By Roland Macher, Tod W. Burke, Ph.D., and Stephen S. Owen, Ph.D.
In Florida, a 14-year-old boy was admitted to the emergency room after experiencing seizures and difficulty breathing. He and his brother had smoked herbal incense, referred to by local police as Mr. Nice Guy.1 In another case, a 17-year-old boy in western Texas was hospitalized in May 2010 after smoking synthetic marijuana before school. After feeling sick on the bus ride to the campus, his symptoms became progressively worse. He was admitted to the hospital, treated, and released within the same day.2 Statistics indicated that emergency room visits across the country due to the use of synthetic marijuana have risen from 13 in 2009 to approximately 560 in the first half of 2010.3
In March 2011, the U.S. Drug Enforcement Administration (DEA) temporarily placed five synthetic chemicals—JWH-018; JWH-073; JWH-200; CP-47, 497; and cannabicyclohexanol—into Schedule I of the Controlled Substances Act (CSA).4 These substances produce druglike effects that resemble those resulting from tetrahydrocannabinol (THC), a cannabanoid and the primary psychoactive ingredient in marijuana, but have distinct chemical structures.5 Individuals use them to coat herbal blends and then sell these products under such names as K2, Spice, Mr. Nice Guy, Genie, and others.6 Under the DEA’s ruling, punishments for the possession or sale of these chemicals mirror those for marijuana. Law enforcement agencies should gain an understanding of synthetic marijuana, its distribution, potential harmful effects, and concerns for officers.
In 1995, a Clemson University professor used a synthetic compound to conduct research identifying the effects on the brain from cannabinoids. Following the publication of a paper detailing the experiment, the description of the method and ingredients became popular among persons searching for a marijuana-like high. People began spraying the synthetic chemical compound described in the article on dry herbs and then smoking them as they would regular marijuana.7
Mr. Macher, a recent graduate from Radford University in Radford, Virginia, currently is studying law in North Carolina.
Dr. Burke, a former police officer, serves as a professor of criminal justice and as associate dean for the College of Humanities and Behavioral Sciences at Radford University in Radford, Virginia.
Dr. Owen is an associate professor of criminal justice and core director at Radford University in Radford, Virginia.
The main chemical used to produce synthetic marijuana is JWH-018 (the initials are those of the professor conducting the Clemson University experiment), similar to THC.8 The moniker “imitation marijuana” actually may be a misnomer as no psychopharmacological differences exist between this substance and marijuana. Both chemicals are considered cannabinoids, which attach themselves to the cannabinoid, or CB, receptors in the brain. However, the synthetic compounds and THC differ in levels of potency.9
While significantly different, marijuana and the synthetics share many similarities, including their appearance, method of consumption, euphoriclike high experienced after inhaling or ingesting, negative side effects, and the concerns of law enforcement officials regarding the dangers associated with all such substances. The manufacturing of these products proves fairly simple: Individuals produce the synthetic chemicals separately and then spray them onto dry herbs and plants. Their simplistic creation and low cost ($20 to $50 for 3 grams) make synthetic forms of marijuana attractive to users.10
Smoke shops and convenience stores across the nation sell synthetic marijuana labeled as incense. Because local dealers, not laboratories, manufacture the products, health officials have concerns. The risk of contamination—and, therefore, negative side effects—increases.11 In addition to the United States, Britain, Germany, Poland, France, and Canada also have banned synthetic marijuana.12
The DEA has expressed concern about synthetic marijuana’s recreational use and its potential for harm, abuse, and addiction. The agency has controlled five synthetic cannabinoids in Schedule I under the temporary scheduling provision of the CSA, placing them in the same category as LSD, heroin, and marijuana.13 A Schedule I drug or substance has a high potential for abuse, provides no currently accepted medical use in the United States, and lacks accepted safety standards for use under medical supervision.14
In addition, the U.S. Food and Drug Administration does not approve for human consumption synthetic chemicals banned by the DEA. The increasing number of poison control center calls—2,500 through mid-December 2010—and emergency room visits from individuals smoking synthetic marijuana prompted the DEA to act quickly.15
Research identifying how consuming these chemicals may affect the body exists but has been limited. For instance, a 2011 study noted a variety of negative physical effects resulting from the use of synthetic marijuana. While most effects dissipated after several hours “with no residual adverse effects in many cases,” the study did highlight both short- and long-term impacts of synthetic marijuana as causes for concern.16
Both prior and subsequent to the DEA’s action, many states moved to ban synthetic marijuana. As of March 2011, 20 states had imposed bans either through legislation or administrative and regulatory processes. Additional legislation remains pending in 37 states. Each state differs in terms of how it approaches synthetic marijuana. For example, among states, some have listed it as a Schedule I drug while others have not, definitions of what constitutes synthetic marijuana differ, and penalties (including classification as a felony or misdemeanor) also vary.17 In spite of the differences, the theme is clear: States see synthetic marijuana as a significant concern.
