Strox is a popular synthetic cannabis in Egypt that consists of smokable herbal products laced with unidentified synthetic cannabinoids [Δ 9-tetrahydrocannabinol (THC) analogs]. Acute Strox intoxication manifested by acute toxic psychosis and severe cases could develop cardiovascular instability and fatal coma. Strox-related toxicity could be attributed to THC analogs and anticholinergic agents along with presence of additives such as ketamine. Limited knowledge considering exact Strox ingredients makes its identification in biological samples using standard toxicology impossible. In 2018 Egyptian law incriminated usage of five THC analogs that is rapidly followed by alteration of Strox constituents by its creators using non prohibited cannabinoids to escape legal prohibition.
Therefore, comprehensive studies are needed to identify Strox constituents with subsequent successful detection. Moreover, the amendment of the law is essential to include all substances that have cannabis-like actions in the schedules of prohibited substance.
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