Year(s) and type of review / ECDD meetings
Drug Class
Technical information (most recent pre-review / critical review report)

Recommendation (from TRS)

Substance identification
ADB-BUTINACA (IUPAC chemical name: N-[1-(Aminocarbonyl)-2,2- dimethylpropyl]-1-butyl-1H-indazole-3-carboxamide) is an indazole-derived synthetic cannabinoid. It is described as a crystalline solid or a beige or yellowish powder and has also been found sprayed onto plant material and paper. It is commonly smoked or vaped, although isolated cases of oral use have also been reported.

WHO review history
ADB-BUTINACA has not been formally reviewed by WHO and is not currently under international control. Information was brought to the attention of WHO that this substance is manufactured clandestinely, poses a risk to public health and has no recognized therapeutic use.

Similarity to known substances and effects on the central nervous system
ADB-BUTINACA is a synthetic cannabinoid that binds to CB1 and CB2 receptors with high affinity and is a potent full agonist at both receptors. Its effects are similar to those of other potent CB1 agonists that are currently controlled under Schedule II of the Convention on Psychotropic Substances of 1971.

No controlled studies of the effects of ADB-BUTINACA have been reported. Online self-reports describe euphoria, appetite stimulation, sedation and paranoia after its use. These effects are consistent with the known effects of cannabinoid agonists.

Dependence potential
No controlled studies of the dependence potential of ADB-BUTINACA in animals or humans have been reported. Its effects at the CB1 receptor suggest that it would be expected to produce dependence similar to other synthetic cannabinoids.

Actual abuse and/or evidence of likelihood of abuse
In an animal model predictive of abuse potential, ADB-BUTINACA had effects similar to the CB1 receptor agonist delta-9-tetrahydrocannabinol. No studies have been conducted to determine the likelihood of abuse of ADB-BUTINACA in humans; however, CB1 receptor agonists have known abuse potential.

A number of countries in various regions have reported use of ADB-BUTINACA and harm related to its use, including multiple deaths and presentations of patients to emergency departments with altered consciousness and loss of consciousness. Other substances were usually also involved in these cases, although a number of deaths involved only ADB-BUTINACA.

Therapeutic usefulness
ADB-BUTINACA is not known to have any therapeutic use.

ADB-BUTINACA (N-[1-(Aminocarbonyl)-2,2-dimethylpropyl]-1-butyl-1H- indazole-3-carboxamide) is a potent synthetic cannabinoid receptor agonist with a mechanism of action and effects similar to those of a number of other synthetic cannabinoids that are controlled under Schedule II of the Convention on Psychotropic Substances of 1971. Its mode of action suggests the likelihood of abuse and potential for dependence. Use of ADB-BUTINACA has been associated with severe adverse effects, including fatal intoxications. ADB-BUTINACA has no known therapeutic use.

Recommendation: The Committee recommended that ADB-BUTINACA (N-[1- (Aminocarbonyl)-2,2-dimethylpropyl]-1-butyl-1H-indazole-3-carboxamide) be added to Schedule II of the Convention on Psychotropic Substances of 1971.

ECDD Recommendation