By Scott Mitchell, LCDC
These two substances seem to have emerged on the scene in the past year or so and are becoming increasingly more popular, especially among the younger patients. In actuality, reports from the media indicate the phenomenon has been growing since 2006. Essentially, both of these substances offer the same "benefits" to our chemically dependent patients. They are a mixture of herbal compounds, manufactured in China and Korea, that contain synthetic cannabinoids, or as my patients say, "fake weed" that produces effects in the brain similar to THC. Some of my recent patients talk about using these while on probation because they are not detectable in any of the drug screening methods available at this time. Oddly enough, they were discovered during a cannabinoid research study at Clemson University in the 1990's.
At the present time, there are no studies available regarding the effect of these substances on the body with the exception of one German toxicology study that concluded that three ounces of Spice had potentially the same harmful effects as one pack of cigarettes. Clinicians and physicians across the country who are treating the smokers of K2 and Spice are reporting that the patients are having hallucinations, nausea and vomiting, agitation, and increased blood pressure and heart rate readings. They further speculate that the synthetic cannabinoids can have the same detrimental effects as THC.
In addition, both substances are currently considered unscheduled with regard to DEA regulations and therefore technically legal in the U.S. Incidentally, the majority of K2 / Spice sales seem to be online. Since 2010, these substances have been banned or moved into a controlled category by three states and legislation is being considered in six others to do the same. In 2011, Texas legislated that possession and sale of these products now carry the same penalty as marijuana. They have also been banned in 18 countries in Europe, Asia, South America, and in the Pacific Islands but are currently legal in Canada, New Zealand and the US. Spice was recently classified and is being regulated in the United Kingdom as a scheduled drug.
While the names of these two drugs are being used interchangeably by patients, they do have some differences. As near as I can determine, the main difference is that they use a different mixture of herbs and cannabinoids. Spice, which is manufactured under 21 different brand names, is sold at smoke shops as an "herbal smoking alternative." On the other hand, K2 is sold as incense in other stores and bears the label "Not for Human Consumption”. This may be the reason that smokers of K2 experience agitation and vomiting when they smoke heavier amounts.
When dealing with patients that have been using these substances and are considering returning to their use, I bring up some specific points. First, since there are no definitive studies on these products, no one knows how much harm they can do. Russian Roulette anyone? Can anything good come from inhaling smoke anyway? I never see people running into burning buildings in order to inhale the smoke. Secondly, I point out that the use of these substances is an attempt at bargaining in recovery much the same way an alcoholic does when he drinks "non-alcoholic" beer. They are, in essence, trying to hold on to whatever vestiges of their former lives they can. In this case, the patient's understanding and commitment to Step One is questionable. Finally, it all comes down to trying to change the way we feel. If the patient is working a solid recovery program and is becoming spiritually fit, why are substances like this even necessary? It’s food for thought. I am sure we will hear more from the treatment community and the media about these substances as time goes by.