{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T20:26:59Z","timestamp":1773520019860,"version":"3.50.1"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Novel psychoactive substances (NPSs), commonly referred to as \u201cK2\u201d or \u201cspice,\u201d are a relatively new toxicology challenge for pediatricians. Adolescents often incorrectly believe that these drugs are safe and can be used without major adverse effects. Although recent legislation attempts to ensure that these drugs are not commercially available, many are able to be purchased online as \u201cnot fit for human consumption\u201d or under various misnomers such \u201cincense.\u201d In addition, there is a wide chemical variation among these substances, making regulation challenging. Standard urine drug screens test for tetrahydrocannabinol, which may not cross-react with synthetic substances, making NPS poisonings difficult to diagnose. We report a case of fatal cardiac arrest in a 16-year-old adolescent boy temporally associated with use of the NPS, 5F-ADB. The case illustrates the dangerous consequences that these unregulated substances pose to users, as well as the need for the consideration of comprehensive toxicological testing in patients with a history of substance use and sudden cardiac arrest, despite a negative drug screen.<\/jats:p>","DOI":"10.1097\/pec.0000000000002316","type":"journal-article","created":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T21:08:32Z","timestamp":1631912912000},"page":"e63-e64","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["The Spice of Death"],"prefix":"10.1097","volume":"38","author":[{"given":"Ryan W.","family":"Steele","sequence":"first","affiliation":[{"name":"Pediatrics"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffery H.","family":"Moran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy L.","family":"Patton","sequence":"additional","affiliation":[{"name":"PinPoint Testing, LLC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles P.","family":"Kokes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura P.","family":"James","sequence":"additional","affiliation":[{"name":"Pediatrics"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A.","family":"Storm","sequence":"additional","affiliation":[{"name":"Pediatrics"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen M.","family":"Schexnayder","sequence":"additional","affiliation":[{"name":"Pediatrics"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,9,17]]},"reference":[{"key":"bib1-20250504","article-title":"Impaired driving associated with the synthetic cannabinoid 5F-ADB","volume":"6","year":"2018","journal-title":"J Forensic Sci Criminol"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1056\/NEJMp1505328","article-title":"Synthetic cannabinoid-related illnesses and deaths","volume":"373","year":"2015","journal-title":"N Engl J Med"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.annemergmed.2012.03.007","article-title":"A characterization of synthetic cannabinoid exposures reported to the National Poison Data System in 2010","volume":"60","year":"2012","journal-title":"Ann Emerg Med"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"e1622","DOI":"10.1542\/peds.2010-3823","article-title":"Myocardial infarction associated with use of the synthetic cannabinoid K2","volume":"128","year":"2011","journal-title":"Pediatrics"},{"key":"bib6-20250504","first-page":"i6848","article-title":"Novel psychoactive substances: types, mechanisms of action, and effects","volume":"356","year":"2017","journal-title":"BMJ"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1089\/cap.2012.0004","article-title":"Synthetic cannabinoid-induced psychosis: two adolescent cases","volume":"22","year":"2012","journal-title":"J Child Adolesc Psychopharmacol"},{"key":"bib8-20250504","first-page":"18","article-title":"Hospitalisation associated with use of the synthetic cannabinoid K2","volume":"126","year":"2013","journal-title":"N Z Med J"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"692","DOI":"10.15585\/mmwr.mm6527a2","article-title":"Acute poisonings from synthetic cannabinoids - 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