{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:59:20Z","timestamp":1792007960062,"version":"4.4.0"},"reference-count":82,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T00:00:00Z","timestamp":1738972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Reports"],"abstract":"<jats:p>Background: Synthetic cathinones and cannabinoids have emerged as significant public health concerns, particularly in pediatric populations. Marketed under deceptive names such as \u201cbath salts\u201d and \u201cK2\/Spice\u201d, these substances pose unique challenges due to their accessibility, potency, and unpredictable effects. This narrative review synthesizes evidence on the toxicological effects of synthetic cathinones and cannabinoids in pediatric patients, emphasizing clinical presentations, management challenges, and public health implications. Methods: A structured narrative review was conducted using PubMed and Scopus databases to identify peer-reviewed studies published between January 2010 and September 2024. The selected articles focus on neuropsychiatric, systemic, and management outcomes associated with these substances in individuals aged 0\u201318 years. Results: Five studies demonstrate that synthetic cathinones frequently cause seizures, sympathomimetic toxidrome (tachycardia, hypertension), and neuropsychiatric effects like paranoia and catatonia. Seven studies show synthetic cannabinoids induce psychosis, respiratory depression requiring ventilation in 12% of cases, and cardiovascular complications like myocardial ischemia. One study highlighted severe outcomes in pediatric accidental exposures, emphasizing the unpredictable and life-threatening effects of these substances, often exacerbated by co-ingestion with alcohol or THC. Conclusions: Pediatric exposure to synthetic cathinones and cannabinoids results in severe and unpredictable toxicological effects, necessitating tailored clinical management strategies and enhanced diagnostic capabilities. Public health measures, including stringent regulatory controls, targeted education initiatives, and robust surveillance systems, are critical to mitigating these risks. A multidisciplinary approach is essential to safeguard vulnerable pediatric populations from the escalating dangers posed by synthetic drugs, and future research must address the long-term impacts and mechanisms of toxicity.<\/jats:p>","DOI":"10.3390\/pediatric17010019","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T05:53:22Z","timestamp":1739166802000},"page":"19","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Clinical and Public Health Challenge of Handling Synthetic Cathinone and Cannabinoid Abuse in Pediatric Care: A Narrative Review"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1717-2530","authenticated-orcid":false,"given":"Valerio","family":"Ricci","sequence":"first","affiliation":[{"name":"Psychiatry Department, San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, Italy"},{"name":"Department of Neurosciences \u201cRita Levi Montalcini\u201d, University of Turin, Via Cherasco n. 15, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2533-140X","authenticated-orcid":false,"given":"Giuseppe","family":"Maina","sequence":"additional","affiliation":[{"name":"Psychiatry Department, San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, Italy"},{"name":"Department of Neurosciences \u201cRita Levi Montalcini\u201d, University of Turin, Via Cherasco n. 15, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,8]]},"reference":[{"key":"ref_1","unstructured":"United Nations Office on Drugs and Crime (2024, November 15). Synthetic Cannabinoids in Herbal Products. SCITEC, Available online: http:\/\/www.unodc.org\/documents\/scientific\/Synthetic_Cannabinoids.pdf."},{"key":"ref_2","unstructured":"European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) (2018). European Drug Report 2018: Trends and Developments, Publications Office of the European Union."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1089\/cyber.2014.0486","article-title":"Mind navigators of chemicals\u2019 experimenters? A web-based description of e-psychonauts","volume":"18","author":"Orsolini","year":"2015","journal-title":"Cyberpsychology Behav. Soc. Netw."