The dramatic increase in cannabis use combined with the growing popularity and availability of synthetic drugs poses an increased risk to people who experiment with them or see them as a safer alternative to other drugs.
Cannabis and synthetic drugs are not safe and put people at more risk than the marijuana familiar to previous generations. Growers in the United States have become adept at cloning and manipulating cannabis plants in recent years, engineering the plant for higher levels of THC, the active ingredient in marijuana.
Prior to 1995, the average level of THC in marijuana confiscated in the United States was about 5 percent, but now it is not uncommon for marijuana to have levels of THC reaching 20 percent. At the same time, marijuana growers have engineered down the levels of cannabidiol (CBD), the ingredient that inhibits the psychoactive effects of THC.
With much higher THC and lower CBD, this is not your grandfathers or your fathers marijuana. It is far more potent and has a much stronger effect on the brain and body. It is particularly dangerous for the developing adolescent brain. The effect of high doses of THC in the adolescent brain is much stronger than the same dose in the adult brain. The most notable difference is the risk of developing a dependence on cannabis. Adolescents are five times more likely to develop cannabis dependence when compared to all other age groups.
Can Prompt Psychotic Episodes
Cannabis use also interferes with a critical process in the brain in which excess connections between neurons are trimmed away to make the connection more efficient. When THC is introduced to the adolescent brain, that process is diminished, which can lead to numerous effects. A British study recently looked at episodes of first-time psychotic events and found a strong correlation with the use of high-potency marijuana. Researchers examined 410 patients in south London who had been in the hospital for their first psychotic incident.
Comparing this data to that of 370 control individuals, they found that people who used high-potency marijuana were three times more likely to be diagnosed with a psychotic disorder when compared to people who had never smoked marijuana, and daily users were five times more likely to develop a psychotic disorder. Most importantly, they estimated that 24 percent of all new cases of psychosis are associated with the use of this new high-potency marijuana. For more on the study, see https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(14)00117-5/fulltext.
The risk of such effects are not just during the period that the person is actually using marijuana. Any use of high-potency marijuana predisposes the person to a psychotic episode some time later in life. An adolescent using high THC content marijuana just on the weekend is tripling his or her risk of a psychotic event, according to the British study, and this is no small risk.
People take risks during a psychotic event, such as jumping off buildings because they think they can fly or taunting police because they think they are invulnerable. Once a person has one psychotic event, they are predisposed to experiencing future episodes of psychosis.
With the push toward legalization of marijuana in the United States, adolescents are receiving the wrong message about the safety of the drug. An openness to legalization sends the message that marijuana must not be very harmful, when in fact todays marijuana is far more dangerous than in past years. The risk to adolescents is shown in the Monitoring the Future study, an ongoing examination of the behaviors, attitudes and values of American secondary school students, college students and young adults. For more on the Monitoring the Future results, see https://www.monitoringthefuture.org//pubs/monographs/mtf-vol1_2014.pdf.
Marijuana Use Increasing
The Monitoring the Future study results show that every time the perceived risk of a drug goes down, the next survey will show increased use of that drug. The lowest perceived risk for marijuana occurred in 1975, accompanied by the highest reported use. In the following decade, perceived risk went up and use went down. Recent efforts to legalize marijuana have had the effect of bringing perceived risk to the same low as 1975 and now reported marijuana use is at its highest level since the study began.
Synthetic cannabinoids are another part of the problem. These are man-made, mind-altering chemicals that are either sprayed on dried, shredded plant material so they can be smoked (often called herbal incense) or sold as liquids to be vaporized and inhaled in e-cigarettes and other devices (liquid incense). They are frequently sold as potpourri and labeled not for human consumption. Labeling frequently claims they contain natural material taken from a variety of plants.
Synthetics often are packaged in colorful foil packages like liquid incense products, or like other e-cigarette fluids, come in plastic bottles. Synthetics go by many names, but in recent years K2 and Spice were common. Other common names are Joker, Black Mamba, Kush and Kronic. Though some of the products and chemicals in them are illegal, manufacturers frequently change the chemical structure to avoid prosecution.
These synthetic drugs are popular among young people, partly because they are easy to obtain and promoted as natural. Also, standard drug tests do not detect many of the chemicals in synthetic marijuana.
Synthetic cannabinoids, which are promoted as providing the same effects as marijuana, are a step beyond highly engineered, super-potent marijuana. These products contain compounds that are not found naturally in the plant at all. Rather, they are engineered in the lab by highly skilled chemists to have a much more potent effect on the cannabinoid receptor in the brain than even the strongest THC. The synthetics also have longer lasting effects on the brain.
Compared to cannabis and THC, the adverse effects from synthetics are often much more severe and can include hypertension, rapid heartbeat, heart attack, agitation, vomiting, hallucinations, psychoses, seizures, convulsions and panic attacks. Use can result in psychotic effects, as with potent marijuana, but more extreme.
Synthetic marijuana users can feel extreme anxiety, confusion, paranoia and experience hallucinations. Police departments all over the country have become familiar with calls about people acting bizarrely and dangerously after using synthetics. In one survey of 35 major city police departments, 30 percent have attributed some violent crimes to synthetic marijuana. New York City Police Commissioner William Bratton has called synthetics weaponized marijuana.
More Emergency Room Visits
Twenty years ago it was uncommon for people to need emergency care after using marijuana. But now patients are presenting to the emergency department with symptoms from synthetics. The Partnership for Drug-Free Kids reports that from Jan. 1 to Aug. 2, 2015, poison control centers received calls regarding 5,008 exposures to synthetic marijuana. That is a much higher rate than 2014, when poison control centers received 3,682 in the whole year.
The most common symptoms are accelerated heartbeat, high blood pressure, nausea, blurred vision, hallucination and agitation. Patients also may suffer epileptic seizures. Emergency physicians are finding that synthetic-related psychotic episodes are not treated easily.
The medicines typically used to treat a psychotic episode sometimes do not work at all on patients with synthetic-induced psychotics.
The risk from synthetics is extreme because, in addition to the known effects of these chemicals, the user has no idea what he or she is ingesting. There is no uniformity from one sample to the next, and in fact, most users have no idea which type of synthetic they are using. One death has been related to synthetic marijuana and several others have been investigated for possible connections.
Marijuana and synthetic marijuana products pose a much greater risk than most people realize, especially to young people who are lured into thinking these drugs are safe. Parents and the medical community must dispel these myths and explain that high-potency marijuana and synthetics have the potential to ruin lives.