Physicians and medical professionals need to understand and help prevent the spread of a serious new threat posed by synthetic cannabinoids. These smokeable herbal mixtures containing synthetic cannabimimetics (SC) are sold under a variety of names and are often referred to as “K2” or “spice”. SC are synthesized in clandestine laboratories and have become the second most popular illegal drug among American teenagers after marijuana. Parents and doctors need to be aware how accessible this drug is and the serious side effects it causes, and use the following information to help educate them and increase prevention.

SC is sold on the internet and in convenience stores as spice, mister nice guy, aroma or K2 and is labeled “not for human consumption.” These products are not marijuana but rather herbs that are sprayed with solutions containing one or more research chemicals that bind to the same brain receptors like the active constituents in marijuana or cannabis. Its popularity is attributed to its intense psychoactive effects and lack of detectability in a routine urine test.

The White House Administration has been working with Congress, federal/state/ and local authorities, and even non-governmental partners to put policies and legislation in place to combat this harmful drug. At least 41 states (including Texas with SB 331) and Puerto Rico have legislatively banned synthetic cannabinoids. On July 9, 2012, the federal Synthetic Drug Abuse Prevention Act of 2012 was signed into law. Unfortunately, new SC groups are more structurally-diverse cannabimimetic compounds and may not be covered under current regulations or detected in routine drug tests. For example, 51 new SC were identified in 2012, compared to just two in 2009. Legislation in 2009 and 2010 targeted specific versions of the drugs, but again new variations with minor changes in the chemical structure have far outpaced regulation aimed to stop them.

A 2013 survey of approximately 50,000 U.S. high school students included questions related to lifetime and past year SC intake in 2011–2013: 12,900 (25.8%) reported past-year cannabis intake and 3,200 (6.4%) SC intake. In addition, thousands of teens and young adults, mostly young males, are ending up in emergency rooms with severe symptoms that may include vomiting, a racing heartbeat, elevated blood pressure, seizures, hallucinations, psychosis, suicidal ideation and heart attack.

Physicians should be aware of the tremendous health risk caused by this drugs and be aware that a negative urine drug screen does not mean anything with this dangerous drug. The first sign parents usually notice is a change in behavior. K2 users tend to be more aggressive, change their personality, and have episodes of psychosis. Parents should work with their pediatricians to help determine if their kids are using the drug. Physicians should learn more about these types of drugs so they can educate others about them, the dangers posed to unsuspecting children, and why these drugs are so easily undetected.
Because I think a picture is worth a thousand words, I encourage you to watch this video:

For more information, visit these websites, as well:
http://www.whitehouse.gov/ondcp/ondcp-fact-sheets/synthetic-drugs-k2-spice-bath-salts
http://www.recovery.org/topics/spice-and-k2-recovery/

Diana Nichols-Vinueza, MD