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1002\/hup.2299","article-title":"Promoting Innovation and Excellence to Face the Rapid Diffusion of Novel Psychoactive Substances in the EU: The Outcomes of the ReDNet Project","volume":"28","author":"Corazza","year":"2013","journal-title":"Hum. Psychopharmacol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e2606","DOI":"10.1002\/hup.2606","article-title":"The Risk of Violence Associated with Novel Psychoactive Substance Misuse in Patients Presenting to Acute Mental Health Services","volume":"32","author":"Shafi","year":"2017","journal-title":"Hum. Psychopharmacol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e2586","DOI":"10.1002\/hup.2586","article-title":"Substance-Related Psychopathology and Aggressiveness in a Nightlife Holiday Resort: Results from a Pilot Study in a Psychiatric Inpatient Unit in Ibiza","volume":"32","author":"Martinotti","year":"2017","journal-title":"Hum. Psychopharmacol."},{"key":"ref_7","first-page":"15","article-title":"Novel psychoactive substances of interest for psychiatry","volume":"14","author":"Schifano","year":"2015","journal-title":"World Psychiatry Off. J. World Psychiatr. Assoc. (WPA)"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.5409\/wjcp.v5.i1.16","article-title":"Synthetic Cannabinoids 2015: An Update for Pediatricians in Clinical Practice","volume":"5","author":"Castellanos","year":"2016","journal-title":"World J. Clin. Pediatr."},{"key":"ref_9","unstructured":"Chao, Y.S., and McCormack, S. (2019). Medicinal and Synthetic Cannabinoids for Pediatric Patients: A Review of Clinical Effectiveness and Guidelines, Canadian Agency for Drugs and Technologies in Health."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1002\/hup.2312","article-title":"\u201cSpiceophrenia\u201d: A Systematic Overview of \u201cSpice\u201d-Related Psychopathological Issues and a Case Report","volume":"28","author":"Papanti","year":"2013","journal-title":"Hum. Psychopharmacol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/PEC.0000000000000069","article-title":"Bath Salts and Other Emerging Toxins","volume":"30","author":"Thornton","year":"2014","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1111\/j.1365-2125.1990.tb05447.x","article-title":"Amphetamine-Like Effects in Humans of the Khat Alkaloid Cathinone","volume":"30","author":"Brenneisen","year":"1990","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_13","first-page":"706","article-title":"Khat (Catha edulis): Health Aspects of Khat Chewing","volume":"13","author":"Hassan","year":"2007","journal-title":"East Mediterr. Health J."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Ayano, G., Yohannis, K., and Abraha, M. (2019). Epidemiology of khat (Catha edulis) consumption among university students: A meta-analysis. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-6495-9"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1007\/s00508-009-1259-7","article-title":"Khat: A Controversial Plant","volume":"121","author":"Balint","year":"2009","journal-title":"Wien. Klin. Wochenschr."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ahmed, A., Ruiz, M.J., Cohen Kadosh, K., Patton, R., and Resurrecci\u00f3n, D.M. (2021). Khat and neurobehavioral functions: A systematic review. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0252900"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2287","DOI":"10.1021\/ja01395a032","article-title":"Synthetic Homologs of D, L-Ephedrine","volume":"50","author":"Hyde","year":"1928","journal-title":"J. Am. Chem. Soc."},{"key":"ref_18","first-page":"284","article-title":"Sur un Homologue de la Soci\u00e9t\u00e9 Chimique de France","volume":"45","author":"Sanchez","year":"1929","journal-title":"Soc. Chim. Fr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s13181-011-0193-z","article-title":"The Toxicology of Bath Salts: A Review of Synthetic Cathinones","volume":"8","author":"Prosser","year":"2012","journal-title":"J. Med. Toxicol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.forsciint.2011.03.015","article-title":"New Designer Drug of Abuse: 3,4-Methylenedioxypyrovalerone (MDPV). Findings from Apprehended Drivers in Finland","volume":"210","author":"Kriikku","year":"2011","journal-title":"Forensic Sci. Int."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2895","DOI":"10.1007\/s00204-021-03083-3","article-title":"An updated review on synthetic cathinones","volume":"95","author":"Soares","year":"2021","journal-title":"Arch. Toxicol."