Synthetic cannabinoids

Discussion in 'Medical Toxicology (MD, DO, PharmD)' started by name?, Apr 12, 2011.

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  1. name?

    name? 10+ Year Member

    Apr 29, 2004
    Does anyone else wish they would just legalize marijuana so that maybe fewer people would use these synthetics? I've had a few people in the last month using "K4" and "K2" from a local shop who look an awful lot like a bad combo of PCP and marijuana--paranoid, anxious, a little psychomotor agitation, wide vacant eyes (although I haven't appreciated the nystagmus of our favorite "wet" customers). I can't recall a single person that I've taken care of who was an isolated marijuana intoxication, and this is working in an area where "do you smoke?" is answered with "weed, not cigarettes" more often than not. Most Friday's I'd happily trade a herd of stoned hippies for the ETOH and PCP users...although we might run out of crackers.
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  3. WilcoWorld

    WilcoWorld Senior Member 10+ Year Member

    Nov 2, 2004
    Amen. I've seen more people come to the ED for side effects of Spice/K2 in the last 3 months than I've seen come in for side effects of pot in my whole career.

    Stick to the real stuff people.
  4. Dakota

    Dakota Senior Member 10+ Year Member

    Sep 5, 2005
    I saw a ton of that here in Louisiana. Pts were always agitated like a "PCP Light." Never mellowed out which I thought was supposed to be the point. After it was banned people quickly moved onto bath salts which were even worse.

    Although the bath salt craze did lead to one confused pt I had who tried snorting tide (as in the actual detergent). Needless to say it didn't have the desired effect.
  5. Hamhock

    Hamhock 7+ Year Member

    May 6, 2009
    I have no idea how that link got there. Deleting post.

    Last edited: Mar 16, 2012
  6. Venko

    Venko True to self Lifetime Donor 10+ Year Member

    Jan 24, 2006
    Rochester, MN
    I, personally, do not support its legalization.
  7. southerndoc

    southerndoc life is good Moderator Emeritus Lifetime Donor 10+ Year Member

    Jun 6, 2002
    Marijuana definitely has less side effects than the synthetics, and in fact, I think it has less side effects than alcohol.

    At least with its legalization the country could get some tax revenue that might help get us out of debt!
  8. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

    I don't support it either but I'm pretty ambivilant about it. In other words I wouldn't fight too hard to keep it illegal. I do think that the whole "medical MJ" industry that has popped up is crap. I have way more respect for those who advocate its legalization based on its own merits (or rather characteristics) than those who are trying to slip in in the back door of medical necessity.
  9. EctopicFetus

    EctopicFetus Keeping it funky enough 10+ Year Member

    May 3, 2004
    Medical MJ is a joke but while I am not nor have I ever been an avid user I do think it is more harmless than alcohol and the amount of not just tax revenue (I have seen estimates of 100 billion per yr) but the ability to not have to put these people into our legal system would save us just as much. One of the biggest groups fighting legalization is the prison guard union. That tells me all I need to know. They want to keep their jobs keeping non violent offenders in jail. Thats a cush gig.
  10. EctopicFetus

    EctopicFetus Keeping it funky enough 10+ Year Member

    May 3, 2004
    Also FWIW with the synthetic crap had a kid come in who was trying to commit suicide by smoking spice and eating shrooms.

    Kind of a bizarre mixture for sure. Anyways he asked I not put an IV in which I was fine with since he agreed to allow labs and other psych stuff to be done.

    Then the dude bradys to 40s and then a pause with 1 beat in 15 seconds. Then while we scramble his heart rate hits 140 then up and down 50-150.

    I called tox they said this came happen depending what they spray this on. Needless to say PICU transfer and admit.

    Not using this to form my opinion of legalization of MJ but thought I would share.
  11. Hamhock

    Hamhock 7+ Year Member

    May 6, 2009
    I have no idea how that link showed up. I guess I suck at even simple 'copy-paste'...although I do think that link shows some excellent art.

