Physician Discusses the Dangers of Synthetic Cannabis Spice: Schizophrenia

One thing we know for certain is that we cannot dis-invent psychoactive drugs. They are here to stay while underground nurseries hatch new “highs” every year for the multibillion-dollar world drug market.

All we can do to assure our safety is to learn the truth about them from impartial sources. From there one can avoid these substances or exercise caution with usage.

One of the problems I’ve encountered is trying to discern fact from fiction whenever a new drug hits the streets and starts receiving media attention. For the layperson it’s particularly frustrating. Where do the real facts end and fiction begin?

The popular press often times plays loose with the facts while trumpeting their own agenda. For example, whenever a novel recreational drug becomes vogue the press are usually quick to demonize it by highlighting the most dangerous side effects no matter how rare they are. In this case you might think that using Spice will buy you a quick trip to the county morgue.

They may be right.


Enter the synthetic cannabinoids (SC) many of which are available online or in novelty stores. This time the reports from Europe and America concerning the serious adverse drug effects of SC are all saying the same thing. That some of these drugs are exceedingly dangerous.

Here’s the problem: while hundreds of new chemical “highs” are being pushed onto the world market every year, none have had even the most basic toxicity studies performed. That means risk is unpredictable.

Today we’ll talk about a particularly troubling adverse effect: the inducement of psychosis with the recreational use of one SC which is developing an alarming reputation, Spice.

In a study published in 2013 researchers described:

…the symptoms of 50 patients who presented with intoxication from synthetic cannabis.

Nearly all of the patients presented with severe agitation, disorganized thoughts, paranoid delusions, and assaultive behavior. Other common symptoms included suicidal ideation (30%), anxiety (28%), depression (20%), and catatonia (0.05%).[ref](medscape.com 05/23/2015[/ref]

The findings were presented at the American Academy of Addiction Psychiatry’s (AAAP) 24th Annual Meeting & Symposium.

The typical user profile is a young man 18-25 years old who also tests positive for THC and cocaine in addition to synthetic cannabis, and has a past history of psychosis or substance abuse.


The synthetic drug Spice is about ten times stronger than natural cannabis. By design, it’s a potent CB1 agonist. Compare this to THC which is only a partial CB1 agonist.

The odd thing is that most patients interviewed felt that these materials were safe since they were sold as “incense” or as a “legal high.” But safety in this setting is a pipe dream, literally.

In addition to the psychoactive effects, synthetic cannabis can cause adverse physical effects, including tachycardia, tachyarrythmia, myocardial infarctions — even in young, healthy adults — cardiotoxicity, chest pain, nausea, vomiting, and death, according to the study. Additionally, there have been reports of acute kidney injury and seizures.


According to Dr Lee, one of the presenters at the meeting, the symptoms of cannabinoid psychosis have recently been dubbed “Spiceophrenia” (Papanti D et al, Hum Psychopharmacol. 2013;28:379-389) because of their similarity to symptoms of schizophrenia.

In other words patients presenting to the ED after intoxication with Spice, will often look identical to those suffering a psychotic (schizophrenic) break.

As suggested in Dr. Kelly’s findings, Dr. Lee noted that the effects are not always dose dependent.

“The hallucinations and delusions experienced are not only among chronic users but sometimes reported in acute users who may have used it the first time and binged on it.”

Confounding factors are the use of cocaine and marijuana together with Spice as well as a possible genetic predisposition toward psychosis among the victims. Dr Lee related to Medscape Medical News.