},{"key":"ref_22","first-page":"209","article-title":"Neurotoxicology of Synthetic Cathinone Analogs","volume":"32","author":"Anneken","year":"2017","journal-title":"Curr. Top. Behav. Neurosci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.cll.2012.07.010","article-title":"Bath Salts","volume":"32","author":"Gerona","year":"2012","journal-title":"Clin. Lab. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"499","DOI":"10.3109\/15563650.2011.590812","article-title":"Clinical Experience with and Analytical Confirmation of \u201cBath Salts\u201d and \u201cLegal Highs\u201d (Synthetic Cathinones) in the United States","volume":"49","author":"Spiller","year":"2011","journal-title":"Clin. Toxicol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Costa, V.M., Grando, L.G.R., Milandri, E., Nardi, J., Teixeira, P., Mlad\u011bnka, P., Remi\u00e3o, F., and OEMONOM (2022). Natural Sympathomimetic Drugs: From Pharmacology to Toxicology. Biomolecules, 12.","DOI":"10.3390\/biom12121793"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.ccc.2021.03.002","article-title":"Drugs of Abuse: Sympathomimetics","volume":"37","author":"Brown","year":"2021","journal-title":"Crit. Care Clin."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s13181-011-0202-2","article-title":"Here Today, Gone Tomorrow\u2026and Back Again? A Review of Herbal Marijuana Alternatives (K2, Spice), Synthetic Cathinones (Bath Salts), Kratom, Salvia divinorum, Methoxetamine, and Piperazines","volume":"8","author":"Rosenbaum","year":"2012","journal-title":"J. Med. Toxicol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.jep.2009.11.005","article-title":"The Stimulant Khat\u2014Another Door in the Wall? A Call for Overcoming the Barriers","volume":"132","author":"Odenwald","year":"2010","journal-title":"J. Ethnopharmacol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"220","DOI":"10.2174\/0113892002300638240513065512","article-title":"Disposition Kinetics of Cathinone and Its Metabolites After Oral Administration in Rats","volume":"25","author":"Sabei","year":"2024","journal-title":"Curr. Drug Metab."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1515\/dmpt-2022-0154","article-title":"Cathine and cathinone disposition kinetics and neurotransmitter profile in several organs of rats exposed to a single dose of Catha edulis (Vahl) Forssk. ex Endl. extract","volume":"38","author":"Alamir","year":"2023","journal-title":"Drug Metab. Pers. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Poyatos, L., P\u00e9rez-Ma\u00f1\u00e1, C., Hladun, O., N\u00fa\u00f1ez-Montero, M., de la Rosa, G., Mart\u00edn, S., Barriocanal, A.M., Carabias, L., Kelmendi, B., and Taoussi, O. (2023). Pharmacological Effects of Methylone and MDMA in Humans. Front. Pharmacol., 14.","DOI":"10.3389\/fphar.2023.1122861"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"718","DOI":"10.7205\/MILMED-D-10-00356","article-title":"Spice: A Legal Marijuana Equivalent","volume":"176","author":"Johnson","year":"2011","journal-title":"Mil. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1007\/s12272-021-01326-6","article-title":"Pharmacology and adverse effects of new psychoactive substances: Synthetic cannabinoid receptor agonists","volume":"44","author":"Chung","year":"2021","journal-title":"Arch. Pharm. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s40001-023-01443-6","article-title":"The Synthetic Cannabinoids Menace: A Review of Health Risks and Toxicity","volume":"29","author":"Almahasneh","year":"2024","journal-title":"Eur. J. Med. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"258","DOI":"10.3949\/ccjm.79a.11147","article-title":"Synthetic Legal Intoxicating Drugs: The Emerging \u201cIncense\u201d and \u201cBath Salt\u201d Phenomenon","volume":"79","author":"Jerry","year":"2012","journal-title":"Cleve Clin. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"109299","DOI":"10.1016\/j.drugalcdep.2022.109299","article-title":"Relative Reinforcing Effects of Cocaine and 3,4-Methylenedioxypyrovalerone (MDPV) Under a Concurrent Access Self-Administration Procedure in Rats","volume":"232","author":"Seaman","year":"2022","journal-title":"Drug Alcohol Depend."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.7205\/MILMED-D-12-00180","article-title":"Spice, Bath Salts, and the U.S. Military: The Emergence of Synthetic Cannabinoid Receptor Agonists and Cathinones in the U.S. Armed Forces","volume":"177","author":"Loeffler","year":"2012","journal-title":"Mil. Med."