Princeton's Ask The Doctor March-April 2019

Synthetic cannabinoids: What are they? What are their effects? By Cassandra Mayall

H E A L T H A R T I C L E S A N D Q & A

Synthetic cannabinoids (“synthetic marijuana,” “Spice,” “K2”) are various manmade chemicals that some people may use as an alternative to marijuana. These seemingly inno- cent little packages of “fake weed” can cause serious side effects that are very different from those of marijuana. Synthetic cannabinoid products can be toxic. As a result, people who smoke these prod- ucts can react with rapid heart rate, vomiting, agitation, confusion, and hallucinations. Some have to get help from emergency medical services or in hospital emergency depart- ments or intensive care units. Synthetic cannabinoids are not one drug. Hundreds of different synthetic cannabinoid chemicals are manufactured and sold. New ones with unknown health risks become avail- able each year. Synthetic cannabinoids are popular because users often believe they are legal and relatively safe. These chemicals are called cannabinoids because they act on the same brain cell recep-

tors as tetrahydrocannabinol (THC), the main active ingredient in marijuana. However, the hundreds of known synthetic cannabinoid chemicals and THC are different chemicals. In fact, synthetic cannabinoids may affect the brain in different and unpredictable ways compared to marijuana. Synthetic cannabinoids are used in a variety of ways: • Sprayed onto plant material and smoked • Mixed into a liquid and vaped in electronic nicotine delivery devices (such as e-cigarettes) • Added to herbal tea or to food and swallowed Consumers can buy synthetic cannabinoids in convenience stores, from individual drug dealers, or online as incense or natural herbal products. They are sold under a number of brand names, including • K2 • Spice • AK-47 • Mr. Happy There are no standards for making, packaging, or selling synthetic cannabinoid chemicals. That means that two packets of a brand-named product may have completely different chemicals. Synthetic cannabinoids can affect brain function. Signs and symptoms and health problems include: • Agitation and irritability • Confusion and concentration problems • Hallucinations, delusions, psychosis, suicidal thoughts, and violent behavior • Seizures • Sleepiness and dizziness • Breathing problems • Gastrointestinal problems • Heart attack, fast heart rate, high blood pressure, and stroke • Kidney failure • Muscle damage These health problems depend on many factors, including the specific synthetic cannabinoid, the dose (how much), and the duration of use (for how long). The long-term effects of long-term synthetic cannabinoid use are unknown. Synthetic cannabinoids may be addictive, since some people have reported withdrawal symptoms after heavy use over a long time. Experts think that the severity of these symptoms is related to how much synthetic cannabinoid is used and for how long. If you or anyone you know becomes sick after using synthetic cannabinoids, seek immediate medical attention. Call 911 or go to the closest emergency room. If you have questions about synthetic cannabinoids, including whether or not to go to the emergency room, please call your healthcare professional or contact your local poison center by calling 1 800 222 1222. • Scooby Snax • Kush • Kronic

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