The difference between real and synthetic cannabis
CCTV footage released by police show the harmful side-effects of the drug. Credits: Video – Newshub; Image –
The Green, a gathering place in New Haven, Connecticut, near Yale University looked like a mass casualty zone, with 70 serious drug overdoses over a period spanning August 15-16, 2018.
The cause: synthetic cannabinoids, also known as K2, Spice, or AK47, which induced retching, vomiting, loss of consciousness and trouble breathing. On July 19, 2018, the US Food and Drug Administration warned consumers that another batch of synthetic marijuana had been laced with rat poison. In 10 states and the District of Columbia, hundreds of people were hospitalized with severe bleeding, and four people died.
Many parts of the US have seen episodic crises due to synthetic marijuana, the largest occurring in Mississippi, where 721 adverse events were logged between April 2-3, 2015.
Even with outbreaks aside, synthetic cannabinoids are 30 times more likely to harm you than regular marijuana. Even with these risks, 7 percent of high school seniors and approximately 17 percent of adults have tried synthetic cannabinoids. It is easy to understand why these synthetic substitutes are alluring. They are easy to purchase, relatively inexpensive, produce a more potent high and don’t emit the typical marijuana scent. And, they are much harder to detect in the urine or blood than marijuana.
As an intensive care pharmacist and clinical pharmacologist, I have been researching street drugs for over a decade to help emergency room, critical care and poison control clinicians treat overdosing patients.
Why is using synthetic marijuana risky?
When you open a packet of a synthetic cannabinoid like K2 or Spice and pour the dried vegetation into your hand, it looks like marijuana. These dried leaves and stems can be inert or come from psychoactive plants like Wild Dagga. Some of these plants are contaminated with heavy metals, pesticides, mold or salmonella.
However, synthetic cannabinoids are anything but natural. They are mass-produced overseas and then shipped in bulk to the US, where they are dissolved and then mixed with dried vegetation, which absorbs the liquid. This process is very imprecise, so the dose in one packet can differ greatly within or between batches.
The real thing. Photo credit: Newshub.
There are several hundred synthetic cannabinoids in existence, and they all stimulate cannabinoid type 1 receptors (CB1), just like the active component in natural marijuana, THC, that provides the high. But they do so with different intensities and for differing periods of time. Some incorporate the central ring structure of the THC molecule before laboratory modification, but many others do not. More problems arise because some of the synthetic cannabinoids stimulate non-cannabinoid receptors and can cause unanticipated effects as well. There is no way to know which synthetic cannabinoids are actually in the product you purchased.
Natural marijuana does not comprise only THC. The other constituents in natural marijuana such as cannabidiol actually help to temper the negative impact of THC but are absent in synthetic cannabinoids. In addition to these myriad risks, there is also a risk that synthetic cannabinoids can be adulterated with other chemicals, ranging from opioids to rat poison.
Synthetic cannabinoids were initially designed by legitimate researchers in the US and around the world who were looking to explore the function and structure of cannabinoid receptors. They did not intend for illegal drug labs to use their recipe to mass-produce these synthetic cannabinoids.
What are the consequences of using these drugs?
In addition to giving the user a high, the primary psychological and neurological effects of synthetic cannabinoid use include anxiety, agitation and paranoia, although psychosis and seizures have also occurred. The anxiety and psychosis can cause the heart to beat fast and even trigger heart attacks or strokes when the body’s adrenaline gets flowing. Many people suffer upset stomach with synthetic cannabinoids, and vomiting is also common (which is paradoxical, since medical marijuana is used to prevent vomiting). Finally, there is a risk that synthetic cannabinoids can damage both the muscles and kidneys.
Rarely, people reported having trouble breathing, but in some cases this is due to adrenaline release. In other cases, the butane that was used to extract THC from marijuana before laboratory alteration was not removed. The butane ignites during smoking and damages the lungs. Early detection and aggressive treatment for all of these adverse events can help to prevent severe adverse events or death.
Synthetics have been blamed for dozens of deaths in New Zealand. Photo credit: Getty
What can we do to protect ourselves?
Many of the risks of synthetic cannabinoids and other illegal drugs of abuse arise because of contamination, adulteration, substitution and inconsistent dosages. As long as people are able to manufacture, transport and sell these drugs secretly, there is no way to assure buyers of a consistent quality product. Public health personnel, teachers and parents need to educate adults and students alike about the inherent risks of the drugs in their pure form but should also include the risks associated with poor manufacturing practices.
People generally prefer natural marijuana to synthetic forms, but as long as natural marijuana remains illegal, highly desired, easily detected and periodically unavailable, the desire to purchase synthetic forms will persist.
Finally, synthetic cannabinoids are primarily manufactured overseas. Foreign governments, especially in Asia, need to crack down on illegal drug factories and better scan freight for illegal drugs. In addition, all shipping companies need to do more to detect the illegal transport of drugs into the US. There are hand-held detectors that can help identify some but not most synthetic cannabinoids. However, detection will still be painstakingly slow.
