Recommendation (from TRS)
Substance identification
4F-MDMB-BINACA (methyl (2S)-2-{[1-(4-fluorobutyl)-1H-indazole-3- carbonyl]amino}-3,3-dimethylbutanoate) is a synthetic cannabinoid also known as 4F-MDMB-BUTINACA. It has been detected in powdered form, in liquids used for vaping and as a constituent of plant mixtures used for smoking.
WHO review history
4F-MDMB-BINACA has not been reviewed previously. A critical review was proposed on the basis of information brought to WHO’s attention that 4F-MDMB-BINACA is manufactured clandestinely, poses a risk to public health and society and has no therapeutic use recognized by any Party.
Similarity to known substances and effects on the central nervous system
4F-MDMB-BINACA is an agonist at CB1 receptors. It is an analogue of 5F-ADB (5F-MDMB-PINACA), which is listed in Schedule II of the Convention on Psychotropic Substances of 1971. In humans, 4F-MDMB-BINACA produces central nervous system effects that include paranoia, agitation, confusion and insomnia. Euphoria, irregular heartbeat, chest pain and vomiting have also been described.
Dependence potential
No controlled experimental studies of the dependence potential of 4F-MDMB- BINACA in humans or animals were available. In view of its action on the central nervous system as a full CB1 agonist, however, 4F-MDMB- BINACA would be expected to produce dependence in a manner similar to other synthetic cannabinoids.
Actual abuse and/or evidence of likelihood of abuse
There are no data on the abuse potential of 4F-MDMB-BINACA in animal or human models.
Seized and collected specimens of 4F-MDMB-BINACA have been reported in numerous countries in various regions. In some countries, 4F-MDMB- BINACA has been detected in cases of attempted smuggling into prisons.
4F-MDMB-BINACA has been detected in biological specimens from drug-related fatalities and from cases of impaired driving. It was frequently found with other psychoactive substances.
Therapeutic usefulness
4F-MDMB-BINACA is not known to have any therapeutic uses.
Recommendation
4F-MDMB-BINACA is a synthetic cannabinoid receptor agonist that is administered by smoking plant material sprayed with the substance or inhaling vapour after heating. Its mode of action suggests the likelihood of dependence and abuse and similar ill effects to other synthetic cannabinoids. Its use has been associated with a wide range of severe adverse effects, including death. These effects are similar to those produced by other synthetic cannabinoids that are placed in Schedule II of the Convention on Psychotropic Substances of 1971. 4F-MDMB-BINACA has no therapeutic use.
■ Recommendation: The Committee recommended that 4F-MDMB-BINACA (methyl (2S)-2-{[1-(4-fluorobutyl)-1H-inda- zole-3-carbonyl]amino}-3,3-dimethylbutanoate) be added to Sched- ule II of the Convention on Psychotropic Substances of 1971.