Spice, K2, and Synthetic Marijuana Abuse and Withdrawal

An alarming trend of new alternatives to illicit drugs has taken the world by storm for those seeking a “legal high” that they may deem “safer.” At the top of the list is that of synthetic cannabinoid products often called Spice and K2 as well as by the misnomer synthetic marijuana. These products are often marketed as “herbal” or “natural” while in truth they are chemical compounds manufactured in laboratories. Synthetic cannabinoids may be similar in effect to marijuana and may be sprayed onto herbal materials, giving rise to the name fake weed.

Synthetic cannabinoids are usually designed to mimic the psychoactive ingredient in marijuana, delta-9-tetrahydrocannabinol, or THC, although according to NPR, these products may be 100 times more potent than marijuana. This is due in part to the fact that synthetic cannabinoids may work better at binding to the cannabinoid receptors in the brain, increasing the risk for overdose or adverse side effects that may include vivid hallucinations, delusions, paranoia, or other psychotic symptoms.

Synthetic cannabinoids are sold in foil packages, or in vials of liquid, labeled “not for human consumption” and as “herbal incense,” or “potpourri” at head shops, music stores, gas stations, and online. They are often smoked, vaped in an e-cigarette, or added to food or drinks as edibles.

Synthetic cannabinoids have many different chemical makeups, many with cannabimimetic properties. They go by a variety of names on the street in addition to Spice, K2, and synthetic marijuana, such as:

  • Spice Silver or Gold
  • Yucatan Fire
  • Blaze
  • Zohai
  • Black Mamba
  • Bliss
  • Genie
  • Blonde
  • Red X Blend
  • Sky High
  • Skunk
  • Moon Rocks
  • Galaxy Gold
  • Scooby Snax
  • Black Voodoo
  • Green Giant
  • Smacked
  • Wicked X
  • Ninja
  • Mojo
  • Bizzaro
  • AK-47
  • Citron
  • Nice Guy

Synthetic cannabinoids may cause effects similar to marijuana, such as altered perceptions, relaxation, and increased pleasure, but they may also raise heart rate and blood pressure to dangerous levels and induce psychosis, violence, or suicidal thoughts. These drugs may be addictive as well, the National Institute on Drug Abuse (NIDA) reports.

Synthetic drugs can be unpredictable, and users may never know what exactly is in the compound they are ingesting, thus increasing the odds for a dangerous interaction with potentially life-threatening consequences. Fortunately, abuse and addiction to synthetic cannabinoids may be treated in a similar fashion to marijuana abuse and addiction, through substance abuse treatment programs that include behavioral therapies and counseling, as well as complementary therapies to treat the whole person emotionally, spiritually, and physically.

Spice Abuse Trends

Since the first seizure of Spice, or synthetic cannabinoids laced into plant material, was reported in Ohio in 2008, there have been numerous attempts to control and regulate these potentially dangerous drugs within the United States by the Office of National Drug Control Policy (ONDCP), the Drug Enforcement Administration (DEA), and the U.S. Food and Drug Administration (FDA). In 2012, the Synthetic Drug Abuse Prevention Act was passed that placed many of the known synthetic cannabinoids into the Schedule I classification, meaning that these drugs were now considered illegal, dangerous, and with no accepted medical purpose.

Prior to the scheduling of these synthetic cannabinoids, the Monitoring the Future (MTF) Survey of 2012 reported that synthetic marijuana was the second most popular drug abused by high school seniors that year behind only actual marijuana, with 11.4 percent of 12th graders abusing it in the year prior to the survey. Synthetic drugs may be increasingly popular with young people who may be ordering them off the Internet and exploring new methods and strains to abuse from a variety of pro-drug websites. The journal Addiction Science & Clinical Practice published that designer drugs, which are drugs created in laboratories for their psychoactive effects, are commonly abused by those in their teens all the way up to those in their 40s, and they are most commonly abused by males in their mid to late 20s.

In 2011, almost 80 percent of the close to 30,000 people seeking emergency department treatment for a reaction to synthetic cannabinoids were male, the Drug Abuse Warning Network (DAWN) reported, thus indicating that these drugs may be more popularly abused by men than women. Also, many synthetic drugs do not appear on regular drug tests, so the journal Social Work Today reports that they may be popular drugs of abuse for individuals who are required to submit to regular toxicology screens.

