Synthetic cannabis, also known as Spice, AK-47 or K2, has received extensive news coverage after overdoses and deaths increased after these drugs became available in 2014. Synthetic cannabis can cause bizarre behavior, disorientation, and violence. For several years, synthetic drug overdoses and deaths were growing until recent cannabis policy changes. A study published in the Journal of Clinical Toxicology found that poisonings and deaths due to Spice and other designer drugs decreased in states that have legalized cannabis.
The retrospective study analyzed National Poison Data System (NPDS) data from 2016 to 2019 and traced synthetic poisoning reported incidents and annual state cannabis law and market status during this time period. States were categorized into restrictive (cannabis illegal or limited medical legalization), medical (allowing THC-containing medical cannabis use) and permissive (allowing non-medical use of THC-containing cannabis by adults). The data included 7,600 calls to NPDS regarding synthetic cannabinoid poisoning. 64.8% of these cases also required medical attention. 61 deaths were reported during this three-year period. There were 13% fewer poisoning reports in medical states and a 37% decrease in permissive states.
Spice intoxication may be a possibility when there is extremely agitated, paranoid, and bizarre behavior and significant cognitive impairment. The risk of subsequent psychosis triples with use of designer drugs. However, synthetic cannabis is not even truly cannabis; the only similarity is that natural cannabis and synthetic cannabinoids both act on the same receptors as cannabinoids. Natural cannabis is a partial agonist at the CB1 receptor whereas synthetic cannabinoid is a full agonist with no cannabidiol to mitigate potential psychotic effects. Synthetic cannabinoids have 800 times greater binding affinity than natural cannabis.
Accessibility to safe and natural cannabis products plays a critical role in reduction of life-threatening synthetic cannabinoid poisonings. The opening of medical cannabis markets was associated with 36% fewer reported exposures. The researchers concluded that more permissive cannabis law may lessen the motivation and harms associated with use of synthetic cannabis products.
Source: Journal of Clinical Toxicology