},{"key":"ref_38","unstructured":"National Institute on Drug Abuse (2024, November 15). Drug Facts: Spice (Synthetic Marijuana). 2012, Available online: http:\/\/www.drugabuse.gov\/publications\/drugfacts\/spice-synthetic-marijuana."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Cohen, K., and Weinstein, A.M. (2018). Synthetic and Non-Synthetic Cannabinoid Drugs and Their Adverse Effects\u2014A Review From Public Health Prospective. Front. Public Health, 6.","DOI":"10.3389\/fpubh.2018.00162"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Kendall, D.A., and Yudowski, G.A. (2017). Cannabinoid Receptors in the Central Nervous System: Their Signaling and Roles in Disease. Front. Cell. Neurosci., 10.","DOI":"10.3389\/fncel.2016.00294"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Oliva, I., Kazi, F., Cantwell, L.N., Thakur, G.A., Crystal, J.D., and Hohmann, A.G. (2024). Negative Allosteric Modulation of CB1 Cannabinoid Receptor Signaling Decreases Intravenous Morphine Self-Administration and Relapse in Mice. Addict. Biol., 29.","DOI":"10.1111\/adb.13429"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"487","DOI":"10.6004\/jnccn.2012.0048","article-title":"Cannabinoids in the treatment of chemotherapy-induced nausea and vomiting","volume":"10","author":"Todaro","year":"2012","journal-title":"J. Natl. Compr. Cancer Netw. JNCCN"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S67","DOI":"10.1097\/j.pain.0000000000001941","article-title":"Cannabinoids, cannabis, and cannabis-based medicines for pain management: An overview of systematic reviews","volume":"162","author":"Moore","year":"2021","journal-title":"Pain"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/j.psychres.2013.12.038","article-title":"Cannabis use, gender and age of onset of schizophrenia: Data from the \u00c6SOP study","volume":"215","author":"Donoghue","year":"2014","journal-title":"Psychiatry Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/j.euroneuro.2018.07.095","article-title":"The Effects of Synthetic Cannabinoids (SCs) on Brain Structure and Function","volume":"28","author":"Livny","year":"2018","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Theunissen, E.L., Reckweg, J.T., Hutten, N.R., Kuypers, K.P., Toennes, S.W., Neukamm, M.A., Halter, S., and Ramaekers, J.G. (2021). Intoxication by a Synthetic Cannabinoid (JWH-018) Causes Cognitive and Psychomotor Impairment in Recreational Cannabis Users. Pharmacol. Biochem. Behav., 202.","DOI":"10.1016\/j.pbb.2021.173118"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s11920-016-0694-1","article-title":"Adverse Effects of Synthetic Cannabinoids: Management of Acute Toxicity and Withdrawal","volume":"18","author":"Cooper","year":"2016","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"115053","DOI":"10.1016\/j.psychres.2023.115053","article-title":"First Episode Psychosis with and without the Use of Cannabis and Synthetic Cannabinoids: Psychopathology, Global Functioning and Suicidal Ideation and Antipsychotic Effectiveness","volume":"320","author":"Ricci","year":"2023","journal-title":"Psychiatry Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.psychres.2018.08.012","article-title":"Psychosis and Synthetic Cannabinoids","volume":"268","author":"Deng","year":"2018","journal-title":"Psychiatry Res."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Ricci, V., Di Muzio, I., Ceci, F., Di Carlo, F., Mancusi, G., Piro, T., Paggi, A., Pettorruso, M., Vellante, F., and De Berardis, D. (2024). Aberrant Salience in Cannabis-Induced Psychosis: A Comparative Study. Front. Psychiatry, 14.","DOI":"10.3389\/fpsyt.2023.1343884"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1080\/03602532.2018.1428343","article-title":"Pro-psychotic effects of synthetic cannabinoids: Interactions with central dopamine, serotonin, and glutamate systems","volume":"50","author":"Fantegrossi","year":"2018","journal-title":"Drug Metab. Rev."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1136\/eb-2015-102188","article-title":"Synthetic Cannabinoid Receptor Agonists: A Heterogeneous Class of Novel Psychoactive Substance with Emerging Risk of Psychosis","volume":"18","author":"Whiting","year":"2015","journal-title":"Evid.