Potential Harmful Effects
The DEA’s recent restriction provides federal regulations that allow law enforcement officials throughout the country to crack down on the use of synthetic marijuana. One state senator recognizes that the illicit drug market will adapt to the bans on synthetic marijuana, perhaps increasing the street demand for the substance; however, he still believes that laws will successfully minimize “the threat to public safety.”18
According to the American Association of Poison Control Centers, some users of synthetic marijuana have reported “a fast, racing heartbeat, elevated blood pressure, and nausea.”19 In addition, research found that the chemicals in synthetic marijuana “are three to five times more potent than THC found in marijuana,” leading to symptoms, including “loss of consciousness, paranoia, and, occasionally, psychotic episodes.”20 Research in Germany also discovered that synthetic marijuana use can lead to “withdrawal symptoms and addictive behaviors.”21
One researcher, a toxicologist and the director of the Missouri Regional Poison Center (MRPC), conducted a study on the effects of synthetic marijuana on humans. He has observed over 30 instances in which teenagers have had negative reactions after using the substances, including harmful effects on the “cardiovascular and central nervous systems.”22 One death has potential links to synthetic marijuana—a teenager in Iowa committed suicide after using a synthetic. The young man’s friend said the victim “‘freaked out’ from the drug.”23
The MRPC expert further concluded that symptoms resulting from use of the synthetics differ from those of marijuana. In addition to the observable symptoms, such as elevated heart rate and blood pressure and muscle twitching, agitation sometimes accompanies synthetic marijuana use. This differs from marijuana intoxication, commonly marked by “euphoria and a sense of detachment.”24 This has led some medical professionals to suggest that, perhaps, attaching the label “marijuana” to synthetic substances could be misleading because they may more appropriately be viewed as “an altogether different…chemical entity.”25
Concerns and Recommendations
A man from West Virginia overdosed after trying synthetic marijuana in February 2011. Emergency room officials stated that he experienced extreme agitation and had a heart rate of around 200, well over the normal rate of 60 to 100. Doctors were unsure how to treat him because of the lack of available information and research on the substances. Only after contacting a local poison control center did the doctors learn about synthetic marijuana and properly treat the victim, who made a full recovery.26 While the lack of information about synthetic marijuana presents a significant public health concern that emergency department physicians must address, a similar issue arises for law enforcement officials. Officers must receive training and information to raise their awareness of synthetic marijuana.
“Smoke shops and convenience stores across the nation sell synthetic marijuana labeled as incense.”
One of the potential problems with synthetic marijuana is the inability to identify the substances or recognize the immediate effects they may have on an individual. One report suggested that the aroma of synthetic marijuana contains elements of mustard, tarragon, oregano, and pepper, with additional similarity to “stale lavender…like an antique shop.”27 The same report also indicated that smoke from synthetic marijuana “smelled nothing like marijuana smoke.”28 This type of information may aid in the identification of synthetic marijuana. With the recent ban of the chemicals associated with synthetic marijuana, law enforcement officers also should be trained to identify the substances and the dangers associated with them. Medical officials should share information with police officers, particularly school resource officers, in hopes that the spread of knowledge will aid in efforts aimed at prevention and treatment of abuse.