After the drug’s scheduling in 2012, the MTF Survey of 2014 found that synthetic marijuana usage seemed to decline among 8th, 10th, and 12th graders; however, this could just be due to the fact that the compounds that were known to be synthetic cannabinoids and put under federal control were altered in order to avoid such regulation.

The American Association of Poison Control Centers (AAPCC) reported that there were almost 8,000 exposures to synthetic cannabinoids in 2015, around double the amount of exposures the year before.

NIDA reported a staggering 160 hospitalizations for negative reactions to synthetic cannabinoid products in mid-April 2015 in northeastern states.

Early on, Spice may have been a formulation of CP-47/479 or JWH-018, the United Nations Office on Drugs and Crime (UNODC) reported, which was subsequently banned in America by authorities in 2012. In its place, other compounds, XLR-11, UR-144, and AKB48, were created. They were found to be dangerous and commonly abused, and thus, they were placed under federal control in 2013, the DEA published. Chemists and drug manufacturers were not deterred, however. In 2015, AB-PINACA, AB-CHIMNACA, and THJ-2201 were soon created and placed under control by the DEA.

The DEA’s Drug Threat Assessment of 2014 reported that abuse and availability of synthetic cannabinoids were likely to continue to increase. Authorities struggle to keep up with the changing chemical compounds. As control over one or two synthetic cannabinoids, sometimes referred to as SCs, is established, several more pop up that are technically legal since they vary slightly in makeup from the outlawed varieties.

Synthetic Marijuana and Addiction

treatment optionsDrugs that alter perceptions and moods, or produce mind-altering effects, are changing the chemistry in the brain in order to do so. THC works by binding to cannabinoid receptors in the brain and interferes with the endocannabinoid system, a part of the nervous system partially responsible for time and sensory perception, thinking abilities, memory, pleasure, coordination, and movement, NIDA reports. Like many other drugs, marijuana and synthetic marijuana disrupt the natural production of dopamine, one of the neurotransmitters that signals a person to feel pleasure. With regular use of synthetic marijuana, the brain may get used to these alterations and even expect the drug’s influence in order to function “normally.” Without the drug stimulating the release of dopamine, for example, a person may have trouble feeling happy as the body will not produce this chemical messenger as readily without help from its expected outside influence. As dopamine levels in the brain drop and synthetic marijuana leaves the bloodstream, depression, anxiety, irritability, and restlessness may be common withdrawal symptoms.

NIDA estimates that around 9 percent of people who use marijuana will develop a dependence on the drug. For users who start as teenagers, the number increases to 17 percent. Daily users may become dependent between a quarter to half the time.

Since synthetic cannabinoids act in much the same way in the brain and on the nervous system, it is likely that individuals abusing these drugs become dependent and addicted in a similar fashion. Once dependence is established, it may be relatively easy for addiction to manifest. Dependence is a physical reaction by the brain and body to changes in its chemical circuitry caused by drug abuse, while addiction has many behavioral symptoms. An individual who is addicted to synthetic cannabinoids is also dependent on these drugs, although not everyone who develops dependence will suffer from addiction.

Some of the signs that an individual is addicted to a synthetic cannabinoid include:

  • Inability to stop using the drug, even after many attempts
  • Sleeping at odd times
  • Using higher doses of the drug and for longer than intended
  • Tolerance to the drug, meaning that someone will have to take more of it in order to feel “high”
  • Use of the drug even when it is understood that there will be undesired physical, emotional, or social consequences
  • Decline in ability to fulfill school, work, or family responsibilities or obligations, potentially resulting in loss of employment or a sharp drop in grades at school
  • Using the drug in potentially hazardous situations
  • Social withdrawal and decreased interest in anything outside of drug use
  • Increased secrecy and increased time spent online in drug abuse forums or ordering from sites that sell synthetic cannabinoids
  • Changes in appetite and possible weight fluctuations
  • Mood swings, erratic behavior, and potentially even a shift in personality
  • Potential legal or financial troubles relating to drug abuse
  • Withdrawal symptoms when the drug leaves the bloodstream

Addiction is considered a disease, and like many other chronic diseases, it is treatable and can be effectively managed.

