How Legalizing Marijuana Might Stave Off 'Spice' Epidemics
The same approach used to regulate and manage legal marijuana in several states could be used to control knockoff weed.
The first time Stewart Martin tried knockoff weed he was 15 and on probation for marijuana possession. Martin and his friends would buy the stuff legally from local head shops and bodegas in Virginia, smoking brands like "Space Cadet," "Scooby Snacks," and "Bizarro".
"You never knew whether the results were going to be calm and mild or whether you were going to throw up or fight people or run into traffic," said Martin, who's now 21. It was worse when Martin was sent to prison for a different drug charge—a place where, according to him, "It was Spice that ruled all."
The cheap and easy-to-hide man-made drugs, commonly known as Spice or K2, are synthetic cannabinoids, a group of active chemical compounds found in the cannabis plant. In countries where they haven't been outlawed, brands of synthetic cannabinoids* are marketed as having effects that are similar to that of natural cannabis, only we know that's not the case. Smoking the blends led prisoners to freak out, attack guards, even one time chew on electrical wires, Martin explained.
"Ninety-nine percent of the time, the only reason folks would have anything to do with it was because they couldn't smoke regular marijuana while they were on probation," Martin said.
Paula Santiago would agree. Santiago has seen a lot in her three decades working as a harm reduction specialist on New York City's streets. Helping homeless youth in the 1980s, she faced off against the crack epidemic spreading through the city. In the 1990s, she helped pioneer the needle exchange programs that staved off the HIV infections plaguing intravenous drug user populations.
Now, as the harm reduction coordinator at the grassroots activist organization VOCAL New York, she's witnessed synthetic cannabinoid take hold among street users. And she's seen enough to know the similarity between synthetic "marijuana"—a widely-used misnomer—and natural marijuana is in name only.
"The only thing that happens when someone uses marijuana is they get really hungry or really funny or really stupid," she said, "as opposed to someone on K2 saying, 'The guy in front of me has become a worm,' or hallucinating that they are falling through the floor."
Santiago isn't optimistic that law enforcement crackdowns on synthetic cannabinoids, like the coordinated raids last year on city bodegas selling the drugs, have done much good. After all, last month, K2 overdoses in Brooklyn sent 33 people to the hospital, and two days later the Center for Disease Control and Prevention reported that while this sort of designer drug use is decreasing nationwide, K2 overdoses are on the rise—meaning the substances themselves could be getting more dangerous. Nor does Santiago believe the resulting hysterical and apocryphal media reports of Spice turning users into zombies (while 30 times more dangerous than marijuana, most instances of synthetic cannabinoid use don't lead to horrible reactions) will discourage sales for long.
But there is one thing Santiago thinks could cut down on Spice and K2 use: legalization of the natural marijuana. "That would definitely help," she said. "It may lower the use of K2, or even eliminate the use of K2."
Santiago isn't alone in this belief. One of the main reasons people say they use synthetic cannabinoids is because the substances, which commonly are marketed as potpourri or incense and not for human consumption, don't show up on most drug tests, unlike cannabis. So by ending marijuana criminalization, some people believe there wouldn't be much incentive to use K2 at all.
It's why a June New York City summit of scholars, policy experts, and service providers on synthetic drugs titled "New Strategies for New Psychoactive Substances" recommended, among other things, that policymakers work to legalize cannabis. And a recent report on synthetic cannabinoids by the New York City Department of Health concluded that removing marijuana from drug screens "has the potential to reduce the escalating health, safety, and cost burdens associated with [synthetic cannabinoid] use."
Just like marijuana activists are championing studies that suggest cannabis reforms could lead to decreased heroin and opioid use, stopping the spread of K2 could become a rallying point for the marijuana movement. As Dr. Adam Winstock, a London-based consultant psychiatrist and founder of the Global Drug Survey put it, "In some regions, it could be the best argument for legalization in quite some time."
The rise of K2 could be in part fueled by a twist on the much-maligned "gateway drug" theory: it's not marijuana use, but marijuana criminalization, that could lead many to turn to synthetic cannabinoids.
Study after study has found that along with its cheap street price and availability, the main attraction of synthetic cannabinoids, which was first developed by chemists for research purposes in the 1990s and began spreading across the United States and Europe in the 2000s, is that their chemical makeup is often too inconsistent to be detectable on toxicology tests. That makes it attractive to parolees, human services recipients, athletes, soldiers, and anyone else who's staring down the barrel of a drug screening.
"It's become very popular among low-income folks in East Harlem and parts of Brooklyn in part because it doesn't show up on drug tests," said Julie Netherland, New York City-based Director of Drug Policy Alliance's Office of Academic Engagement. "If they are involved in the criminal justice system, shelter system or any number of other services that may require drug testing, they don't want to lose access to these services or risk further entanglement in the criminal justice system."
Otherwise, all things being equal, researchers have found that 93 percent of those who've tried both natural marijuana and synthetic cannabinoids prefer the real thing. "Synthetic cannabis [sic] is harder to titrate, the effects don't last as long, and it's a less pleasant high," said Winstock. "So what are you left with?"
