C42.4 Synthetic Cannabinoid Withdrawal
• 6C42.5 Synthetic Cannabinoid-Induced Delirium
• 6C42.6 Synthetic Cannabinoid-Induced Psychotic Disorder
• 6C42.70 Synthetic Cannabinoid-Induced Mood Disorder
• 6C42.71 Synthetic Cannabinoid-Induced Anxiety Disorder
• 6C42.Y Other Specified Disorder Due to Use of Synthetic Cannabinoids
• 6C42.Z Disorder Due to Use of Synthetic Cannabinoids, Unspecified

An additional category of disorder induced by psychoactive substances is included in another part of the ICD-11 chapter on Mental, Behavioural, and Neurodevelopmental Disorders. This is cross-listed in the section below on Substance-induced Mental Disorders for reference:

• 6A41 Catatonia Induced by Substances or Medications

The first three diagnoses listed above (Episode of Harmful Use of Synthetic Cannabinoids, Harmful Pattern of Use of Synthetic Cannabinoids, and Synthetic Cannabinoid Dependence) describe the pattern of synthetic cannabinoid use. One of these three diagnoses, or Disorder Due to Use of Synthetic Cannabinoids, Unspecified, for cases in which the use pattern in unknown at the time of evaluation, is considered to be the primary diagnosis. That is, one of these four diagnoses should be assigned when making a diagnosis of a Disorder Due to Synthetic Cannabinoid Use.

The remaining diagnoses reflect the impact of the pattern of synthetic cannabinoid use and are thus considered to be associated with one of the primary use pattern diagnoses. These diagnoses should therefore be assigned together with the relevant primary diagnosis. For example, 6C42.1/ 6C42.5 is Harmful Pattern of Use of Synthetic Cannabinoids associated with Synthetic Cannabinoid-Induced Psychotic Disorder, 6C42.2/6C42.70 is Synthetic Cannabinoid Dependence associated with Synthetic Cannabinoid-Induced Mood Disorder, 6C4Z/6C42.3 is Disorders Due to Substance Use, Unspecified associated with Synthetic Cannabinoid Intoxication (i.e., the pattern of use in this last case is unknown).

Synthetic Cannabinoid-induced Mental Disorders are characterized by psychological, cognitive, or behavioural symptoms that develop during or soon after synthetic cannabinoid intoxication or withdrawal or use. The duration or severity of the symptoms is substantially in excess of the characteristic syndrome of Synthetic Cannabinoid Intoxication or Synthetic Cannabinoid Withdrawal.