Getting Help for Synthetic Cannabinoid Abuse and Addiction

There are several methods of addiction treatment available. In order to determine which type might be the most beneficial for an individual, several factors must be taken into consideration. One such factor may be the presence of a co-occurring mental health disorder, which means that a person may suffer from both addiction and mental illness at the same time. An estimated half of all adults battling serious mental illness also struggle with a substance use disorder, Psychology Today reports.

Marijuana use, and therefore likely synthetic marijuana use as well, may be linked to an increased risk for psychological disorders like anxiety, depression, amotivational syndrome, and schizophrenia. These disorders may be related to changes in the brain caused by long-term and regular abuse of the drug, NIDA reports. When someone suffers from co-occurring disorders, regardless of which one may have come first, specialized treatment that focuses on caring for a dual diagnosis in an integrated fashion may be the optimal course of action.

Demographics and age can be factors in substance abuse and addiction treatment as well.

getting help from friends
For instance, adolescents may do best in a peer-centered and young adult or teenage treatment program that can focus on the specific circumstances and needs of this population group. Education for families and preventative tactics that can help explain the dangers of synthetic drug abuse in a nonconfrontational and accessible manner may be helpful as well.

A person’s level of dependency on drugs, and potential abuse of additional drugs or alcohol, may also be relevant when deciding on a treatment plan. Someone who has been abusing drugs for a long time or who abuses multiple substances may be best suited to care in a comprehensive residential treatment program that strives to treat the whole person by addressing the physical, social, and emotional aspects of drug abuse and addiction.

As of yet, there are no specific medications for the treatment of marijuana, or synthetic marijuana, addiction. Sometimes, pharmaceuticals may help an individual sleep, ward off potential psychosis symptoms, and help manage withdrawal, NIDA publishes. Typically, behavioral therapies, such as Cognitive Behavioral Therapy (CBT), is beneficial in treating and enhancing recovery from drug abuse and addiction. CBT helps to define negative behaviors that may stem from self-destructive thoughts or emotions, and it can help improve stress management and coping skills. Counseling and therapy sessions in both group and individual settings can also improve communication and life skills in general.

Detox from K2: What to Expect

When people have been abusing synthetic marijuana for a long period of time, they may be significantly dependent on the drug. Detox can safely remove it from the body by helping to minimize the potential side effects of withdrawal. NIDA reports that physical symptoms and discomfort may include muscle aches, insomnia, fatigue, sweating, chills, headache, stomach cramps, fever, and changes in appetite. These symptoms usually peak within a week or so after stopping marijuana use, which is likely similar to the withdrawal and detox timeline from synthetic cannabinoids. Psychological symptoms of withdrawal, like anxiety, depression, trouble concentrating, difficulty feeling motivated, memory impairment, and a general lousy mood, may also accompany withdrawal.

The length of time that these symptoms persist may be directly related to the level of dependence, although medical detox can manage the withdrawal process, making it more comfortable. Medical detox is performed in a specialized facility that provides 24/7 medical and mental health care, and it can be very beneficial for individuals dependent on mind-altering drugs. Detox may also be done in an outpatient setting as well, as long as the person has a strong support system at home to help prevent relapse. Medical detox can minimize withdrawal symptoms with the help of pharmaceuticals or supplements, and potentially even with the use of holistic techniques that may include yoga, massage, or other complementary methods.

Herbal but Not Natural

While  Spice is often marketed as “herbal incense” and even touted as being “natural” and a “legal alternative” to marijuana, it is created in labs. Synthetic cannabinoids are actually more effective at binding to receptor sites in the brain than marijuana is, thus making them more potent and potentially more dangerous than plant-based marijuana.

Authorities continue to ban or attempt to control synthetic cannabinoids as more and more individuals are abusing these drugs and ending up in emergency rooms, or in addiction treatment centers. Treatment for synthetic cannabinoid abuse may typically follow similar methods as care for marijuana abuse and addiction, advocating therapy and complementary treatments to build a strong base for a long and sustained recovery.

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