The Dangers of Synthetic Marijuana

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Synthetic marijuana, known as synthetic cannabinoids, consists of mind-altering chemicals that are human-made with unknown ingredients. They are either sold as a liquid so that they can be used in e-cigarettes or are sprayed on dried or shredded plant material so that they can be smoked.¹ They are frequently referred to as synthetic marijuana or fake weed to create the illusion of safety and, as such, are marketed as safe, but they are anything but safe. The dangers of synthetic marijuana include paranoia, aggression, psychosis, seizures, and overdose, among many more risks.¹

Why is Using Synthetic Marijuana So Dangerous?

Synthetic marijuana is particularly dangerous because, unlike marijuana, it affects the brain more powerfully, the effects are unpredictable, and it can be more dangerous or life-threatening. It is part of a group of substances called new psychoactive substances (NPS), which produce the same effects as other illegal substances.¹

Synthetic marijuana is identified and further classified as dangerous for a myriad of reasons. For example, the types of effects they induce are more severe, including:²

• Respiratory difficulties
• Hypertension
• Tachycardia
• Chest pain
• Muscle twitches
• Acute renal failure
• Agitation
• Anxiety
• Psychosis
• Suicidal ideation
• Cognitive impairment

As if the above is not bad enough, chronic use frequently results in serious medical and psychiatric conditions and even death.²

Manufacture-Based Risks

Dangers of synthetic marijuana, in part, are derived from its marketing, which is inaccurate, misleading, visually attractive, and overly accessible. Although synthetic marijuana is labeled as not for human consumption, the labels also claim that they are derived from plants despite the active, mind-altering cannabinoid compounds being made in laboratories.¹

Packaging is designed to attract consumers and can be brightly colored foil packages or plastic bottles. Additionally, accessibility is a problem as it can be purchased over the internet, at gas stations, novelty stores, or drug paraphernalia shops.¹

Short- and Long-Term Side Risks of Synthetic Marijuana

You can experience short-term (acute) and long-term (chronic) side effects of synthetic marijuana. The most prevalent and pervasive psychological effects are the development of mental health disorders like affective disorders, schizophrenia, and psychotic states.^3,4

One study found that these acute and long-term side effects occur across seven areas of functioning: neuropsychiatric, cognitive, cardiovascular, neurologic, gastrointestinal, and other.²

Neuropsychiatric Functioning

The short-term neuropsychiatric dangers of synthetic marijuana include:²

• Persistent psychotic episodes
• Paranoia
• Perceptual alterations
• Catatonia
• Auditory and visual hallucinations
• Aggression
• Agitation

Long-term synthetic marijuana use increases the risk of developing psychotic disorders, especially in those with risk factors.²

Affect Regulation

Acute affect risks include suicidal ideation, negative mood, depression, mania, and panic attacks, while long-term dangers include irritability, chronic depression, and persistent anxiety.²

Cognitive Abilities

Synthetic marijuana use can cause short-term cognitive dangers, such as amnesia, attention difficulties, and alterations in memory. Chronic use can cause deficits in executive functioning specific to working memory and attentional capacities.²

Cardiovascular Issues

Synthetic marijuana can cause many heart issues in the short-term, such as:²

• Heart palpitations
• Tachycardia
• Chest pain
• Hypertension
• Arrhythmias
• Heart attack

Long-term cardiovascular dangers of synthetic marijuana include cardiovascular disease.²

Neurological Issues

Synthetic cannabinoid use can cause short-term neurological risks, including:²

• Involuntary muscle contractions and twitches
• Dizziness
• Sensation changes
• Sleepiness
• Hyperextension
• Muscle tightness
• Seizures

Preliminary evidence indicates that long-term synthetic marijuana use can cause functional and structural alterations in the central nervous system.²

Gastrointestinal Issues

Acute gastrointestinal effects of synthetic marijuana include nausea, vomiting, and changes in appetite, while long-term use can cause severe weight loss.²

Other Complications

Other complications of synthetic marijuana use may include:²

• Deficiencies in driving ability
• Acute kidney injury
• Cough
• Abdominal pain
• Rhabdomyolysis
• Miosis (excessive constriction of the pupil)
• Mydriasis (dilation of the pupil)
• Fatigue
• Hyperthermia
• Xerostomia (the salivary glands in your mouth do not produce enough saliva and, therefore, cause dry mouth)

Long-term dangers of synthetic marijuana include dependence, withdrawal, tolerance, kidney disease, nightmares, and insomnia.²

If you have pre-existing medical conditions that involve respiratory difficulties, hypertension, heart problems, and cognitive problems, using synthetic marijuana would likely exacerbate these conditions and lead to potentially life-threatening consquences.