C. Michael White is a professor and head of the Department of Pharmacy Practice at the University of Connecticut.
Synthetic cannabinoids are anything but natural.
What to Know About Synthetic Marijuana (Fake Weed) Use
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Synthetic cannabinoids, also called synthetic marijuana or fake weed, have been used by many as an alternative to marijuana since products were first introduced in 2002. Despite the fact that these man-made products were created in laboratories to help scientists study the cannabinoid system in the human brain, they often claim to be made of “natural” material from a variety of plants.
Hundreds of synthetic cannabinoids exist and the effects can be unpredictable and even life-threatening.
Also Known As: There are countless fake weed products being sold as herbal smoking blends, legal bud, herbal smoke, marijuana alternatives, fake weed, or herbal buds. This makes it difficult for parents and other adults to identify them. Some of the brand names include Blaze, Blueberry Haze, Dank, Demon Passion Smoke, Genie, Hawaiian Hybrid, K2, Magma, Ninja, Nitro, Ono Budz, Panama Red Ball, Puff, Sativah Herbal Smoke, Skunk, Spice, Ultra Chronic, and Voodoo Spice.
Drug Class: Synthetic marijuana products are classified as new psychoactive substances (NPS), or unregulated mind-altering substances intended to produce the same effects as illegal drugs.
Common Side Effects: Side effects of the drug include elevated mood, relaxation, altered perception, symptoms of psychosis, extreme anxiety, confusion, paranoia, hallucinations, violent behavior, suicidal thoughts, rapid heart rate, raised blood pressure, vomiting, kidney damage, and seizures.
How to Recognize Fake Weed
Synthetic marijuana often contains a mixture of dried leaves from traditional herbal plants. They are various colors, including green, brown, blonde, and red, and often sold in small packets approximately two by three inches. The packets are often colorful foil packs or plastic zip bags. Some online sellers of legal fake weed products do so with disclaimers like “not for human consumption.”
What Does Synthetic Marijuana Do?
Fake weed works on the same brain cell receptors as THC or delta-9-tetrahydrocannabinol (the psychoactive ingredient in marijuana that gets you high). It is typically smoked, brewed in tea, or vaped. Many of these products are legally marketed as “herbal incense” or “potpourri”.
Some people who use herbal buds say that it produces a high similar to that of marijuana, but it doesn’t last as long. Others experience a relaxed feeling, rather than the “head high” that real marijuana produces. Also of note is the “harsh” taste, which people say “makes your throat burn and your lungs ache” long after you smoke.
Since there are no standards for making, packaging, or selling synthetic weed, it’s impossible to know the type and amount of chemicals in each product as well as what the fake weed will do to you.
What the Experts Say
Although they are often marketed as “100% organic herbs,” none of the fake weed products on the market are completely natural. They have all been found to contain various synthetic cannabinoids, or chemicals produced in laboratories.
Originally, fake marijuana products contained a chemical called HU-210, which has a molecular structure very similar to THC. Because HU-210 is listed as a Schedule I controlled substance in the United States, these fake weed products were manufactured and sold only in Europe.
Since then, new synthetic cannabinoid agonists have been created. They are too numerous to list. Some are similar in structure to THC; others are not. Some are classified as controlled substances. By using different synthetic marijuana mixtures, manufacturers are able to continue to legally market their products in the United States when another formulation becomes illegal.
According to the DEA, the majority of these chemical compounds are produced in Asia with no regulations or standards. They are then smuggled into the United States where they are sprinkled onto “plant material,” packaged and ultimately sold in tobacco shops, convenience stores, and the like.
Some of these chemicals are still legal. However, since synthetic marijuana first hit the market, more than 20 of these compounds have become controlled in some way at the federal level. At the same time, they noted that more than 75 additional compounds have been identified but are not currently controlled.
In 2015, the DEA listed 15 varieties of synthetic marijuana as Schedule I controlled substances in the Drugs of Abuse resource guide. This places them in the same federal category as heroin, crack cocaine, and marijuana.
Many people buy into the idea that fake marijuana products are safe since the chemicals are “legal” and contain “natural” ingredients. However, this has proven to be false with multiple cases of severe, unexplained bleeding or bruising, and some deaths. Other reports show an increase in emergency room visits due to rapid heart rate, vomiting, violent behavior, suicidal thoughts, kidney damage, and seizures.
Some of the fake marijuana products sold commercially claim to contain herbs traditionally used for medicinal purposes, including:
- Beach bean (Canavalia maritima)
- Blue Egyptian water lily (nymphaea caerulea)
- Dwarf skullcap (scutellaria nana)
- Indian warrior (pedicularis densiflora)
- Lion’s tail (leonotis leonurus)
- Indian lotus (nelumbo nucifera)
- Honeyweed (leonurus sibiricus)
However, one study revealed that some of the herbal ingredients listed by the manufacturers could not be found in the products.