Until society becomes better informed, law enforcement professionals and health officials must recognize the risks posed by synthetic marijuana chemicals to individuals. Drug and field tests should focus on helping to identify the substances because standard marijuana screens may not detect the chemicals.29 This also will allow medical personnel to better treat individuals under the influence of synthetic marijuana. Further research likely will aid the DEA in its determination of whether these chemicals need to be placed on the federal list of controlled substances permanently and, if so, how they should be scheduled. Although some light has been shed on the negative effects of synthetic marijuana, and the recent DEA ban has given law enforcement officials basis on which to enforce punishment, the future of these substances remains unclear. However, apparently, concerns about the risks of synthetic marijuana will continue as a topic of discussion among legislators, medical professionals, and law enforcement officers.
Synthetic marijuana is not the first type of drug that has raised such concerns, nor will it be the last. For instance, attention recently has focused on the abuse of bath salts, which have effects mimicking those of methamphetamine.30 Regardless, the increasing popularity and evident health risks associated with synthetic marijuana have raised concerns among legislators, medical personnel, and law enforcement officers across the country. The number of unreported cases of negative effects from consumption of synthetic marijuana remains unknown. The DEA designed its recent ban to address these problems, at least temporarily, giving researchers time to study the effects of synthetic marijuana.
“One of the potential problems with synthetic marijuana is the inability to identify the substances or recognize the immediate effects they may have on an individual.”
1 Linda Trischitta, “Teens Hospitalized After Smoking Mr. Nice Guy: State and Federal Governments Seek to Prohibit Legal Incense That Users Consider Fake Marijuana,” South Florida Sun Sentinal, http://articles.sun-sentinel.com/2011-01-05/health/fl-teen-legal-poy-20110105 _1_ synthetic-marijuana-smoking-incense (accessed August 31, 2011).
2 Beth Rankin, “West Brook Student Hospitalized After Smoking Fake Marijuana,” Beaumont Enterprise, http://www.beaumontenterprise.com/ news/article/West-Brook-student- hospitalized-after-smoking-730379.php (accessed August 31, 2011).
3 Alicia Fabbre, “County Tells Parents to Beware of Fake Marijuana,” Chicago Tribune, http://articles.chicagotribune.com/ 2010-12-22/news/ct-x-s-faux-marijuana -1222-20101222_1_synthetic-marijuana-drug-court-participants-fake-pot (accessed August 31, 2011).
4 Willows Journal, http://www.willows-journal.com/articles/ dea-5740-products-chemicals.html (accessed August 30, 2011); U.S. Department of Justice, Drug Enforcement Administration, “DEA Moves to Emergency Control Synthetic Marijuana,” http://www.justice.gov/dea/pubs/pressrel/ pr112410.html (accessed August 30, 2011); and Donna Leinwand, “Places Race to Outlaw K2 ‘Spice’ Drug,” USA Today, http://www.usatoday.com/ news/nation/2010-05-24-k2_N.htm (accessed August 30, 2011).
7 Sarah D. Wire, “Cops: Imitation Pot as Bad as the Real Thing,” Utah Standard-Examiner, http://www.standard.net/topics/drugs/2010/02/17/ cops-imitation-pot-bad-real-thin (accessed August 31, 2011).
8 U.S. Department of Justice, Drug Enforcement Administration, “DEA Moves to Emergency Control Synthetic Marijuana.”
9 Melissa Jones, “Researchers Find Legal High More Potent Than Marijuana,” AFRO, http://www.afro.com/ sections/news/Baltimore/story.htm? storyid=2341 (accessed August 31, 2011).
