- Signs and Symptoms of K2 or Spice Abuse
- What Are the Effects of K2 Abuse?
- Combining Spice with Other Drugs
- How Do I Know if I'm Addicted to Spice?
- Who Is at Risk for K2 Addiction?
- When to Seek Help from K2 Recovery Programs
- K2 Rehab and Treatment Options
- Teen K2 Abuse and Addiction
- Sources
What is Spice?
Synthetic cannabinoids or herbal marijuana alternatives, colloquially referred to as “K2” or “Spice,” are marketed as incense or potpourri. They are intentionally altered with synthetic cannabinoid compounds and produce psychoactive effects when smoked, but are not detectable in traditional marijuana drug screens.
The diagnosis of Spice abuse or addiction is determined on the basis of a pathological pattern of behaviors related to its use. This includes:
How Widespread is K2 Abuse?

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Signs and Symptoms of K2 or Spice Abuse
One of the main concerns with respect to synthetic marijuana is the variability of symptoms. The symptoms can be hard to predict because the formulations are difficult to regulate.
With an onset similar to that of THC, the immediate psychological effects of K2 include:
- Euphoria.
- Feelings of well-being.
- Serenity.
- Creative thinking.
- Elevated mood.
- Drowsiness.
- Light-headedness.
- Elevated heart rate (tachycardia).
- Feeling of clumsiness.
- Dizziness.
- Nausea.
- Tinnitus/ringing in the ears.
- Vomiting.
Behavioral or Psychosocial symptoms:
- Hallucinations.
- Paranoia.
- Nervousness/anxiety.
- Confusion.
- Disorientation.
- Depressed mood.
- Aggressive behavior.
- Psychosis (a number of cases have been reported and indicate that this may be even more serious for those with a genetic predisposition for psychotic disorders).
What Are the Effects of K2 Abuse?
- Synthetic marijuana is fairly new compared to other illicit drugs.
- It is difficult to detect in the common toxicology screens run on urine tests.
- Its active constituents are difficult to identify.
- Individuals who use synthetic cannabinoids also use other drugs, causing more difficulty in specifically examining K2 or spice induced effects.
However, a few adverse long-term effects have been observed. These include:
Adolescent abusers of this product are particularly vulnerable to psychosis because of over-activation of the cannabinoid system in their developing brains.

Combining Spice with Other Drugs

- A cohort study of injection drug users (IDUs) in California found that injecting stimulants (e.g., cocaine and methamphetamine), and misuse of psychoactive prescription drugs were significantly associated with synthetic cannabinoid use.
- IDUs have a significant risk of contracting HIV-AIDS and HEP-C, and the accompanying use of synthetic drugs may put users at a greater risk for HIV and other blood-borne illnesses.
Consequences of polydrug use with K2 can be speculated based on drug interactions with marijuana.
- Use of alcohol with THC is known to attenuate or worsen cognitive performance, especially in those individuals that are vulnerable to mental illness.
- Marijuana users are known to consume higher amounts of alcohol and tobacco, possibly resulting in impaired working memory, cognitive flexibility, and verbal memory than either substance alone.
How Do I Know if I'm Addicted to Spice?
Using the DSM-V, if at least 2 of the following criteria are met within a 12- month period, you may have a diagnosis of substance abuse disorder pertaining to use of K2, and you may need help:
- Synthetic marijuana is often taken in increasingly large amounts over a period of time.
- There is a persistent desire to cut down, but efforts to achieve this are unsuccessful.
- A great deal of time is spent craving Spice, using it, or looking for ways to get it.
- Problems in fulfilling work, home, or school obligations.
- Continued use despite interpersonal and social problems.
- Important social, occupational or recreational activities are given up.
- Recurrent use of K2 in hazardous situations.
- Continued use despite knowledge of persistent or recurrent physical or psychological problems which are caused or exacerbated by K2.
- The development of a marked withdrawal syndrome when one abstains from K2.

