From the Guidelines
Synthetic cannabinoids like K2 can cause severe health effects, and treatment is primarily supportive care, with no specific antidote available. The effects of K2 use can include rapid heart rate, vomiting, agitation, confusion, hallucinations, psychosis, seizures, kidney damage, and in some cases, death 1. Medical management typically includes:
- Monitoring vital signs
- Providing intravenous fluids
- Administering benzodiazepines like lorazepam (1-2 mg IV) or diazepam (5-10 mg IV) for agitation or seizures
- Antipsychotics such as haloperidol (2-5 mg IV/IM) for severe psychosis
- Beta-blockers like metoprolol (25-50 mg orally) for cardiovascular symptoms
Long-term treatment involves substance use counseling, cognitive behavioral therapy, and possibly rehabilitation programs, with recovery support groups also being beneficial 1. It is essential to note that K2 is particularly dangerous due to its varying composition between batches, making effects unpredictable, and its potential to bind more strongly to brain receptors than natural cannabis, leading to more intense and dangerous reactions 1. Anyone experiencing severe symptoms after K2 use should seek immediate medical attention, as complications can develop rapidly and become life-threatening. The recent resurgence of synthetic cannabinoid receptor agonists as adulterants in the era of cannabis legalization highlights the urgent need for clinical preparedness and robust quality control measures to mitigate the health risks associated with intentional and unintentional use of synthetic cannabinoids 1.
From the Research
Effects of Synthetic K2 Drug Use
- The use of synthetic K2 (synthetic cannabinoids) has been associated with higher rates of toxicity and hospital admissions compared to natural cannabis 2.
- Common reported toxicities with SCB use include tachycardia, agitation and irritability, drowsiness, hallucinations, delusions, hypertension, nausea, confusion, dizziness, vertigo, and chest pain 2.
- Acute kidney injury has also been strongly associated with SCB use 2.
- Synthetic cannabinoids may exhibit higher toxicity than THC and longer-lasting effects, with a higher potential to trigger a convulsive crisis, a decline in consciousness, and hemodynamic changes 3.
- The prevalence of neuropsychiatric symptoms is higher in third-generation SCs, and their use may be harmful, especially in people with epilepsy and schizophrenia 3.
Treatment of Synthetic K2 Drug Use
- Treatment for synthetic K2 drug use mostly involves symptom management and supportive care 2.
- More research is needed to identify which contaminants are typically found in synthetic marijuana and to understand the interactions between different SBCs to better predict adverse health outcomes 2.
- The role of SCs in psychosis is complex and may not be a simple extension of the typical effects of cannabis or natural cannabinoids 4.
- Induction of psychotic symptoms after consuming SC products has been reported, including new-onset psychosis and psychotic relapses 4.
Pharmacology and Metabolism of Synthetic K2
- Synthetic cannabinoids in K2 products act as full cannabinoid receptor type 1 (CB1R) and type 2 (CB2R) agonists, unlike the partial agonist properties of Δ(9)-THC 5.
- Several SCB metabolites retain high affinity for, and exhibit a range of intrinsic activities at, CB1 and CB2Rs, which may contribute to the observed toxicity 5.
- The distinct pharmacological properties and metabolism of SCBs relative to Δ(9)-THC may contribute to the greater health risks associated with K2 products compared to marijuana 5.