10 John Gehringer, “K2 Ban Bill Moves to Senate,” The Maneater, http://www.themaneater.com/ stories/2010/3/5/k2-ban-bill-moves-senate/ (accessed August 31, 2011).
12 Katie Drummond, “Synthetic Marijuana Explained: Quick Facts About K2,” AOL News, http://www.aolnews.com/2010/07/12/ synthetic-marijuana-explained-quick-facts-about-k2/ (accessed August 31, 2011); and “Synthetic Marijuana Seized at Seven Calgary Stores,” Calgary Beacon, http://www.calgarybeacon.com/2011/01/synthetic-marijuana-seized-at-seven-calgary-stores/ (accessed August 31, 2011).
13 U.S. Department of Justice, Drug Enforcement Administration, “DEA Moves to Emergency Control Synthetic Marijuana.”
14 21 U.S.C. §812 (13)(b)(1).
15 Jessica Wehrman, “Fake Marijuana Spurs More Than 2,500 Calls to U.S. Poison Centers This Year Alone,” American Association of Poison Control Centers, http://www.aapcc.org/dnn/Portals/ 0/K2releasedec21.pdf (accessed August 31, 2011).
16 Daina L. Wells and Carol A. Ott, “The ‘New’ Marijuana,” Annals of Pharmacotherapy 45, no. 3 (2011): 414-417.
17 National Council of State Legislatures, “Legislation on Synthetic Cannabinoids as of March 21, 2011,” http://www.ncsl.org/default.aspx?tabid=22431 (accessed August 31, 2011).
18 Alan S. Zagier, “Bans on Fake Pot in 13 States Do Little to Deter Business,” New Orleans Times Picayune, http://www.nola.com/crime/index.ssf/2010/09/bans_on_fake_pot_do_little _to.html (accessed on August 31, 2011).
19 Jessica Wehrman, “Fake Marijuana Spurs More Than 2,500 Calls to U.S. Poison Centers This Year Alone.”
20 Katy Bergen, “Kansas Lab Looked at Synthetic Marijuana’s Effect on Brain,” The Columbia Missourian, http://www.columbiamissourian.com/stories/2010/02/17/legal-substance-mimic-marijuana-has-harmful-effects/ (accessed August 31, 2011).
22 Sarah D. Wire, “Update: Toxicologists Studying Effects of Synthetic Pot,” The Columbia Missourian, http://www.columbiamissourian.com/stories/2010/03/03/toxicologists-studying-effects-synthetic-pot/ (accessed August 31, 2011).
23 Jason Kuiper, “Busts Begin for K2 Possession,” Omaha World-Herald, http://www.omaha.com/ article/20110315/NEWS97/303159904/10 (accessed August 31, 2011).
24 David Vearrier and Kevin C. Osterhoudt, “A Teenager with Agitation: Higher Than She Should Have Climbed,” Pediatric Emergency Care 26, no. 6 (2010): 462-465.
26 Keith Morris, “Synthetic Drug K2 Causes Overdose in Kanawha County, W.VA,” Charleston Environmental News Examiner, http://www.examiner.com/environmental-news-in-charleston/ synthetic-drug-k2-causes-drug-overdose-kanawha-county-w-v (accessed August 31, 2011).
27 Keegan Hamilton, “Daily RFT Product Testing Laboratory: K2 Synthetic Marijuana,” DailyRFT Blogs, http://blogs.riverfronttimes.com/dailyrft/2010/02/daily_rft_product_testing_laboratory_k2 _synthetic_marijuana_does_it_really_get_you_high.php (accessed August 31, 2011).
28 Keegan Hamilton, “Daily RFT Product Testing Laboratory: K2 Synthetic Marijuana.”
29 David Vearrier and Kevin C. Osterhoudt, “A Teenager with Agitation.”
30 John Gramlich, “‘Bath Salts’ Pose New Test for Law Enforcement,” Stateline, http://www.stateline.org/live/details/story?contentId=548769 (accessed August 31, 2011).