Synthetic Marijuana Guide

According to the National Institute on Drug Abuse (NIDA), synthetic marijuana (often labeled as synthetic cannabinoid products because they attach to the same receptors in the brain as cannabis products) is synthetically produced. These products are marketed as liquids to be used in e-cigarettes or vaporized, or added to dried plant material to be vaped or smoked like marijuana products. These chemicals are vaguely related to the types of psychoactive chemicals found in the cannabis plant (e.g., THC), but they are not actually synthetic marijuana products. These chemicals are potentially dangerous.

The market for synthetic cannabinoids has declined in recent years as more and more states legalize marijuana for medicinal and even personal use. The primary market for synthetic cannabinoids is younger individuals who cannot legally obtain marijuana and marginalized individuals (e.g., homeless people) who purchase these products at gas stations or head shops because they are cheaper and easier to obtain than marijuana.

Products labeled as synthetic marijuana or synthetic cannabinoids may be manufactured abroad in countries like India, Pakistan, or China. Some of the more recognizable names for these products include skunk, Spice, and K2.

The manufacturers of these substances attempted to sidestep the law by changing their chemical composition slightly when the United States Drug Enforcement Administration (DEA) outlawed a particular chemical formulation. The DEA listed the majority of these substances as potentially dangerous, and numerous states have enacted legislation to make them illegal. Nonetheless, different forms of synthetic marijuana are still available at certain gas stations, head shops, and through other sources such as the Internet. They are often marketed as being “safe” or “legal” alternatives to cannabis products even though they are not.

Effects of Synthetic Marijuana Products

According to the DEA and NIDA, the psychoactive effects of synthetic cannabinoids (synthetic marijuana) will typically consist of:

• Feelings of euphoria and invincibility
• Relaxation and even sedation
• Alterations in sensory perception, particularly in visual and auditory sensory perception
• The potential to develop hallucinations and/or delusions (psychotic behaviors)

Some of the additional alterations of perception as a result of synthetic marijuana products include feelings of not being attached to one’s body or feeling as if things are not real (dissociation), a significantly slowed perception of the passage of time, and seeing or hearing things that are not actually there.

The ingestion of these products produces numerous physical changes that can have potentially dangerous consequences.

• These products often result in increased blood pressure and rapid heartbeat or tachycardia when used.
• Individuals often become very irritated, agitated, and even paranoid when under the influence of these substances.
• People may become violently ill and experience extreme nausea and vomiting.
• Many individuals experience delirium, which consists of disorientation, mental confusion, lethargy or hyperactive behavior, and even psychotic behavior.
• Individuals may experience significant suicidal thoughts while under the influence of these substances.
• Seizures have been reported in some users.
• Habitual users of these substances have been known to develop physical dependence on them (experiencing both tolerance and withdrawal syndromes).

Because there is quite a bit of variability in the different chemicals that are marketed as synthetic marijuana, there can be numerous individual reactions to these substances. Some individuals may experience problems with severe psychosis, whereas others may become lethargic or sedated. The syndrome of physical dependence that occurs when individuals chronically use synthetic cannabinoids is noted to be far more intense than the symptoms of physical dependence that occur as a result of real cannabis products.

Findings Regarding Physical Dependence on Synthetic Marijuana Products

An article published in the International Journal of Pharmacology in 2014 provides some of the best information regarding the symptoms of physical dependence associated with many of the products being marketed as synthetic marijuana. The development of physical dependence on synthetic cannabinoids is still reported as being relatively uncommon because chronic use of these substances is rather low; for example, individuals may be buying different chemicals every time they purchase products labeled as synthetic marijuana, Spice, etc. The 2014 article suggests that about 9-10 percent of individuals who use these products may develop physical dependence on them.

According to the available data, tolerance to these drugs appears to develop relatively rapidly. The syndrome of physical dependence associated with these drugs is more intense than the physical dependence that occurs with actual cannabis products. The symptoms of withdrawal include:

• Gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
• Muscle spasms, aches and pains, and cramps
• Cardiovascular issues, including irregular heartbeat and alterations of blood pressure
• Headaches, jitteriness, and irritability
• Mood swings, including depressive symptoms, anxiety, and, in rare cases, psychosis
• Significant cravings to use marijuana or synthetic marijuana products

The actual timeline of the symptoms associated with withdrawal is still not reliably documented, but the available research suggests that the withdrawal symptoms often appear rapidly after chronic users have discontinued their use. Many begin to experience symptoms within one day after discontinuation of the drug. The severity of the withdrawal symptoms often peaked between two and three days after they appeared, and the overall withdrawal syndrome appears to last between seven and 10 days in most cases. Some individuals found that mood swings and depression lingered for longer than 10 days.