Who Is at Risk for K2 Addiction?
The risk factors for developing an addiction to Spice are similar to those for marijuana addiction and/or addiction to other drugs. These include:
- Alcohol, marijuana and/or other drug use.
- Synthetic marijuana use is frequently associated with the use of other drugs.
- Marijuana dependent individuals who want to avoid a positive drug test but still become intoxicated (particularly true for adolescents and young adults).
- Being male.
- Lack of parental supervision or a disruptive home environment.
- Being younger in age.
- History of drug abuse.
- Hereditary predisposition to drug abuse or mental illness.
- Exposure to, or a demonstrated propensity for, criminal activity.
- Evidence suggests that over activating the cannabinoid system in adolescent brains results in the kinds of deficits which can produce psychosis.
- In addition to young adults, high school students are also vulnerable to Spice abuse.
- In a 2012 national survey, 11.3% of 12th graders (17+ years) reported use of synthetic cannabinoids.
Additionally, those who want to escape detection on random drug testing at their place of employment, and elect to use Spice – which is not detectable on routine immunoassay screening devices – may also be susceptible to long-term use, and increase their risk of addiction.
When to Seek Help from K2 Recovery Programs
Get Help, Because Why Not?
Find a treatment program that can comprehensively help you handle your symptoms and your life.
Addiction is a chronic illness, not a passing condition like a wound which will heal by itself. If you meet the criteria above or have concerns about your use of Spice, you cannot handle this illness alone. It is progressive, relapsable, and tough to tackle alone. If you are concerned, this is the time to seek assistance.
Help for Addicted Friends and Family
The addiction of one family member has a great effect on other family members, and the dynamics in a family can influence both the onset and progression of a family member’s addiction.
Helping friends or family members who are addicted to K2 means helping the whole family. As a family member it is important that you are involved in the treatment process. You can assist by:
- Helping to identify and fix your enabling behavior towards your loved one.
- Identifying the assistance that everyone in the family needs due to their exposure to the individual’s substance abuse; i.e., neglect, emotional problems, and psychological issues.
- Finally, as a family member, you can contact mental health professionals in the community who will work with you in confronting and motivating your loved one to seek treatment.
K2 Rehab and Treatment Options
There is no specific treatment for K2 addiction.
- The use of benzodiazepines such as lorazepam (Ativan) or the longer-acting diazepam (Valium) can work well with withdrawal seizures, agitation and anxiety.
- Where these are not effective in reducing symptoms, administration of quetiapine (Seroquel) has been shown to be effective in stabilizing the patient.

