'Fake drugs' pose real threats

A host of marijuana like substances are legal and widely available in the US
A host of marijuana like substances are legal and widely available in the US

K2. Spice. Zohai. Genie. Have you heard your kids using any of these words lately? If so, they may be smoking a legal, herbal “incense,” commonly misused as a marijuana substitute.

When inhaled, the products produce a similar experience to smoking marijuana and are available at tobacco and head shops for roughly the same price as their street drug equivalent. But unlike pot, these “herbal supplements” are currently legal in 45 states and are untraceable by tests designed to detect cannabis, making their use easy to conceal.

“The main problem with K2, which is similar to problems we saw in the 1980s with designer drugs, is people have been able to alter the molecules of illegal drugs just enough to create a substance that replicates the effects of the drugs, without breaking the law,” says Sharon Levy, MD, MPH, director of Children’s Hospital Boston’s Adolescent Substance Abuse Program. “But legal or not, they’re still psychoactive substances and carry a lot of the same risks.”

From a molecular standpoint, the products’ key ingredients seem to bind to the cannabinoid receptors in the brain in a manner similar to THC– the compound in marijuana that induces the drug’s high– and produce similar results. But while the ingestion and aftermath of smoking K2 is closely aligned with marijuana use, its ingredients are tweaked just enough to classify it as a different substance, allowing it skirt most states’ current controlled substance laws.

Levy hasn’t seen any patients for K2 use in her practice yet, but says the substance’s molecular similarities to marijuana suggests it will effect many users in a similar manner, including some of its more negative effects.

“Some kids who use marijuana chronically, or products with similar effects, are subject to what’s called the amotivational syndrome, where they lose interest in school or work, but are not able to see the connection between their loss of interest and their use of cannabis,” she says. “Their lack of awareness to the change has to do with how slowly it occurs over time, and because of the direct effect of cannabinoids on the brain.”

Some marijuana users justify their drug use by saying it lowers their anxiety levels, which may be true because the human body naturally produces cannabinoids that seem to play a role in modulating anxiety. However, as Levy points out, elevated cannabinoid levels and total loss of anxiety can be harmful.

Sharon, Levy, MD, MPH
Sharon, Levy, MD, MPH

“Marijuana and similar substances can make the user feel good because they reduce anxiety, but when taken in extremely high doses, they actually may be reducing anxiety too much,” she says. “A small amount of anxiety is usually a good thing. A little bit of anxiety gets you to work on time or makes you study that much harder for an upcoming history exam.”

While Levy is worried that the legal status of products like K2 could fool young people into believing they’re a safe alternative to marijuana, she is also wary that over-hyped campaigns to warn teen about their dangers could be counterproductive.

“I think using these substances is risky, but I also believe that unless its use is widespread, media attention on these things should be downplayed because they’re easily available,” she says. “Too much coverage may just pique teenagers’ curiosity.”