-Based Ment. Health"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"109118","DOI":"10.1016\/j.drugalcdep.2021.109118","article-title":"Cannabis Use Disorder and Dissociation: A Report from a Prospective First-Episode Psychosis Study","volume":"229","author":"Ricci","year":"2021","journal-title":"Drug Alcohol Depend."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"307","DOI":"10.24869\/psyd.2023.307","article-title":"Cannabis Use and Suicide in Non-Affective Psychosis: A Mini-Review of Recent Literature","volume":"35","author":"Ricci","year":"2023","journal-title":"Psychiatr. Danub."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1177\/0269881120907973","article-title":"Synthetic Cannabinoid Use in Psychiatric Patients and Relationship to Hospitalisation: A Retrospective Electronic Case Register Study","volume":"34","author":"Hobbs","year":"2020","journal-title":"J. Psychopharmacol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/j.pcl.2019.08.013","article-title":"Focus on Adolescent Use of Club Drugs and \u201cOther\u201d Substances","volume":"66","author":"Williams","year":"2019","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/phn.12653","article-title":"The perceived impact of legalized cannabis on nursing workload in adult and pediatric emergency department visits: A qualitative exploratory study","volume":"37","author":"Wolf","year":"2020","journal-title":"Public Health Nurs."},{"key":"ref_58","first-page":"e2023028","article-title":"Acute exogenous intoxications in childhood: Factors related to hospitalization","volume":"42","author":"Platt","year":"2023","journal-title":"Rev. Paul. Pediatr. Orgao Of. Da Soc. Pediatr. Sao Paulo"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.pediatrneurol.2014.03.003","article-title":"Seizures Associated with Synthetic Cathinone Exposures in the Pediatric Population","volume":"51","author":"Tekulve","year":"2014","journal-title":"Pediatr. Neurol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1093\/qjmed\/hcq134","article-title":"Mephedrone Use and Associated Adverse Effects in School and College\/University Students Before the UK Legislation Change","volume":"103","author":"Dargan","year":"2010","journal-title":"QJM Mon. J. Assoc. Physicians"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"924","DOI":"10.3109\/15563650.2010.531021","article-title":"Case Series of Individuals with Analytically Confirmed Acute Mephedrone Toxicity","volume":"48","author":"Wood","year":"2010","journal-title":"Clin. Toxicol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1097\/PEC.0b013e318233ed26","article-title":"Clean but Not Sober: A 16-Year-Old with Restlessness","volume":"27","author":"Osterhoudt","year":"2011","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1186\/s13256-024-04819-2","article-title":"Delayed Drug-Induced Catatonia in an Adolescent Girl\u2014Clinical Implications: A Case Report","volume":"18","author":"Winerdal","year":"2024","journal-title":"J. Med. Case Rep."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/PEC.0b013e3181e4f416","article-title":"A Teenager with Agitation: Higher than She Should Have Climbed","volume":"26","author":"Vearrier","year":"2010","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1089\/cap.2012.0004","article-title":"Synthetic Cannabinoid-Induced Psychosis: Two Adolescent Cases","volume":"22","author":"Oluwabusi","year":"2012","journal-title":"J. Child Adolesc. Psychopharmacol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1089\/cap.2011.0122","article-title":"Synthetic Cannabis and Respiratory Depression","volume":"22","author":"Jinwala","year":"2012","journal-title":"J. Child Adolesc. Psychopharmacol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/j.jpeds.2015.06.001","article-title":"Myocardial Ischemia Secondary to Synthetic Cannabinoid (K2) Use in Pediatric Patients","volume":"167","author":"Clark","year":"2015","journal-title":"J. Pediatr."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1177\/0009922816664065","article-title":"Synthetic Cannabinoid Exposure: A New Risk for Children?","volume":"55","author":"Adair","year":"2016","journal-title":"Clin. Pediatr."