Synthetic marijuana use among teenagers raises concerns

By Dr. Ananya Mandal, MDMar 20 2012

According to reports three U.S. teenagers ended up in the emergency department with altered mental states and seriously elevated heart rates after smoking synthetic marijuana.

One 16-year-old girl who was brought in by her boyfriend refused to move or speak and did not respond when doctors rubbed her chest hard or pinched her. Although she was lying down, her pulse was 105. She recovered after getting two kinds of medications - an anti-anxiety drug and one that's used to treat abnormal movements - and resting for several hours. While her urine test was positive for THC, one of the active ingredients in natural marijuana, her boyfriend said they had also smoked K2, one of the many names for synthetic marijuana.

The two other cases involved both involved teenage boys. One of them, an 18-year-old, was brought to the ER from a party, where he had gotten into an altercation. He was aggressive, agitated and sweating profusely and had a pulse of 131. The other, a 16-year-old, seemed confused and agitated and had trouble speaking. Both teens calmed down after getting an anti-anxiety drug and were discharged from the hospital after a number of hours. Both teens had a negative drug screen, but said they had been smoking synthetic pot, which isn't detectable on standard drug tests.

The synthetic versions of marijuana are blends of herbs and spices laced with cannabis-like chemicals, and are sold under a variety of names, including Spice, K2 and Red X Dawn. The drugs were recently banned in the U.S. and the Drug Enforcement Administration has proposed to classify them permanently as schedule 1 controlled substances - a category that includes heroin and natural marijuana. The synthetic drugs are believed to be much stronger than regular pot, however, and the products may include other ingredients, too.

“Because it's unregulated we don't know exactly what's in it,” said Dr. Joanna Cohen, one of the authors of the new report, which was published Monday in the journal Pediatrics. Cohen, an emergency physician at Children's National Medical Center in Washington, D.C., said the three cases described in her report are the only ones she has witnessed personally.

But last November, a team of Texas doctors published a report on three 16-year-olds who had experienced heart attacks after smoking synthetic cannabis. And according to Cohen and her colleagues, poison control centers across the country have received 4,500 calls involving the products since 2010. “If people were getting the effects that they wanted they probably wouldn't be calling the poison control centers,” she told Reuters Health.

“Parents and teens need to be aware of the signs and symptoms of synthetic marijuana use and know that it is out there,” she said. “Anytime your teenager is acting abnormally or having aggressive agitation you should certainly seek medical attention.” “The big danger is that kids’ brains are still developing and we don’t know about the long-term effects. It can have serious consequences such as memory loss, [mental] deficits, and psychosis with long-term, repeated use,” she said.

Users like the fact that you can’t easily detect them in drug tests, says Arthur T. Dean in an email. He is the chairman and CEO of Community Anti-Drug Coalitions of America. “The truth is these products are a disguise for a very scary and potent drug. We know from our members across the country that K2 and Spice are sending kids to the emergency room, causing aggressive and unusual behavior, and even suicides.” This is not something that should be so easy for young people to get their hands on, according to Dean. “We hope that an even more aggressive and permanent solution can be found to the problem," he says.

Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City who was not involved in the study, said the problem is compounded by the fact that these products contain unknown additives and chemicals which may cause a different set of physical symptoms. They include elevated blood pressure, rapid heart rates and paranoia - which could mimic a panic attack - along with hallucinations and even seizures for some users, he said. Effects of long-term use might be even worse. “The truth is that we do not know the long term effects on the brain and nervous system in children and teens after use of synthetic cannabinoids,” Glatter told HealthPop in an email. “With repeated use, potential side effects reported have included cognitive difficulties, including memory loss as well as psychosis.”

David Rotenberg is the vice president of treatment at Caron Treatment Centers in Wernersville, Pa. He is also concerned about the rise in use of these compounds and the number of kids who are finding themselves in the hospital as a result. There are so many unknowns, he says. “You don’t know what you are taking, or what dose you are getting, and what the kid is predisposed to.” These drugs are particularly attractive to kids who are already abusing drugs and alcohol. “Kids who have drug problems and are put on probation or are in an outpatient treatment program gravitate toward this stuff because it doesn’t show up in all urine screens,” he tells WebMD. “This stuff is bad news.”

“Parents should talk to their children about this drug,” Dr. Aaron Schneir, a toxicologist at the University of California in San Diego who was not involved with the study, told LiveScience. “You have no idea what you're getting when you use it.”