2021-09-06-世界卫生组织-4F-MDMB-BICA_critical_review_report_21页_467kb

报告摘要

Summary of ECDD Critical Review Report on 4F-MDMB-BICA

Overview: 4F-MDMB-BICA is a synthetic cannabinoid first identified in March 2020 in Belgium. It is not under international control but is regulated in thirteen Member States. The substance appeared on the European drug market, with seizures reported in Europe and the United States. It is associated with significant public health risks, including deaths and hospitalizations.
Chemistry and Pharmacology: The chemical structure includes an asymmetric carbon, leading to (R) and (S) enantiomers, primarily the (S)-enantiomer found on the market. It is metabolized extensively, with the ester hydrolysis metabolite as a primary biomarker. The mechanism of action is suspected to involve CB1 receptor activation, but binding affinity and canonical pathway activation have not been fully assessed. Limited pharmacodynamic data suggest low potency compared to reference compounds like JWH-018.
Toxicology and Adverse Reactions: 4F-MDMB-BICA has been linked to at least 21 deaths in Hungary and several more in other countries, often with mixtures of other substances detected. Adverse effects include cardiac arrest, seizures, and hospitalizations, particularly in cases of overdose or combined substance use. Public health issues include fatalities, emergency department visits, and incidents like driving under influence and prison use.
Legal Status and Regulation: No international controls specifically target 4F-MDMB-BICA, but it is regulated nationally in countries like Austria, Belgium, and the UK. Of 89 WHO成员国 states, 30 provided data on non-medical use, confirming widespread seizures and use across Europe and other regions.
Non-Medical Use and Impact: Non-medical use is common, with routes primarily smoking or vaping. Seizures peaked in 2020 (537 seizures), and public health concerns include high mortality rates, with over 9,500 drug-related deaths reported in some countries. No known therapeutic or industrial applications exist, and user reports indicate dissociative and adverse psychoactive effects.