Beyond the synthetic cannibinoid HU-210, which is used by scientists to identify cannibinoid receptors in the brain and study the effects Δ-9-tetrahydrocannabinol (Δ-9-THC), there are no approved or off-label medical uses for synthetic marijuana.
Common Side Effects
While research is advancing, the effect synthetic marijuana products may have on the human body is largely unknown. To date, few studies have been published testing the effects of the chemicals on users. Within the DEA report, they note overdoses that have caused fatal heart attacks. Similarly, acute kidney injury resulting in hospitalization and dialysis have been connected to these synthetics.
One study compared the level of impairment for drivers who were arrested for intoxicated driving. One group had smoked synthetic cannabinoids and those in the other group were high on marijuana. The study found a significant increase in confusion, disorientation, and incoherence in the synthetic marijuana group. Slurred speech, a side effect not normally associated with natural cannabis use, was also reported among the synthetic cannabinoid users.
Beyond the short-term effects mentioned, an increase in blood pressure, as well as seizures, tremors, and anxiety, have been noted in synthetic marijuana users.
Whether these observed symptoms will have lasting effects, particularly on adolescents and young adult users, is not yet known. Of course, smoking any substance could have negative effects on the lungs.
“The problem with JWH-018 (a synthetic cannabinoid compound) is that absolutely nothing is known regarding its toxicity or metabolites,” says John Huffman, who helped develop the JWH-018 chemical. “Therefore, it is potentially dangerous and should not be used.” JWH-018 is also known as 1-Pentyl-3-(1-naphthyl) indole and is one of the Schedule I controlled substances listed with the DEA.
Recently, a version of synthetic marijuana was laced with rat poison, causing uncontrolled bleeding in hundreds of people and killing several others who ingested the tainted products.
If you or a loved one has used synthetic marijuana and begin experiencing severe, unexplained bleeding or bruising, call 911 or asked a loved one to take you to the hospital immediately. These are all signs of contaminated cannabinoid products.
Signs of Use
If you are a parent of a young adult, it pays to know the behaviors and physical effects of using fake weed. While exhibiting one or two of these signs might not mean that your child is using, they are all strong indicators of drug use and should be taken seriously.
- Burning incense
- Buying or using eye drops
- Possessing dried plants or herbs
- Having rolling papers or vape pens
- Receiving suspicious packages in the mail
- Displaying unusual or secretive behaviors
- Red or irritated eyes
- Pale complexion
- Acting confused
Myths and Common Questions
Perhaps one of the biggest misconceptions about herbal bud is that it is “natural marijuana.” It is not; it is created from any of several hundred man-made synthetic chemicals that are sprayed onto the chopped plant material.
Synthetic marijuana is also far more potent, containing TCH analogs or synthetic cannabinoids that can be up to 600 times more potent than THC found in marijuana. Often, additives, toxic impurities, and other types of drugs are also found in fake weed products.
Tolerance, Dependence, and Withdrawal
Regularly using “fake weed” can result in increased tolerance, or needing more and more of the drug to experience the same high. If you regularly use synthetic cannabinoids, you can also become both physically and psychologically dependent. This means if you stop abruptly, you’ll likely experience withdrawal symptoms.
Since the chemical composition of fake weed is unknown and can change from batch to batch, tolerance, dependence, and withdrawal may also vary.
How Long Does Fake Weed Stay in Your System?
How long synthetic cannabinoids stay in your system depends on several factors, including the type, how it is administered (i.e., inhaled or ingested), amount consumed, and frequency of use. Since these synthetic drugs don’t trigger a positive result on most standard urine drug tests , many people turn to these drugs in an attempt to avoid positive drug screens for employment, rehab, or legal reasons.
Long-term, regular use of synthetic cannabinoids can lead to addiction. If you have a history of mental illness or a substance use disorder, the risk of addiction is even greater.
In addition to building up a tolerance and experiencing symptoms of withdrawal, other signs of synthetic cannabinoid addiction can include:
- You use more than intended, even after telling yourself that you’ll only “take a few hits.”
- You are unable to cut down or stop and have likely failed numerous times at quitting.
- You spend lots of time getting high, often at the expense of spending time with loved ones or doing activities you once enjoyed.
- You continue to use despite any problems with family and friends, employment, or legal troubles.
- You depend on the drug to “relax” or for creativity.
Symptoms of synthetic weed withdrawal can range from mild to severe, depending on how frequent and how long you have been using, and include the following:
- Severe anxiety
How to Get Help
If you suspect that someone you love is using synthetic marijuana, the most important thing you can do is spend time with them, communicate the dangers of fake weed, and watch for any signs of use. While behavioral therapies and medications have yet to be specifically tested for the treatment of synthetic cannabinoid addiction, a health care professional can work with you and your loved one to safely detox from the drug as well as identify and treat any co-occurring mental illness.
In addition to getting a recommendation from a trusted health care professional, the Partnership at DrugFree.org has a helpline and tips so families know what to ask when vetting a rehab.
If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Learn what experts have to say about synthetic marijuana or "fake weed" as well as common side effects, myths, signs of use, and risk for addiction.