An example of "spice." (Associated Press file)

Synthetic cannabinoids are not “synthetic marijuana”: What you need to know about Spice and K2

Hey, Cannabist!
What’s the deal with Spice? Is it synthetic marijuana? I’m confused because people have died from using Spice. If it is an artificial version of marijuana, why are deaths attributed to its use?
–Conclusive Cameron 

Hey, Cameron!
Great question! Let’s clear up a few things about fake pot, shall we?

Synthetic marijuana is a misnomer and the substance is not derived from cannabis plants at all.

The substance goes by many names on the street — Spice, K2, Black Mamba, Mr. Nice Guy, Blaze and dozens of others. Spice is made to look and smoke like ground-up marijuana buds or is sometimes formulated into liquid vape juice; either way it is consumed, it can produce extreme effects in the body.

The smokable Spice is made by taking shredded and dried plant material and spraying it with synthetic cannabinoids (SCBs — the acronym varies, some researchers refer to them as SCs). The synthetic cannabinoids such as artificial THC are made from chemicals and manufactured in formulations that have changed over the years in order to dodge federal restrictions.

According to the Diversion Control Division of DEA, in 2008, Spice started to appear for sale in convenience stores, gas stations, head shops and online. It is often packaged in bright foil wrappers, and typically mislabeled with a message saying it’s “Natural incense: Not intended for consumption.” The products may be touted as a “legal” form of marijuana, and undetectable by mandatory drug test screens.

what is synthetic marijuana? Synthetic cannabinoids explained
An assortment of Spice products removed from O’s Pipes and Tobacco as part of the four Spice-related cases filed by Colorado Attorney General Cynthia H. Coffman. (Colorado Attorney General’s office)

Originally, SCBs began as lab research compounds. The synthetic cannabinoids, like the natural plant compounds in marijuana such as tetrahydrocannabinol (THC) and cannabidiol (CBD), engage with the endocannabinoid system in the body.

How the body’s endocannabinoid system works

There is a difference between SCBs and naturally occurring cannabinoids found in marijuana plants in how they interact with the endocannabinoid system.

Pharmacist and educator Kari L. Franson, who’s an associate dean at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, explains that in the body, the difference between synthetic and naturally occurring THC at the endocannabinoid receptor sites is like water pressure in a hose.

“I do know that (Spice) is a full agonist at the cannabinoid receptors,” Franson told The Cannabist. “This is in contrast to our bodies’ own endocannabinoids and THC, which are partial agonists. Essentially, the full agonist turns the receptors on 100 percent versus a partial that may only do 50 percent.  Think of a garden hose versus a fire hose … even with a higher dose of water, only so much can come out of the garden hose.”

In other words, synthetic cannabinoids completely open the receptor doors in the brain, while natural cannabinoids partially open the receptor doors.

This physiological difference means hits of Spice are more intense than marijuana. While Spice has been said to produce psychoactive effects similar to marijuana such as relaxation and elevated mood, it can also have more drastic repercussions. In March 2017, Trends in Pharmacological Science, published a review of synthetic cannabinoids as an illicit drug and stated:

“SCBs present in K2/Spice products produce a variety of dangerous acute and chronic adverse effects, including psychosis, seizures, tolerance, dependence, and death, with a greater severity and frequency than observed following marijuana use.”

That’s not good!

Despite any claims on product packaging, Spice is not legal in the United States. In 2011, the U.S. Drug Enforcement Administration placed five SCBs under federal Controlled Substance Schedule I, the most restrictive classification. The DEA added more SCBs to Schedule I in 2015 and 2017. The SCB formulas in Spice have been known to change to elude state and federal regulations that outlaw a specific SCB chemical formula. These undisclosed formula changes also create additional risks for consumers who don’t know the difference.

Synthetic cannabinoids and drug testing

Although Spice is touted to fool drug tests, one group of experts say Spice use can indeed be uncovered by drug tests. The American College of Medical Toxicology says that although synthetic cannabinoids are not detected in drug screens for marijuana, specialized screens can reveal the presence of synthetic cannabinoids.

In Colorado, periodic flares of emergency room visits have been linked to Spice use. One of the largest outbreaks was in August 2013, with 221 emergency room visits that were attributed to Spice. Although no one died, according to an incident report from the Centers for Disease Control, the patients — predominantly young men — had increased blood pressure and heart rates and exhibited various behaviors such as somnolence, aggression, agitation and confusion. In 2015, 15 deaths in the U.S. were attributed to Spice. Similar to the 2013 Colorado patient summary, nationally the patients who were treated tended to be young — 26 was the average age — and predominantly male.

Additional side effects listed by the American College of Medical Toxicology on a resource page created by Dr. Scott Lucyk include: hallucinations/psychosis, seizures, heart attack, nausea and vomiting, and kidney failure. Lucyk additionally noted that synthetic cannabinoids are known to cause physical dependence and can trigger withdrawal symptoms when use is stopped.

This wraps up the rundown on the illicit drug Spice. To sum up, it’s best to stay safe, natural and legal with your cannabinoid use. XO