Treatment can be sought on an inpatient or outpatient basis.
- Inpatient treatment programs are typically 30-90 days, and address multiple areas of concern around drug use, like acute behavioral changes.
- Some provide services for co-occurring mental disorders which are common in the addicted population.
- Some of these programs provide vocational guidance, with referrals to agencies who can assist with employment and housing services.
- If the patient poses a risk to self or others, inpatient treatment is mandated.
Given that the symptoms of withdrawal from K2 generally dissipate over a period of a few days, outpatient treatment may be sufficient, and may offer a more financially viable option than long hospital stays.
In the case of persistent mental illness, non-addictive medications can help treat mood and psychotic symptoms, along with individual therapy.
The ultimate goal of any treatment program is to enable and maintain complete abstinence from K2. However, there is a need to change behaviors and adopt healthier lifestyles.
- Group Therapy can help in this process by helping you resolve any ambivalent feelings you have towards your addiction. The sense of bonding with others can also help reduce feelings of stigma and isolation.
Teen K2 Abuse and Addiction
Commercial advertising is often aimed at teens and young people to perpetuate the idea that synthetic cannabinoids are simply “natural and harmless” herbal mixtures.
- 36% of high school seniors (17+ years of age) in the US used cannabis in 2013.
- After controlling for gender, alcohol use and other illnesses, one study found specific deficits in executive functioning, sustained attention, verbal learning, and psychomotor speed related to synthetic cannabinoid use.
Weekly cannabis use before the age of 18 has been linked with lower performance on IQ tests and deficits in attentional processing.
Regular cannabis exerts much less action on the cannabinoid system than Spice, which can be anywhere from 2-800 times more potent than regular cannabis/marijuana.
- Given this kind of affinity for CB1 receptors by K2, the damage to the developing brain of an adolescent – while not well documented – is in urgent need of our attention.
In spite of legal restrictions on its sale, adolescents continue to perceive that synthetic cannabinoids, like K2 or Spice, are safe and undetectable alternatives to regular marijuana, enabling a false sense of security that they will not be caught or held accountable by law enforcement or school authorities.
Sources
- Auwärter, V., et al., (2013). Synthetic Cannabinoid Receptor Agonists. In Dargan, P.I., and Wood, D.M., eds. Novel Psychoactive Substances: Classification, Pharmacology, Toxicology. Boston: Elsevier, pp.317-343.
- Brents, L.K., and Prather, P. L., (2014). The K2/Spice phenomenon: emergence, identification, legislation, and metabolic characterization of synthetic cannabinoids in herbal incense products. Drug Metab Rev 46(1): 72-85.
- Brewer, T.L., and Collins, M. (2013). A review of clinical manifestations in adolescents and young adults after use of synthetic cannabinoids. Journal for Specialists in Pediatric Nursing 1-8.
- Daley, D.c., et al., (2009). Group Therapies. In Ries, R.K., Fiellin, D.A., Miller, S.C., and Saitz, R. editors. Principles of Addiction Medicine. Fourth Edition. Philadelphia, PA: Lippincott, Williams & Wilkins, pp. 757-767.
- Gunderson, E.W., et al., (2012). “Spice” and “K2” Herbal Highs: A Case Series and Systematic Review of the Clinical Effects and Biopsychosocial Implications of Synthetic Cannabinoid Use in Humans. The American Journal on Addictions 21: 320-326.
- Herzig, D.A., et al., (2014). Alcohol and Relatively Pure Cannabis Use, but Not Schizotypy, Are Associated with Cognitive Attenuations. Front Psychiatry 5: 133.
- Khullar, V., et al., (2014). Emergence of new classes of recreational drugs – synthetic cannabinoids and cathinones. J Gen Intern Med.29(8): 1200-4.
- Liepman, M.E., et al., (2009). Family Involvement in Addiction, Treatment and Recovery. In Ries et al., eds. Previously cited. pp. 857-868.
- Lisdahl, K.L., et al. (2014). Considering Cannabis: The Effects of Regular Cannabis Use on Neurocognition in Adolescents and Young Adults. Curr Addict Rep 1(2): 144-156.
- Musselman, M.E., and Hampton, J.P., (2014). “Not for Human Consumption”: A Review of Emerging Designer Drugs. Pharmacotherapy 34(7): 745-757.
- Nacca, N. et al., (2013). The Synthetic Cannabinoid Withdrawal Syndrome. J Addict Med 7(4): 296-298.
- Renard, J. et al., (2014). Long-term consequences of adolescent cannabinoid exposure in adult psychopathology. Front Neurosci 8: 361.
- Rosenbaum, C.D., et al., (2012). Here Today, Gone Tomorrow…And Back Again? A Review of Herbal Marijuana Alternatives (K2, Spice), Synthetic Cathinones (Bath Salts), Kratom, Salvia divinorum, Methoxetamine, and Piperazines. J Med Toxicol 8: 15-32.
- Sbaderna, M., et al., (2013). Spicing Things Up: Synthetic Cannabinoids. Psychopharmacology (Berl) 228(4): 525-540.
- Seely, K.A., et al., (2012). Spice drugs are more than harmless herbal blends: a review of the pharmacology of synthetic cannabinoids. Prog Neuropsychophamacol Biol Psychiatry 39(2): 234-243.
- Wagner, K.D., et al., (2014). Use of synthetic cathinones and cannabimimetics among injection drug users in San Diego, California. Drug Alcohol Depend. 141: 99-106.
- Winstock, A., and Barratt, M.J. (2013). Synthetic cannabis: A comparison of patterns of use and effect profile with natural cannabis in a large global sample. Drug and Alcohol Depend.