    I intended to paste a link to the most recent NYTimes article about 'bath salts', which I can't seem to find now.

    1. Pardon
    2. Nevermind.

  12. ccfccp

    ccfccp Stays crunchy in milk! 7+ Year Member

    Aug 12, 2007
    Tourist Mecca, USA
    That's funny. I spent about 10 minutes earlier today looking uber carefully at that picture trying to figure out where it fit in the discussion. Never came up with anything besides a possible reference to a bad trip. Glad I didn't make anything out of it that wasn't there :)
  13. WilcoWorld

    WilcoWorld Senior Member 10+ Year Member

    Nov 2, 2004
    Very interesting, and even more disturbing.
  14. rologist


    Dec 21, 2011
    It would seem that California is becoming a model for Marijuana legalization. It will be interesting to see the trends in that state in the next decade. My hunch: it's not such a terrible concept, and generally does not lead to Cocaine, Meth, etc addiction.
  15. Shnurek

    Shnurek Banned 2+ Year Member

    Apr 10, 2010
  16. bananaface

    bananaface Pharmacy Supernerd Moderator Emeritus Lifetime Donor 10+ Year Member

    Apr 24, 2004
    gone to seed
    The indie shops are a BS distribution system though. Legally, the states have the right to reschedule drugs. But, when they do they should not set dispensing practices or product standards that are more lenient than federal law allows. Prescription drugs should be dispensed through the pharmacy or a medical provider and drug products should be subject to the same quality control requirements as other prescription drugs. Marijuana should not be exempt from laws which were drafted to protect the public from legitimate problems like adulteration and misbranding. There needs to be oversight to ensure that products which do not meet quality control standards or pose a risk to patient health due to contamination are not put into the distribution system or are able to be recalled effectively.

    I get that there is no good legal distribution system in place and that is why this craptastic system is going on. But, that doesn't excuse the problems with the current system. If we are going to prescribe marijuana for medical purposes or otherwise introduce it onto the legal drug market, we need to do better.
    Last edited: Dec 23, 2011
  17. Nervous Ned

    Nervous Ned 5+ Year Member

    Apr 7, 2010
    Worcester, MA
    The problem with medical marijuana is the same problem we have with all natural products: you can't quality control them. The amounts of active ingredients change based on things like growth conditions, time of year, pressure from predators, etc. Plus, you're talking about a whole family of related compounds, not just one single compound. The only way to standardize dosages would be to use synthetic THC. Which we already have, as marinol.
  18. Pharmavixen

    Pharmavixen foxy pharmacist 7+ Year Member

    Jan 20, 2008
    I've worked in addiction tx for a while now, and one of the things we've noticed about the medical mj advocates is an outstanding percentage of them have convictions for mj possession, trafficking, etc. Seems like the mj usage came first, and then they develop an illness for which mj conveniently is a "tx."

    Re addiction liability: a couple of years ago, I presented a seminar to other pharmacists on the treatment of neuropathic pain with synthetic cannabinoids. In my reading, what struck me was the number of clinicians asserting that synthetic cannabinioids are a third-line drug mainly because of their addiction liability. But there were no data on addiction liability to speak of; they seemed to be citing other "experts" who said so.

    My personal observation, in dispensing Cesamet and Marinol to people with dx opioid dependence perhaps also on methadone or Suboxone, is that they don't seem to get into hijinks with these. Unlike with, say, Oxycontin, they don't dose escalate, lose their pills, come into the pharmacy to abuse their pharmacist, etc.
  19. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

    I have noticed this too. We don't really have medical MJ in NV but I see a fair number of people from CA who have cards. Interestingly the population of people on medical MJ tend to be in the age group of people who use MJ recreationally (i.e. young) rather than in the age group of people most likely to have one of the MJ "treatable" conditions.

    I agree with your assessment that recreational MJ is a gateway to medical MJ.
  20. FIVE02

    FIVE02 5+ Year Member

    Nov 7, 2011
    Bluegrass State
    Last edited: Apr 2, 2012

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