Synthetic cannabinoids (K2)

What is K2?

Synthetic cannabinoids, also called K2, fake weed, synthetic marijuana, buddha bud, or spice, are drugs designed to act on the same receptors in the brain as THC in cannabis, but don’t cause the same high. They are chemicals produced in a lab, usually sprayed onto plant material and sold as loose flower, cigarettes, and joints. The chemicals can also be put into e-cigarettes or vapes. Synthetic cannabinoid products are often labeled “not safe for human consumption” to protect sellers from legal responsibility.

The drug was first sold as a legal cannabis alternative in Europe in the early 2000s and gained popularity in the United States a few years later. Synthetic cannabinoids remain widely available because their chemical structures can be changed slightly, creating new versions to evade the law. This makes it difficult to schedule or regulate them quickly. Because of these factors, people may encounter products with unknown potency and unpredictable effects.

What are the effects and health risks of synthetic cannabinoids?

Though the high that people get from synthetic cannabinoids is different from that they get from the cannabis plant, people use synthetic cannabinoids primarily because they are inexpensive, accessible, potent, and often undetectable on standard drug screenings. This makes them appealing to people under institutional monitoring, like probation or parole.

However, synthetic cannabinoids are constantly changing, so their dosage and effects are unpredictable and can be much stronger than cannabis, ranging from euphoria to psychosis. Some of the side effects associated with synthetic cannabinoids include:

  • Severe Agitation and psychosis

  • Seizures

  • Cardiovascular problems (tachycardia, hypertension)

  • Sedation/Coma (loss of consciousness)

  • Hyperthermia (overheating)

Most of the effects of K2 go away within a few hours, though in some cases, symptoms can lead to dangerous complications that may require emergency care or hospitalization.

If someone is experiencing the following symptoms after using a synthetic cannabinoid, call 9-1-1 or seek emergency care:  

‍Psychological or behavioral symptoms:

  • Delusions

  • Psychosis

  • Violent behavior

  • Suicidal thoughts

Neurological (brain health) symptoms:

  • Sedation or loss of consciousness

  • Seizures

  • Strokes

Other physical symptoms:

  • Chest pain or irregular heart rate

  • Severe nausea and vomiting

At this point, the long-term effects of K2 use are not yet known. Because of the symptoms associated with the drug, using K2 could cause lasting damage to the heart and kidneys.

Is K2 legal in Pennsylvania?

Synthetic cannabinoids are illegal in Pennsylvania. The Pennsylvania Controlled Substances, Drugs, Devices, and Cosmetics Act (35 P.S. § 780-101) classifies K2 analogs as Schedule I drugs. Legal consequences vary depending on the amount of the drug someone has or whether they are actively selling it or intend to sell it.

However, there are many variants of synthetic cannabinoids, and those variants are created much faster than regulators can keep track of them. Many products containing synthetic cannabinoids are sold at gas stations and smoke shops across the country. These products are unregulated and may be unsafe to consume.

Semi-synthetic cannabinoids (Delta-8)

A newer class of drugs, semi-synthetic cannabinoids, has become popular during the past several years. These are drugs that are created from the cannabis plant that are chemically altered. Delta-8 is the most popular. Usually, the plants’ composition is altered to make the psychoactive chemicals more potent, rendering the effects unpredictable and exposing users to untested, unregulated chemicals.

Harm reduction for synthetic cannabinoids

If you or someone you know uses K2, spice or similar substances, there are things you can do to use them more safely and prevent further risk of dangerous health effects.

  • Using the smallest amount possible can reduce risk, since potency can vary widely from product to product.

  • Go slow. Effects can come on suddenly and intensely.

  • Mixing K2 with other substances, especially alcohol, opioids, benzodiazepines, or stimulants, increases the risk of dangerous reactions.

  • Using in a familiar, safe environment where medical help is accessible can reduce the risk of injury or delayed care.

  • Products marketed as legal or undetectable are not necessarily safe, and newer versions may be more dangerous and unpredictable.

  • K2 products often contain unknown chemicals or contaminants, and labels are frequently inaccurate or misleading.

References

Castaneto MS, Gorelick DA, Desrosiers NA, Hartman RL, Pirard S, Huestis MA. Synthetic cannabinoids: epidemiology, pharmacodynamics, and clinical implications. Drug Alcohol Depend. 2014;144:12-41. doi:10.1016/j.drugalcdep.2014.08.005

New York Department of Health. K2: What Clinicians Need to Know. Ny.gov. Published 2015. https://www.health.ny.gov/diseases/aids/consumers/prevention/oduh/k2_clinicians.htm

Yeruva RR, Mekala HM, Sidhu M, Lippmann S. Synthetic Cannabinoids-"Spice" Can Induce a Psychosis: A Brief Review. Innov Clin Neurosci. 2019;16(1-2):31-32.