By: Dr Aadil Jan Shah, a Psychiatrist
What is spice?
Spice is a synthetic cannabinoid drug sometimes known as “fake weed” because of its similarity to cannabis. Synthetic cannabinoids (SCs) are also referred to as synthetic cannabimimetics or synthetic cannabinoid receptor agonists. The chemicals in the drugs attach themselves to same nerve cell receptors as THC, the mind-altering substance found in cannabis, but can have much stronger effects. They have a strong effect on the endocannabinoid system.
The term ‘Spice’, is the brand name of one the most common synthetic cannabinoid products sold in Europe and is often used as a generic term for all synthetic cannabinoids.
In the pure state, Spice or synthetic cannabinoids are either solids or oils. Smoking mixtures are usually sold in metal-foil sachets, typically containing dried vegetable matter to which one or more of the cannabinoids have been added. Sachets usually contain 0.5–3 g of finely ground plant material. Most synthetic cannabinoids are produced in China and exported, usually in powder form, using wrong declarations, such as ‘polyphosphate’, ‘maleic acid’, ‘fluorescent whitening agent’ or ‘ethyl vanillin’. Once in Europe, the retail products are assembled by lacing inert herbal products with synthetic cannabinoids. They are then dried and packaged for sale.
Spice in the UK has gained popularity, among adolescents and young adults and prison populations. Spice use in the homeless community has been ‘creeping up’ for some years. A recent news item suggested that the police in Manchester are battling an epidemic of the use of spice and attended nearly 60 incidents related to the drug in the city centre in one weekend.
Those who take spice are often left incapacitated or seriously ill and are often referred to as “Zombies”. They can also become aggressive and become a danger to themselves and others.
Is spice legal?
The mind-altering substance in Spice, JWH-018, was banned in 2010 – but manufacturers started to change its formula so that they could continue to sell it.
The Psychoactive Substances Act 2016 made it an offence to produce or supply any substance intended for human consumption that is capable of producing a psychoactive effect, with exemptions for alcohol, tobacco and other “legitimate” substances.
Before the ban in 2016, spice and other so-called legal highs were available to purchase online and in head shops. They were often sold as plant food and were labelled as not fit for human consumption.
How is spice taken?
The primary route of administration of is inhalation, either by smoking the ‘herbal mixture’ as a joint or by utilising a vaporiser, bong or pipe. Both oral consumption and snorting of the compounds have also been described. There are also reports that it can be ingested as an infusion, although this is rare.
Effects of Spice on your brain?
The desired effects of spice are similar to those of cannabis intoxication and include relaxation, altered consciousness, disinhibition, a state of ‘being energised’ and euphoria. The effects on brain include cognitive impairment, behavioural disturbances, changes in mood and sensory and perceptual abnormalities (both auditory and visual). Spice is more likely to be associated with hallucinations than cannabis. There can also be negative mood changes, irritability, paranoid thoughts, difficulties with memory and severe anxiety.
There has also been evidence of sedation, while other users have reported agitation.
What does spice do to your body?
Spice can cause sickness, hotflushes, burning eyes, mydriasis and xerostomia (dryness in the mouth). The most commonly reported unwanted physical effects are nausea and vomiting. It can also cause fast heart rate, changes in the blood pressure, etc
Because the make-up of spice is constantly varying, its effects can greatly differ. Many chemicals used in spice and other drugs are as-yet unidentifiable, and as such research has not yet made clear exactly how the brain is effected
Spice use has been linked to a rising number of emergency department visits and some deaths.
Features of acute intoxication
2. Cardiac- Tachycardia, hypertension, chest pain, palpitations, ECG changes
3. Renal- Acute kidney damage
4. Muscular- Hypertonia, myoclonus, muscle jerking, myalgia
5. Other - Cold extremities, dry mouth, dyspnoea, mydriasis, vomiting, hypokalaemia.
Loss of eyesight and speech also reported.
Management of acute toxicity
Spice cannot be detected by the routine drug screening tests although laboratory techniques have been developed to detect some compounds, but there are currently no widely available tests. One has to heavily rely on the history and presenting symptoms.
Symptoms of intoxication may be self-limiting and resolve spontaneously. In the emergency departments, hydration and monitoring may be enough for patients with mild to moderate intoxication. Benzodiazepines may be of benefit to patients who present with symptoms of anxiety, panic and agitation. Antipsychotic medication may be indicated for some patients, especially those who present with agitation or aggression, when the patient has a history of psychotic disorders, and when the psychotic symptoms do not remit spontaneously or with supportive care. The management of spice toxicity is symptomatic and supportive, as no antidotes exist. Supportive treatment is dependent on a patient’s specific presentation.
For up-to-date guidance on the management of acute toxicity related to synthetic cannabinoids, it is recommended that information be sought from the National Poisons Information Service (NPIS), specifically the NPIS 24-hour telephone service and the poisons information database TOXBASE®: http://www.toxbase.org/Poisons-Index-A-Z/S-Products/Synthetic-Cannabinoid-Receptor-Agonists/
Dealing with dependence
Spice may have a higher addictive potential than cannabis, due to the quicker development of tolerance. The withdrawal symptoms could include drug craving, nocturnal nightmares, profuse diaphoresis, nausea, tremor, hypertension and tachycardia. Psychosis has also been reported among frequent users.
Psychosocial interventions remain the mainstay treatment for dependence apart from symptomatic management with medications like benzodiazepines, antipsychotics and antidepressants.
Overall a multi-agency approach is needed to deal with this problem, and this includes public awareness and education about the effects of synthetic cannabinoids including spice.
1.The Guardian, Manchester police attend 58 spice-linked incidents in one weekend, 10/04/2017.
2. TOXBASE®: http://www.toxbase.org/Poisons-Index-A-Z/S-Products/Synthetic-Cannabinoid-Receptor-Agonists/
3. Guidance on the Clinical Management of Acute and Chronic Harms of Club Drugs and Novel Psychoactive Substances, Novel Psychoactive Treatment UK Network (NEPTUNE), 2015
Cite this article as:
Aadil A Shas (2017). Spice: The Zombie Drug: The Beautiful Space-A journal of Mind, Art and Poetry. May 2017: TBSB118
Please check author names highlighted with each article.
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