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e1064","DOI":"10.1542\/peds.2011-1797","article-title":"Clinical Presentation of Intoxication Due to Synthetic Cannabinoids","volume":"129","author":"Cohen","year":"2012","journal-title":"Pediatrics"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.1097\/PEC.0000000000001454","article-title":"Synthetic Cannabinoid Exposure in Adolescents Presenting for Emergency Care","volume":"37","author":"Gilley","year":"2021","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e355","DOI":"10.1097\/PEC.0000000000001492","article-title":"Unintentional Exposure of an Infant to Synthetic Cannabinoid (Bonzai) Related to the Parent\u2019s Use","volume":"36","author":"Dinleyici","year":"2020","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Bukke, V.N., Archana, M., Villani, R., Serviddio, G., and Cassano, T. (2021). Pharmacological and Toxicological Effects of Phytocannabinoids and Recreational Synthetic Cannabinoids: Increasing Risk of Public Health. Pharmaceuticals, 14.","DOI":"10.3390\/ph14100965"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"103493","DOI":"10.1016\/j.drugpo.2021.103493","article-title":"Cannabis Adulterated with the Synthetic Cannabinoid Receptor Agonist MDMB-4en-PINACA and the Role of European Drug Checking Services","volume":"100","author":"Oomen","year":"2022","journal-title":"Int. J. Drug Policy"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1080\/15563650.2019.1661425","article-title":"Synthetic Cannabinoid Receptor Agonists: Classification and Nomenclature","volume":"58","author":"Potts","year":"2020","journal-title":"Clin. Toxicol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.drugpo.2017.03.006","article-title":"Online Test Purchased New Psychoactive Substances in 5 Different European Countries: A Snapshot Study of Chemical Composition and Price","volume":"44","author":"Brunt","year":"2017","journal-title":"Int. J. Drug Policy"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.drugpo.2018.01.021","article-title":"Drug Affordability\u2014Potential Tool for Comparing Illicit Drug Markets","volume":"56","author":"Groshkova","year":"2018","journal-title":"Int. J. Drug Policy"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.schres.2009.12.001","article-title":"The Synthetic Cannabinoid Spice as a Trigger for an Acute Exacerbation of Cannabis-Induced Recurrent Psychotic Episodes","volume":"118","author":"Sperling","year":"2010","journal-title":"Schizophr. Res."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/164_2018_143","article-title":"The Chemistry and Pharmacology of Synthetic Cannabinoid Receptor Agonists as New Psychoactive Substances: Origins","volume":"252","author":"Banister","year":"2018","journal-title":"Handb. Exp. Pharmacol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"2045125320967197","DOI":"10.1177\/2045125320967197","article-title":"New psychoactive substances: A review and updates","volume":"10","author":"Shafi","year":"2020","journal-title":"Ther. Adv. Psychopharmacol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1176\/appi.ajp.2017.17020223","article-title":"Rates and Predictors of Conversion to Schizophrenia or Bipolar Disorder Following Substance-Induced Psychosis","volume":"175","author":"Starzer","year":"2018","journal-title":"Am. J. Psychiatry"},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Alarc\u00f3-Rosales, R., S\u00e1nchez-SanSegundo, M., Ferrer-Cascales, R., Albaladejo-Blazquez, N., Lordan, O., and Zaragoza-Mart\u00ed, A. (2021). Effects of a School-Based Intervention for Preventing Substance Use among Adolescents at Risk of Academic Failure: A Pilot Study of the Reasoning and Rehabilitation V2 Program. Healthcare, 9.","DOI":"10.3390\/healthcare9111488"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s10802-022-00978-2","article-title":"Substance Use Screening and Prevention for Adolescents in Pediatric Primary Care: A Randomized Clinical Trial using the Family Check-Up","volume":"51","author":"Shaw","year":"2023","journal-title":"Res. Child Adolesc. Psychopathol."}],"container-title":["Pediatric Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7503\/17\/1\/19\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:29:13Z","timestamp":1760027353000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7503\/17\/1\/19"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,8]]},"references-count":82,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["pediatric17010019"],"URL":"https:\/\/doi.org\/10.3390\/pediatric17010019","relation":{},"ISSN":["2036-7503"],"issn-type":[{"value":"2036-7503","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,8]]}}}