Synthetic Cannabinoids (K2, Spice): A Comprehensive Guide

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Introduction

Synthetic cannabinoids, commonly referred to as “fake weed,” “K2,” and “spice,” have gained popularity in recent years. These substances are often found in convenience stores, gas stations, and online. However, their use can have severe consequences, including severe bleeding and even death. In this comprehensive guide, we will explore the dangers of synthetic cannabinoids, their various names, and the measures taken by health professionals to address this issue.

The Dangers of Synthetic Cannabinoids

Synthetic cannabinoids are not a single drug but rather a category of substances. They consist of hundreds of different chemicals, which are sprayed on dried plant material or sold as liquids for inhalation through devices like e-cigarettes. Each year, new cannabinoid chemicals with unknown health risks emerge, making these products highly unpredictable and potentially life-threatening.

The Centers for Disease Control and Prevention (CDC) is actively monitoring outbreaks related to synthetic cannabinoids across the nation. These products have been associated with a range of adverse health effects, including severe bleeding. In fact, there was a confirmed death in Milwaukee County in 2018 linked to synthetic cannabinoid use.

Various Names for Synthetic Cannabinoids

Synthetic cannabinoids are sold under different names, which can make them difficult to identify. Some commonly used names include:

• Black Mamba
• Bling Blang Monkey
• Bombay Blue
• Climax
• Cloud 9
• Fake Weed
• Genie
• Joker
• K2
• Kisha Cole
• Legal Weed
• Matrix
• OMG
• Phantom
• Red, Blue, or Yellow Giant
• Releaf
• Scooby Snax
• Spice
• Zohai

Synthetic Cannabinoids in Wisconsin

In Wisconsin, synthetic cannabinoid use has been a cause for concern. From March 30, 2018, to July 31, 2019, the Department of Public Health (DPH) reported a total of 87 cases related to synthetic cannabinoids. These cases were confirmed and probable, with Dane, Fond du Lac, Milwaukee, Outagamie, Racine, and Rock counties being affected.

To address the issue, health professionals in Wisconsin have developed questionnaires and surveys to gather information from patients who may have used synthetic cannabinoids. The aim is to identify potential cases and provide appropriate medical intervention. If you suspect a patient has used synthetic cannabinoids, it is important to ask about their usage and check their International Normalized Ratio before releasing them.

Health Risks and Unpredictable Effects

The use of synthetic cannabinoids poses significant health risks. These substances are often marketed as a safe alternative to marijuana, but in reality, they can have unpredictable and harmful effects. The chemical composition of synthetic cannabinoids varies widely, and the potency can be much stronger than natural cannabis.

The adverse effects of synthetic cannabinoids can include:

1. Severe bleeding: Synthetic cannabinoids have been associated with cases of severe bleeding, both internally and externally. This bleeding can be life-threatening and requires immediate medical attention.
2. Psychiatric effects: Synthetic cannabinoids can cause hallucinations, paranoia, anxiety, and agitation. These effects can be especially intense and overwhelming, leading to dangerous behaviors.
3. Respiratory problems: Inhalation of synthetic cannabinoids can result in respiratory distress, including difficulty breathing and lung damage. This is particularly concerning for individuals with pre-existing respiratory conditions.
4. Cardiovascular issues: Synthetic cannabinoids can increase heart rate, blood pressure, and the risk of heart attacks. This is especially dangerous for individuals with heart conditions or cardiovascular diseases.
5. Renal and hepatic toxicity: Synthetic cannabinoids can have toxic effects on the kidneys and liver. Prolonged use can lead to organ damage and dysfunction.

Monitoring and Reporting Outbreaks

The CDC closely monitors outbreaks related to synthetic cannabinoids. Through surveillance systems and collaboration with state and local health departments, they gather data to understand the scope and impact of these substances. This information helps inform public health interventions and strategies to address the issue.

Healthcare providers play a crucial role in reporting suspected cases of synthetic cannabinoid use to local health departments. By sharing information on symptoms, patient demographics, and potential sources of exposure, healthcare professionals contribute to the overall understanding and management of outbreaks.

Clinical Guidelines for Healthcare Professionals

Healthcare professionals, particularly those working in emergency departments and urgent care settings, should be vigilant when it comes to identifying and managing cases related to synthetic cannabinoids. If a patient presents with unexplained bleeding or other symptoms associated with synthetic cannabinoid use, healthcare providers are encouraged to:

1. Inquire about synthetic cannabinoid use: Ask patients if they have used synthetic cannabinoids within the last three months. Use terms such as K2, Spice, Synthetic Marijuana, Fake Weed, Legal Weed, or Genie to ensure clarity.
2. Check International Normalized Ratio (INR): If the patient reports synthetic cannabinoid use or there is suspicion of use, it is important to check the patient’s INR before releasing them. Abnormal INR levels may indicate a bleeding disorder associated with synthetic cannabinoids.
3. Follow established protocols: Healthcare professionals should follow the guidelines and protocols provided by their respective institutions and public health agencies. These protocols may include questionnaires, surveys, and specific testing procedures.

Resources for Healthcare Professionals

Healthcare professionals can access a range of resources to support their understanding and management of synthetic cannabinoid cases. These resources include:

• Synthetic Cannabinoid Initial Questionnaire: A questionnaire designed to gather information from patients who may have used synthetic cannabinoids.
• Synthetic Cannabinoid One Week Follow-Up Survey: A follow-up survey to assess the progress and outcomes of patients who have reported synthetic cannabinoid use.
• WSLH Request for Brodifacoum: Information and instructions for requesting Brodifacoum testing from the Wisconsin State Laboratory of Hygiene (WSLH).
• DPH Synthetic Cannabinoid Memos: Memos specifically targeted towards different healthcare settings, including pharmacies, hospital emergency departments, urgent care clinicians, and emergency healthcare workers.

Additional Clinical Information

For healthcare professionals seeking more in-depth information on synthetic cannabinoids, the Illinois Department of Health has released a webinar. This webinar provides insights into the clinical aspects, identification, and management of synthetic cannabinoid cases.

Conclusion

Synthetic cannabinoids, also known as “fake weed,” “K2,” and “spice,” pose significant health risks and have been associated with severe bleeding and other adverse effects. Healthcare professionals play a crucial role in identifying and managing cases related to synthetic cannabinoids, and public health agencies actively monitor and respond to outbreaks. By staying informed and following established guidelines, healthcare professionals can contribute to the prevention and appropriate management of synthetic cannabinoid-related incidents.

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Disclaimer: This guide is intended for informational purposes only and should not be used as a substitute for professional medical advice. Always consult a healthcare professional for personalized guidance and treatment.