The first thing parents should know about synthetic marijuana, says pediatric hospitalist Natalie Evans, MD, is that it is not safer than marijuana, or cannabis.
Commonly known as “Spice” or “K2,” synthetic marijuana is popular among adolescents, especially boys. Yet its use results in a growing number of emergency room visits.
The second thing parents should know is the side effects can be very different, more severe and longer lasting than cannabis.
“The term ‘synthetic marijuana’ is not accurate and is misleading,” Dr. Evans says. “The side effects are very unpredictable and can vary from one batch to the next, and they can be severe and irreversible.”
The side effects include psychosis such as hallucinations and paranoid behavior, respiratory depression, myocardial infarction, cardiac arrest, kidney failure, vomiting, hyperthermia, stroke, seizures and even death.
“These symptoms can occur after just one use,” Dr. Evans says.
Synthetic marijuana use was first reported in the U.S. in 2008. It is a group of man-made chemicals that were originally developed for academic research to attempt to mimic the effects of cannabis. The methods for synthesizing the compounds were published in the scientific literature and unfortunately they’ve been used to produce synthetic marijuana compounds for recreational drug use.
Treating patients who’ve used synthetic marijuana is difficult, which is a problem as its use appears to be on the rise.
“Recently, we have seen an increase in admissions from synthetic marijuana use,” Dr. Evans says. “Some of these patients have had severe agitation/psychosis requiring medications to treat their psychiatric symptoms.”
However, identifying synthetic marijuana use and treating it can be especially difficult.
“Synthetic marijuana is not detected on toxicology screens, so we must rely on patient self-report of use,” Dr. Evans says. “Some patients present with psychosis or altered mental status and we are unable to ask them what they have taken. And some patients will not report use.”
There is a high index of suspicion for any patient who comes to the emergency department with an altered mental status, Dr. Evans says, “even if the patient does not admit to use.”
After a battery of tests and examinations, patients with unstable vital signs or who are agitated and require sedation are admitted to the intensive care unit. Stable patients are admitted and put in the care of the pediatric hospitalist.
“There is no medication to reverse the side effects of synthetic marijuana; we can only treat the symptoms,” Dr. Evans says.
“Parents should educate themselves and their children about the dangerous side effects associated with synthetic marijuana use, and that some of these side effects may be irreversible,” Dr. Evans says. “Parents who suspect their child is abusing any drug should seek guidance from their primary care provider. Parents may also use parental controls for online purchases.”
Meanwhile, Our Lady of the Lake Children’s Hospital continues to develop and improve treatments. “We are in the process of developing a treatment protocol to standardize and improve the care for these patients,” Dr. Evans says.
This story is part of a series Amazing magazine is covering to share important drug-related topics for teens and children. Read the first part of the story, Vape and Mirrors, here.