Synthetic Cannabinoids: A Teen's Death and the Unintended Consequences of Drug Policy
"How Norwegian cannabis policy indirectly led to a tragic death and highlighted the dangers of synthetic alternatives."
In 2015, Egil André Kvelstad Myhre, a 22-year-old Norwegian, tragically passed away from cardiac arrest after experimenting with synthetic cannabinoids. This event, initially reported as an isolated incident, exposed a darker side of drug policy and its unintended consequences.
Myhre, described by his family as someone with no prior drug use, attended a party where he was introduced to a synthetic cannabinoid. The forensic report identified the substance as MBDB, closely related to MDMA. While others at the party also experimented, Myhre's reaction was uniquely fatal.
The case became the first registered fatality in Norway linked to synthetic cannabinoids. National newspapers covered the story as a warning about the dangers of these new and unstable drugs, quoting doctors, police, and health officials who cautioned the public. However, crucial details emerged that painted a more complex picture, revealing the hidden link between drug policy and this tragic outcome.
Current Use and Exposure
Survey data suggest that synthetic cannabinoid use remains rare but is increasing, particularly among people with lower socioeconomic status and people who use other drugs. Cannabis use disorder is associated with higher odds of synthetic cannabinoid use, although researchers say some reports may reflect confusion with emerging cannabis products. The products may be sprayed onto dried plant material for smoking or sold as liquids for vaporization in e-cigarettes and other devices.
Detection Challenges
Synthetic cannabinoids are difficult to analyze because new compounds emerge rapidly, often at low concentrations in biological samples, and may have complex metabolism. Their chemical diversity makes it difficult for forensic methods to keep pace. International guidance notes that control measures aimed at individual compounds can be circumvented as new substances appear.
From Research to Designer Drugs
The development of synthetic cannabinoids began in the 1980s through work by pharmaceutical companies and universities seeking medical alternatives to marijuana. According to a White House report, the first U.S. appearance of synthetic cannabinoids in herbal incense products was recorded in November 2008, when U.S. Customs and Border Protection encountered products such as Spice. Their later development included efforts to create cannabinoid-receptor agonists that could avoid legal restrictions on cannabis.
The Dealer's Story: Apology and a Call for Legalization
A local newspaper, "Trønder-avisa," interviewed the dealer, named "Ørjan," who sold the drug to Myhre's acquaintance. Ørjan claimed to have been selling synthetic drugs for years, with sales volume inversely related to the availability of organic cannabis. He sourced the drugs online, crossing the border to Sweden to pick them up.
- Desire to apologize to Myhre's family.
- Hopes to ignite debate on cannabis legalization.
- Claims he wouldn't share drug with inexperienced users.
An Evolving Evidence Base
Recent research continues to examine synthetic cannabinoids as a diverse and rapidly changing group of new psychoactive substances. The evidence base is developing alongside changes in product chemistry, exposure patterns, and analytical methods. As a result, conclusions about risks and prevalence should be interpreted cautiously, especially when products and terminology change quickly.
Limits of Safety Assumptions
Reviews of clinical evidence focus on adverse effects associated with synthetic cannabinoid use rather than prescribed medications, animal studies, or therapeutic applications. Synthetic cannabinoids, particularly receptor agonists, can be more potent than natural cannabinoids and may produce more severe reactions and medical emergencies. The range of reported toxicities includes concerns involving neurotoxicity and renal toxicity, underscoring the limits of treating these products as equivalent to cannabis.
Different Pharmacology, Different Risks
Synthetic cannabinoids should not automatically be treated as pharmacologically identical to plant-derived cannabis. A pharmacology review reports that synthetic cannabinoid receptor agonists can be more potent and can lead to more severe reactions and medical emergencies. One policy analysis therefore argues that plant-derived cannabis, synthetic cannabinoids, and other emerging substances should be distinguished according to their pharmacology and safety profiles.
A Preventable Tragedy?
Myhre's death highlights the unintended consequences of strict cannabis policies. The pursuit of alternatives like synthetic cannabinoids, driven by the need to circumvent drug testing, can lead to devastating outcomes. As long as cannabis remains illegal, the allure of unregulated and potentially lethal synthetic alternatives will persist, putting vulnerable individuals at risk. The tragic loss of Egil André Kvelstad Myhre serves as a stark reminder of the need for evidence-based drug policies that prioritize harm reduction and public health.
Scheduling New Compounds
A 2026 technical report examines ADB-5Br-INACA and MDMB-5Br-INACA, along with another synthetic cannabinoid, for consideration by New Zealand's Expert Advisory Committee on Drugs. The report was prepared to support a scheduling recommendation under the Misuse of Drugs Act 1975. Its focus illustrates how regulatory authorities assess newly identified compounds individually as they emerge.
Regulated and Research Uses
Market forecasts identify expansion of pharmaceutical-grade cannabinoids, increased research use of synthetic cannabinoids, demand for high-purity formulations, and a shift toward regulated medical applications. Forecasts also point to advances in controlled synthesis methods. One market report projects a 12.5% compound annual growth rate for the global synthetic cannabinoid market from 2025 to 2031, driven by pain-management drugs, neurological-disorder research, and pharmaceutical formulations.
Policy Under Pressure
Synthetic cannabinoids create a policy challenge because chemical compositions can change faster than regulatory systems and testing practices. This can make broad assumptions about product identity, legality, and risk unreliable. A durable response may require coordination among health researchers, forensic laboratories, regulators, and clinicians while acknowledging uncertainty in the evidence.
Vulnerability and Unintended Harm
Potential pharmacodynamic and pharmacokinetic interactions between synthetic cannabinoids and other drugs may worsen clinical presentation and toxicity. People with substance-use disorders or psychiatric illness may be especially vulnerable to these multi-drug interactions. The broader history of synthetic cannabinoids also reflects what one paper calls the hijacking of basic cannabinoid research to create products that can harm human health and behavior.