On August 5, 2015, a man was preparing to smoke K2, a synthetic marijuana drug, on a street in East Harlem, New York City.
Synthetic cannabis, sold under catchy names such as AK-47, K2, Spice, and Scooby Snacks, is far from being a dreamy substance. Most synthetic cannabinoids are packaged in electronic cigarettes, juices, or foods, and sold as dried plant material that has been sprayed with solvents containing laboratory-made psychoactive substances such as acetone, preservatives, or other chemicals.
According to data from the ToxIC case registry, cases of synthetic cannabis poisoning were on the rise between 2010 and 2015, with over 42,000 reported toxic exposure cases during that period. However, Tracy Klein, the assistant director of the Cannabis Policy, Research and Outreach Center at Washington State University in Vancouver, suggests that these numbers may now be decreasing in states where recreational marijuana use is allowed.
She was the lead author of a study that found that in states where recreational marijuana had been legalized between 2016 and 2019, calls to poison control center related to synthetic marijuana decreased by over one-third.
These products are in powder form, which can be sprayed or added to substances that look exactly like natural marijuana. Therefore, in party situations, I can see how someone could accidentally use it," said Klein, who is also an associate professor at the WSU College of Nursing.
However, according to the Centers for Disease Control and Prevention in the United States, people may also use synthetic cannabinoids "in an attempt to avoid positive drug screenings for employment, drug abuse treatment programs, or the criminal justice system.
A fatal issue/problem.
Over the past decade, thousands of people have been rushed to the emergency room due to marijuana use. According to the Centers for Disease Control and Prevention, some individuals have even died, including a 17-year-old boy who reportedly experienced cardiac arrest after using K2/spice marijuana once.
Experts say it is impossible to know what synthetic cannabinoids are actually present in purchased products or what other substances might be present in solvents used to soak and dry plants.
In April 2018, 153 people in Illinois fell ill and four died after using synthetic marijuana that was laced with rat poison. Later that year, in New Haven, Connecticut, K2 marijuana caused 95 people to become ill within two days. They experienced symptoms such as nausea, vomiting, lethargy, and loss of consciousness.
Klein explained that these synthetic products are officially known as "synthetic cannabinoid receptor agonists," which are different from synthetic marijuana products that have medical uses.
They do not appear in standard drug tests," she said. "The body also does not recognize them in any way that has a positive effect.
This research was published on Tuesday in the Clinical Toxicology Journal, analyzing data from the National Poison Data System between 2016 and 2019. The researchers discovered that over these three years, there were 7600 calls relating to the use of synthetic cannabinoids. Approximately 65% of calls made to poison centers concerned situations requiring medical care, with 61 fatalities reported.
A study has revealed that over half of the calls made to poison control centers (56%) were from states with restrictions on marijuana policies. According to the study, nearly one-third (38.6%) of calls were made from states that allow drug use for medical purposes, while 5.5% were from "permissive" states where recreational use is legal.
The working principle of synthetic cannabinoids.
The Centers for Disease Control and Prevention (CDC) stated that synthetic cannabinoids were first developed in the 1980s for the purpose of studying how tetrahydrocannabinol (THC), the psychoactive ingredient in marijuana, affects the brain in producing high levels.
Klein stated, "A specific synthetic marijuana was designed by a pharmaceutical company as a potential pain relief medication. People discovered that it was so potent and had so many side effects that it was not being abused.
Today, synthetic materials are mainly produced overseas and transported to the United States. In fact, according to the Centers for Disease Control, the first shipment of "goods identified as containing synthetic cannabinoids was seized at the U.S. border in 2008.
This is not just a problem in the United States. It has become an international issue", stated Klein. He pointed out that, as of February 2022, data on illegal markets listed at least 320 different types of synthetic cannabinoids being sold.
She added, "These are only those that have been reported and identified.
Klein stated that, although different from natural cannabis, synthetic compounds do indeed act on the same cannabinoid receptors as THC. However, due to the manner in which they bind to brain receptors, their potency can increase up to 100 times.
Exposure could lead to a range of neurological reactions, from mild to severe, such as agitation and depression in the central nervous system, which could even result in coma. The Centers for Disease Control and Prevention highlight other symptoms including "fatigue, irritability, confusion, dizziness, lack of coordination, inability to concentrate, stroke and seizures.
The agency stated that symptoms of mental illness include "hallucinations, delusions, psychosis, violent behavior, and suicidal thoughts." "Other physical signs and symptoms include shortness of breath, tachycardia, hypertension, severe nausea and vomiting, chest pain and heart attack, rhabdomyolysis (damaged muscles rupturing), kidney failure, and death.
The Disease Prevention and Control Center stated that there is no antidote for synthetic cannabinoid toxicity, and the long-term effects are still unknown. Treatment options include intravenous fluids, oxygen therapy, airway protection, and medication for anxiety and aggression, but these treatments are only supportive measures.
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