In other words, the rise of K2 could be in part fueled by a twist on the much-maligned "gateway drug" theory: it's not marijuana use, but marijuana criminalization, that could lead many to turn to synthetic cannabinoids.
"Cannabis legalization might lead to less synthetic cannabinoid use," said Erik Gunderson, an Associate Professor at the University of Virginia's Department of Psychiatry and Neurobehavioral Sciences who's studied K2 use among marijuana users. "It comes from reports and data that suggest people use the drug to evade drug testing and as a cannabis substitute."
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But does the evidence back up such claims? Are places that have decriminalized cannabis or legalized medical or recreational marijuana less prone to K2 epidemics?
"There are reasons to support that general perspective, but the data is problematic for several reasons," said Jon Gettman, a professor at Shenandoah University who studies drug data nationwide. The country's major drug studies—the National Survey on Drug Use and Health and the National Institute on Drug Abuse's Monitoring the Future survey—haven't yet collected information on synthetic cannabinoid use on state-by-state bases, and there's no public data yet on K2 arrests in each state.
The closest thing experts have to state data on K2 use comes from the American Association of Poison Control Centers (AAPCC), which tracks K2-related calls to poison centers. According to the AAPCC, in 2015, the majority of such calls occurred in the Mid-Atlantic and the South, with New York State and Mississippi being particular hotbeds. Western states, including marijuana-friendly locales such as Colorado, California, Oregon, and Washington State, logged very few such calls.
Furthermore, according to Winstock, the Global Drug Survey has found that the European nations associated with drug decriminalization or medical marijuana programs, such as the Netherlands, Portugal, and Spain, are among those with the lowest prevalence of synthetic cannabinoid use. Then there's the fact that according to a Drug Policy Alliance report, Colorado arrests for synthetic cannabinoids dropped by 50 percent after the state launched its legal marijuana regime in 2014.
But such data is far from conclusive. For one thing, in 2015, K2-related calls to poison centers were also on the high end in Arizona, which has harsh cannabis laws but also a fairly robust medical marijuana program. And the other European countries with low K2 prevalence are Norway and Switzerland, which aren't very marijuana-friendly at all.
It could be that marijuana legalization isn't the K2 magic bullet some activists hope it is. For starters, just because you live in a place that's legalized marijuana, that doesn't mean you still can't get busted for it on a drug test. In Colorado, for example, people on probation are no longer required to pass marijuana tests, but according to the state Supreme Court, employers can still test you for the drug—and fire you if you fail it. Plus, legalized marijuana will do nothing to impact the availability and incredibly cheap price and K2 (online it sells for about $5 a gram, about half the going rate of legal marijuana in Colorado), among the main reasons homeless and low-income drug users have turned to such substances.
But even if legal marijuana turns out not to be a K2 cure-all, cannabis reforms could still be tapped in the fight against K2. That's because synthetic cannabinoids are uniquely positioned to evade typical drug-prohibition techniques. Attempts to ban the drugs have simply led to a proliferation of varieties, as outlaw chemists in China and elsewhere come up with new, and potentially more dangerous, chemical formulations that stay a step ahead of the law. Even if lawmakers find a way to fit all current and future versions of K2 into Schedule I of the federal Controlled Substances Act, alongside heroin and other drugs deemed by the US government to have no medical value and high risk for abuse, doing so would severely limit researchers' ability to study the dangers (and potential benefits) of a drug family we know very little about—much the same way marijuana studies have been stonewalled for years.
"K2 would die off in a heartbeat."
It's why in 2013, New Zealand did something utterly unique. Instead of banning all synthetic drugs, the country legalized the sale of low-risk versions of synthetic cannabinoids and similar substances that were carefully tested and regulated. While a government change of power a year later put the experiment on hold, the results in the meantime spoke for themselves: The program reduced the number of synthetic drugs on the market by 75 percent and the number of retailers selling such products by 95 percent.
In other words, the same approach that's now being used to regulate and manage legal marijuana in several states could be used to control synthetic cannabinoids. While it's unlikely US voters and politicians would be ready to embrace such a program anytime soon, the time might come when the country doesn't have a choice, said Grant Smith, deputy director for the Drug Policy Alliance's office of national affairs.
"There are lessons to be learned from the regulation and taxation of marijuana [that we can apply to the synthetic drug market], but I don't know if we are in a position yet apply those lessons in the United States," he said. "It seems to me the future of drugs in a large way is these 100-percent synthetic or almost 100-percent synthetic compounds. We need to consider an alternative to prohibition."
Now out of prison, Martin avoids the stuff, even though it's still easy for him to score at local retailers and online. He thinks regulating the sale of certain synthetic cannabinoid brands would be a step in the right direction, but he doesn't consider any kind of K2 harmless. "I think it would be helpful, but I don't believe any synthetic version is necessarily safe," he said.
A better option, he said, is legalizing marijuana. "It would change everything," he said. "K2 would die off in a heartbeat."
*A previous version of this article used the term "synthetic marijuana" where "synthetic cannabinoid" would've been accurate, as the two aren't interchangeable. The story has been updated to reflect that distinction.