Typically, symptoms and the effects of synthetic marijuana are short-lived.⁵ However, severe toxicity, which can last as long as 12 hours, has a prognosis that begins with preliminary characteristics of severe agitation and restlessness and then evolves into critical life-threatening medical states of coma or seizure.⁵

Addiction and Overdose Risk

Synthetic marijuana, like most mind-altering substances, is addictive. Once you’ve developed a synthetic marijuana addiction, it may be difficult to quit given that addiction involves compulsive and uncontrollable use regardless of negative consequences. If you are addicted to synthetic marijuana, you are likely dependent as well, which means you need to keep using this drug to stave off withdrawal symptoms. Synthetic marijuana withdrawal symptoms may include:¹

• Irritability
• Depression
• Anxiety
• Headaches

Similar to other synthetically made substances, you can also overdose on synthetic marijuana by taking too much of it, wittingly or unwittingly, and then experiencing serious symptoms or even death. Synthetic marijuana overdose symptoms include:¹

• Seizures
• Kidney damage
• Reduced blood supply to the heart
• Elevated blood pressure
• Toxic reactions

Because synthetic marijuana is unregulated and batches may differ from one another, you can never really know what’s in the drug you are taking. Synthetic marijuana has been found to be cut with fentanyl, a deadly and powerful opioid that has led to countless overdose deaths across the country.¹

Treating Synthetic Marijuana Overdose vs. Marijuana and Other Substances

Treating an overdose on synthetic marijuana, fake weed, or synthetic cannabinoids is challenging for three main reasons:⁵

• The toxicity of synthetic marijuana mimics a large number of other substances, probably because it too comprises a kaleidoscope of different substance profiles.
• Synthetic marijuana also mimics a large number of medical conditions. Because of these two overlapping chemical identities, treatment providers are then put in a pretty precarious situation—that is, to make important empirical treatment decisions that are only based on one data stream of input, clinical diagnosis.
• The third difficulty with treating synthetic marijuana overdose stems from the individual seeking help. Oftentimes, those that are experiencing synthetic marijuana toxicity are incapable of accurately reporting the method they used when using the substance (i.e., they cannot tell you if they ingested it or inhaled it), nor are they able to tell you what was used.

What is currently being used, however, are benzodiazepines, which seem to be an acceptable and effective first intervention to calm the agitation and altered mental status of mild toxicity. On the other hand, if the client is dangerously agitated and out of control, sedatives such as haloperidol, atypical antipsychotics, or even ketamine may be used.⁵

To reverse the dystonic-like activity and muscle rigidity in some cases, diphenhydramine, which is an antihistamine, is sometimes used. The acting recommendation is for treatment providers to routinely order laboratory tests that include an electrocardiogram (EKG), urine drug screen, electrolytes, blood ethanol levels, and salicylate and serum acetaminophen levels on clients that are using synthetic marijuana.⁵

Synthetic Marijuana Addiction Treatment

Unlike opioid use disorder or alcohol use disorder which are responsive to medication-assisted treatment (MAT), there is no current MAT option for treating synthetic marijuana use disorder. More importantly, empirically validated treatment is unknown at this time.⁵

Otherwise, synthetic marijuana addiction is treated in much the same way a marijuana addiction is. Behavioral therapies are used to change maladaptive behaviors, enhance coping skills, and address underlying influences on synthetic marijuana use.

Cognitive behavioral therapy (CBT) helps you increase the capacity for self-control (i.e., develop and exercise impulse control), cease synthetic marijuana use, and address overlapping problems (e.g., codependency, depression, trauma, etc.) by learning strategies for correcting maladaptive patterns of behavior.⁶

Contingency management is a strategy that provides tangible rewards for desired behaviors, such as abstinence and substance-free urine tests. This incentivization can help encourage abstinence and create new, substance-free behaviors.⁶

Motivational enhancement therapy is a systematic intervention. This therapy does not attempt to treat you; rather, it aims to generate quick, internally motivated change.⁶ This can be helpful for someone who is ambivalent about seeking treatment at an inpatient rehab or outpatient rehab.

If you are addicted to synthetic marijuana or know someone who is, we can help. Call our confidential helpline at 800-681-1058 (Who Answers?) to speak to a knowledgable treatment support specialist about your rehab options, both near you and in other states.

Resources

1. National Institute on Drug Abuse. (2020). What are Synthetic Cannabinoids?
2. Cohen, K., & Weinstein, A.M. (2018). Synthetic and Non-Synthetic Cannabinoid Drugs and Their Adverse Effects – A Review From Public Health Perspective. Frontiers in Public Health, 6(162), 1-8.
3. Volkow, N.D., Swanson, J.M., Evins, A.E., DeLisi, L.E., Meier, M.H., Gonzalez, R., (2016). Effects of Cannabis Use on Human Behavior, Including Cognition, Motivation, and Psychosis: A Review. JAMA Psychiatry, 73(3), 292-297.
4. Castaneto, M.S., Gorelick, D.A., Desrosiers, N.A., Hartman, R.L., Pirard, S., & Huestis, M.A. (2015). Synthetic Cannabinoids: Epidemiology, Pharmacodynamics, and Clinical Implications. Drug Alcohol Dependence, 144, 12-41.
5. Roberts, J.R. (2015). In Focus Synthetic Cannabinoids Treating Toxicity. Emergency Medical News, 3(8), 12-14.
6. National Institute on Drug Abuse. (2020). Available Treatments for Marijuana Use Disorders.