Decoding the Toxicity of Synthetic Cannabinoids: From Receptor Activation to Multiorgan Dysfunction

Synthetic cannabinoids (SCBs) represent a rapidly expanding and chemically diverse class of new psychoactive substances, deliberately designed to mimic the effects of natural cannabis. However, their high potency and full agonism at cannabinoid receptors lead to severe public health risks. The primary mechanism of SCBs' action involves the robust activation of CB1 and CB2 receptors, which in turn trigger a cascade of downstream events. This includes the profound dysregulation of key neurotransmitter systems, critical ion channel functions, and essential intracellular signaling pathways, culminating in widespread cellular dysfunction and damage. This comprehensive review delves into the multifaceted pathogenesis through which SCBs induce systemic harm. It systematically examines the clinical evidence and molecular mechanisms that connect SCB exposure to a spectrum of adverse outcomes, including life-threatening cardiovascular toxicities, significant neurological and psychiatric disorders, respiratory system diseases, digestive system diseases, and nephrotoxicity, and so forth. The point of this review, elucidating the intricate mechanisms underlying SCB toxicity, will be crucial, as this knowledge is the key to unlocking targeted therapies and effectively mitigating the severe health consequences of their abuse.