Synthetic Cannabinoids: A Growing Problem

Posted on Tue, May 19, 2015
Synthetic Cannabinoids: A Growing Problem

Synthetic cannabinoids represent a growing threat to patients and communities
Since 2008, a new class of designer, synthetic drugs has been popping up in communities all over the US.  Known as K2, spice, chill out and others, these drugs are similar in their chemical make up to the active molecules in marijuana but have a very different safety and toxicological profile.
Marijuana contains dozens of molecules known as cannabinoids which are responsible for the characteristic high that users experience.  Laboratory produced and commercially available synthetic cannabinoids have emerged as a recreational drug with significant toxicity.
The manufactured cannabinoids are typically sprayed onto an herbal base and sold as incents or spices.  In order to avoid regulatory oversight, they are often sold with disclaimers that they are not for inhalation or human consumption.  Though usually smoked, cannabinoids can also be prepared for ingestion.
Although relatively new, the popularity of these drugs is increasing at an alarming rate.  According to the American Association of Poison Control Centers, there have been 2365 exposures to synthetic cannabinoids reported between Jan 1st and May 1st of this year.  A University of Michigan study showed that 11% of high school seniors have tried a drug containing synthetic cannabinoids. 
Though some of the effects of these new synthetic drugs are similar to natural marijuana, there are some important and dangerous differences.  Because there are dozens of different molecules produced in various ways by individual manufacturers, there is no consistency or predictability to the compounds sold as “fake weed”.
The range of toxicity is also highly variable.  Racing heart, nausea, vomiting, agitation and paranoia are common.  More severe reactions including seizures, heart attacks, strokes, and extreme suicidal thoughts are possible.  These symptoms last between a few hours and a few days and have no specific antidote.  The emergency treatment is largely symptomatic and supportive.
According to Dr. Kevin Rittger, Medical Director for Emergency Services at Brazosport Regional Health System, “synthetic marijuana is a very dangerous drug that we have been seeing more and more of in recent years.  I would highly encourage people to avoid using or experimenting with these drugs”.
Dr. Rittger went on to say “K2 and other drugs like it are very unpredictable and can be difficult to manage in an emergency situation”.
The FDA now classifies synthetic cannabinoids as Schedule I drugs which makes them illegal to use, sell or possess.  Though this may help reduce community exposure, it is important to educate our patients, families and communities about the dangers of this emerging drug.

Dr. Adam Corley is a practicing emergency physician with more than 10 years of clinical and leadership experience.  Dr. Corley currently serves as a Divisional Vice President for the West Division.   He is also the medical director for emergency services at Palestine Regional Medical Center and also serves as the medical director for several EMS services and the Anderson Co. Texas Sheriff’s Dept.  Dr. Corley lectures and writes on a variety of topics including decision science and behavioral economics, management of disruptive behavior in healthcare, conflict resolution, and healthcare leadership.

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