Because many of the individuals that use these substances are younger and have not fully developed, psychological issues with anxiety and depression can be particularly dangerous and lead to bingeing on synthetic cannabinoids or other drugs or to thoughts of suicide and self-harm.

Signs One Is Abusing Synthetic Marijuana Products

Because many of the products labeled as synthetic marijuana are considered to be dangerous or illicit, any individual who buys these products should be suspected of having some type of a substance abuse issue. Individuals under the age of 21 who use any of these products should be considered to be abusing them because even in states where cannabis products are legal, they are not legal for this age group.

Some of the signs that a person may have a significant issue with abuse of synthetic marijuana are outlined below.

• Spending a significant amount of time using the product, trying to get the product, or recovering from its use
• Using the product to deal with stress or other everyday issues
• Signs that the person is having issues controlling their use of the substance, such as frequently using more of the product than originally intended, using the product for longer periods of time than originally intended, experiencing problems as a result of use of the drug, continuing to use the drug even though it is causing problems, using the drug in situations where it is dangerous or detrimental to do so, and romanticizing use of the drug
• Neglecting important commitments or duties in favor of using the drug
• Engaging in deceit, illicit behaviors, or similar activities as a result of drug use
• Numerous empty containers or packages of synthetic marijuana on the individual, in their room, car, clothes, etc.
• Becoming defensive or even aggressive when confronted about drug use
• A change in the person’s group of friends that suggests that the person is using drugs
• Development of any of the signs of physical dependence, such as tolerance and withdrawal

Treatment for Synthetic Marijuana Abuse

Treatment for any individual with any type of a substance abuse problem must be approached carefully. Younger individuals often need significant encouragement, understanding, and the support of their peers to engage in treatment-related activities. This means that many of these people need to change their peer group.

In addition, younger individuals often need some type of coercion to enter treatment, such as being forced into treatment by the legal system, parents, or as a result of losing privileges. Fortunately, according to professional sources such as NIDA, the overall outcome for individuals who are forced into treatment is similar to the outcomes for individuals who voluntarily enter treatment. However, the main problem is getting any individual to stick with the treatment program, whether they have volunteered to enter treatment or are forced into it.

The first step is to have the person thoroughly assessed by a group of mental health professionals to identify all of the issues that need to be addressed during treatment. Typically, this assessment should be performed by both a licensed physician trained in addiction issues as well as a behavioral mental health worker such as a psychologist or counselor. All aspects of the individual’s psychological, physical, emotional, and social functioning should be thoroughly examined. The assessment is designed to help develop an individualized treatment plan that will follow the empirically validated principles of successful treatment for any substance use disorder.

Once the treatment plan is in place, the individual may be required to enter a medical detox program if they have developed the signs of physical dependence (a withdrawal management program).

Following completion of a withdrawal management protocol, the person should be required to participate in substance use disorder therapy, peer support groups, and other interventions, such as medical management and other activities that have been identified in the initial assessment. Simply going through the withdrawal period without engaging in these other interventions will lead to a quick relapse. The treatment interventions used should be based on empirically supported treatment approaches.

While there is no specified time that an individual should remain in treatment for a substance use disorder, it is clear from the research that individuals need to remain in treatment-related activities for a sufficient length of time in order to develop the skills, attitudes, and support they need to avoid returning to their old ways. Very often, individuals need to be involved in treatment-related activities for many years, and many recovering alcohol and drug users find that some form of participation in recovery-related activities is required for them for decades or even for the course of their lifetime.

Younger individuals often benefit from involvement in therapy groups and peer support groups that consist of individuals who are close to them in age. Attempts should be made to ensure that at least part of their treatment involves relating to people who are similar to them. In addition, the use of treatment providers who have experience with younger individuals or who have specialized in the treatment of younger individuals can be an important factor in the success of the person’s recovery.

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