Synthetic Cannabis Poisonings Drop In States Where Cannabis Is Legal

  • New research shows a drop in synthetic cannabis poisonings in states that have legalized recreational cannabis.
  • Synthetic cannabis products contain toxic, illegal chemicals that are widely available in stores and online, often legally.
  • Experts warn of the health risks involved with using synthetic cannabis products like delta-8 THC and recommend avoiding them since they’re unregulated.

Each year, U.S. Poison Control Centers receive hundreds of calls related to synthetic cannabinoid poisonings.

These drugs — with names like Spice, K2, and No More Mr. Nice Guy — can cause severe, life threatening health effects such as agitation, confusion, psychosis, and seizures.

Overall, synthetic cannabinoid exposures have dropped in recent years, Poison Control data shows — falling from a high of 7,792 in 2015 to 984 in 2021. That number continued to decline in 2022, with 313 cannabinoid exposures as of July 31.

Some researchers have attributed this decline, at least among adolescents, to increased federal regulation of these compounds, which has reduced their availability.

But a new analysis, published online on August 8 in Clinical Toxicology, suggests that the drop in synthetic cannabinoid poisonings may be due, in part, to the legalization of recreational cannabis in various states, which provides the option for many people to legally buy safer cannabis products, depending on where they live.

“Based on both past research and this current study, it’s evident that users who have a choice to use a less toxic product would potentially do so,” study author Tracy Klein, PhD, an associate professor of nursing at Washington State University said in a news release.

In the new study, researchers examined Poison Control data between 2016 and 2019. During that time, there were 7,600 calls related to synthetic cannabinoid use.

Almost 65% of these calls required medical attention, including 61 deaths, researchers found.

Over half of the calls (56%) occurred in states with restrictive cannabis policies, while over one-third (38.6%) occurred in states that allowed medical use of cannabis.

By contrast, just 5.5% occurred in states that allowed adult use of cannabis for non-medical purposes.

In addition, states with legal recreational cannabis had 37% fewer poisoning reports for synthetic cannabinoids, compared to states with restrictive policies, researchers found.

“This study points to some of the potential benefits of a regulated adult-use [cannabis] market, which allows for testing, labeling and packaging that mitigates (not eliminates) potential consumer harm,” Klein told Healthline.

Because most synthetic cannabinoids are illegal — and unregulated — there’s no way to fully know which cannabinoids or other chemicals are included in a purchased product.

In 2018, more than 150 people in Illinois were sickened and four died after using synthetic cannabinoids laced with rat poison.

That same year, over 100 people overdosed on a bad batch of the synthetic cannabinoid K2.

According to the Centers for Disease Control and Prevention (CDC), tracking the use of synthetic cannabinoids is challenging because they can’t always be detected on standard hospital drug tests, including ones for THC.

Some researchers have also suggested that some of the drop in synthetic cannabinoid poison calls may be attributed to doctors being more familiar with symptoms of synthetic cannabinoid poisoning, thus avoiding a call to Poison Control.

Although synthetic cannabinoids are sometimes referred to as “synthetic marijuana,” they are very different from plant-derived cannabis.

“[These chemicals] behave in the body in a toxic manner and have no relationship to plant-based natural cannabinoids,” Klein said.

Synthetic cannabinoids get their name because they act on the same cannabinoid receptors in the brain as tetrahydrocannabinol (THC), the main psychoactive ingredient in cannabis plants.

There are actually hundreds of different synthetic cannabinoids, some 100 times more potent than THC, according to the CDC.

These chemicals are manufactured in labs and sold at convenience stores, online, and by drug dealers. Although the chemicals are illegal, these products are easily — often legally — obtained, even by young people. According to a 2019 study, over 10,000 synthetic cannabinoid exposures among adolescents were reported to Poison Control Centers between 2007 and 2017.

Synthetic cannabinoids may be sprayed onto plant material and smoked, or mixed into a liquid and vaped, while others may be added to food or tea and ingested. Exposure to these chemicals can cause neurologic symptoms such as agitation, irritability, confusion, and seizures. People may also experience hallucinations, psychosis, or suicidal thoughts.

Other symptoms may include:

  • accelerated heartbeat
  • chest pain
  • nausea
  • vomiting
  • heart attack
  • kidney failure
  • death

There’s no specific treatment for illness caused by synthetic cannabinoids. Doctors will provide supportive treatments such as intravenous fluids, supplemental oxygen, and medications to manage symptoms.

Synthetic cannabis products like delta-8 THC, K2, and others pose a risk to public health, and experts warn that more awareness of the dangers of these products is still needed.

“Clinicians need a great deal of education about how to talk with patients about both medical and non-medical use of cannabis products, as well as other substances such as Kratom, and synthetic cannabinoids, including delta-8 which is often thought of benignly as ‘weed light,’” Klein said.

Delta-8 THC has a similar structure as delta-9 THC, the main compound in the cannabis plants that produces a “high.” While delta-8-THC occurs naturally in cannabis, it is found in minuscule quantities.

“There is a misconception that whenever you pull cannabinoids out of the [cannabis] plant, there’s an abundance of delta-8 and that’s what’s going on the shelves,” Shanna Babalonis, PhD, an assistant professor in the Department of Behavioral Science at the University of Kentucky, told Healthline.

“But that’s not true, because there’s very little delta-8 in the cannabis plant,” she added.

Most of the delta-8-THC bought by consumers is made in a lab from cannabidiol (CBD), a compound found in higher amounts in hemp plants, which are cannabis plants that contain 0.3% or less of THC. Some users report that delta-8 THC produces a “milder” high than delta-9 THC. But because delta-8 products are unregulated, experts say they may also contain harmful chemicals.

Over a 14-month period between 2021 and 2022, national poison control centers received over 2,300 reports of exposures to delta-8-THC products, with the majority requiring medical attention, according to the Food and Drug Administration.

In addition, over 40% of these cases involved children or teenagers, with one child death reported.

Reports of poisoning from synthetic cannabis products seem to be declining in states where recreational cannabis is legal, according to new research.

Although the chemicals found in synthetic cannabis products are illegal, in many cases, the products themselves are not.

Health experts warn of the dangers associated with synthetic products, such as an increased risk of accidental poisoning and even death. Despite their popularity and widespread availability, experts recommend avoiding synthetic cannabis products like delta-8 THC and K2 and other synthetic products like Kratom, since they’re unregulated.

If you live in a state where recreational cannabis is illegal and are seeking alternatives, it’s important to be aware of the risks involved before you consider trying synthetic options.

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