Overview

K2/Spice are synthetic cannabinoids, which are chemicals made in a lab to mimic the effects of delta-9-tetrahydrocannabinol (THC). But K2/Spice are much stronger than THC and can cause serious side effects and health problems. There are currently no known medical uses for these recreational drugs. Common side effects include changes in heart rate or blood pressure, problems thinking clearly, agitation, sleepiness, hallucinations, nausea or vomiting, paranoia, or fear. Serious side effects may include dependence and withdrawal, psychotic-like or dangerous behavior, kidney damage, and seizures. Before using K2/Spice, make sure to tell your health care provider about any health conditions you have or medicines you are taking.

Uses

What is K2/Spice used for?

K2/Spice are synthetic cannabinoids used recreationally to improve mood or feel “high.”

Note: K2/Spice refers to a group of synthetic cannabinoids that are not approved by the FDA for any use. The FDA also does not consider these products to be legal dietary ingredients in the U.S. K2/Spice are schedule I controlled substances, which means that they do not have an acceptable medical use and have a high risk for misuse. Learn more about the legal status of K2/Spice here.

How does K2/Spice work (mechanism of action)?

K2/Spice is a general term for street drugs made of synthetic cannabinoids. These cannabinoids are made in a lab and designed to mimic the effects of delta-9-tetrahydrocannabinol (THC), a natural psychoactive cannabinoid found in the Cannabis sativa plant (cannabis). K2/Spice may go by many other names, including incense and potpourri. These products are usually inhaled by smoking or vaping. There are no known medical uses for K2/Spice.

Synthetic cannabinoids (K2/Spice) are much stronger than natural THC and their use can lead to serious health problems. Since K2/Spice are not regulated or standardized, the actual chemicals in the products may vary. There may also be much higher amounts in some products and batches than in others. This variability increases the risk of overdose and toxicity, which can result in severe nausea or vomiting, agitation, seizures, stroke, kidney damage, coma, and even death. Smaller amounts of synthetic cannabinoids can also cause serious side effects, including psychosis, paranoia, and violence. In some cases, these side effects do not go away after K2/Spice are stopped.

How should I store K2/Spice?

You should store K2/Spice according to the product label. Most products should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.

Side Effects

What are the most common side effects of K2/Spice?

The most common side effects of K2/Spice are listed below. These side effects may vary depending on the dose or the specific product you are using. Tell your health care provider if you have any of these side effects that bother you.

• Abnormal thinking or confusion
• Anxiety or agitation
• Hallucinations (see below)
• Changes in heart rate or blood pressure (see below)
• Nausea or vomiting
• Paranoia or fear
• Sleepiness

There may be other side effects of K2/Spice that are not listed here. Contact your health care provider if you think you are having a side effect. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of K2/Spice?

While less common, the most serious side effects of K2/Spice are described below, along with what to do if they happen.

Severe Allergic Reactions. K2/Spice may cause allergic reactions, which can be serious. Stop using K2/Spice and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching or skin rash
• Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Problems Thinking Clearly. K2/Spice can change your mental function and affect your ability to think clearly. Tell your health care provider if you notice any of the following symptoms while using K2/Spice.

• Confusion
• Increased sleepiness
• Trouble remembering things
• Unable to concentrate

Dependence and Withdrawal Reactions.Some people who use K2/Spice may develop physical dependence, which means your body comes to rely on it. This risk may be higher in people who use K2/Spice regularly. If you stop K2/Spice suddenly, it could lead to withdrawal symptoms. Your health care provider may be able to help you stop K2/Spice in a way that will reduce the risk of withdrawal reactions. Speak to your health care provider if you have any of the following symptoms of withdrawal.

• Headaches
• Sweating
• Nausea, vomiting, or stomach pain
• Irritability, anger, or aggression
• Nervousness or anxiety
• Sleep problems or restlessness
• Changes in appetite or weight
• Depression or low mood

Hallucinations or Psychotic-Like Behaviors. K2/Spice may cause hallucinations or psychotic-like behaviors. This risk may be higher in people who use high doses of K2/Spice or people who also use other street drugs. Tell your health care provider right away if you have any of the following symptoms, or if you have been told by others you have these symptoms.

• Hearing, seeing, smelling, tasting, or otherwise perceiving things that others do not
• Delusional thoughts, such as false beliefs that you are being controlled
• Disorganized thoughts, such as jumping between topics or having a hard time focusing
• Sudden decline in self-care, such as personal hygiene or academic/work performance
• Aggressive behavior
• Behaviors that can place you or others in danger, such as walking into traffic or off of a tall ledge

Changes in Heart Rate or Blood Pressure.K2/Spice may have certain effects on the heart, such as raising your heart rate, blood pressure, or causing an abnormal heart rhythm (arrhythmia). If you measure your blood pressure and the top number (systolic) is 180 or higher or the bottom number (diastolic) is 120 or higher, get medical attention right away. Also call your health care provider or get medical attention right away if you have chest pain or a fast or irregular heartbeat or if you feel your heartbeat more than usual.

Kidney Damage. K2/Spice can cause****kidney damage. Call your health care provider right away if you have any of the following symptoms of kidney damage.

• Reduced need to pee
• Swelling in your feet, ankles, or legs
• Weakness or unusual tiredness
• A hard time catching your breath or chest pain/pressure
• Confusion
• Nausea
• Seizures

Seizures. Some people who have used K2/Spice have reported having seizures. There are many different types of seizures and some of them are not easy to recognize. Get medical help if you have any of the following signs that a seizure is happening or could happen.

• Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
• Stiffening of your arms and legs
• Feeling anxious, nervous, confused, or a sense of dread
• Feeling dizzy or lightheaded
• Falling or losing consciousness

Precautions

Who should not use K2/Spice?

Allergies to Ingredients. People who are allergic to any of the following should not use K2/Spice.

• K2
• Spice
• Synthetic cannabinoids
• Synthetic marijuana
• Any of the ingredients in the specific product

Ask your health care provider if you are not sure what ingredients are in a K2/Spice product.

What should I know about K2/Spice before using it?

The U.S. federal government does not consider K2/Spice to be legal ingredients. K2/Spice are schedule I controlled substances, which means that they do not have any approved medical uses and are at high risk for misuse. K2/Spice products are not regulated and have not been tested to confirm that they contain the ingredients stated on labels.

K2/Spice are controlled substances because they can be misused. Keep K2/Spice out of the reach of children and animals. Small amounts of K2/Spice can cause serious health problems in children. If your child takes any products that contain K2/Spice, get medical help right away. K2/Spice can also be toxic to pets, including cats and dogs. If your pet eats a product that contains K2/Spice, call your vet, emergency animal clinic, or animal poison control center right away.

K2/Spice can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how K2/Spice affects you.

What should I tell my health care provider before using K2/Spice?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if K2/Spice is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions.Tell your health care provider if you have any of the following.

• Heart problems
• Kidney problems
• Mental health problems, such as depression, a past suicide attempt, anxiety, hallucinations, paranoia, or psychosis
• History of misusing prescription medicines or street drugs
• Drink large amounts of alcohol

Other Medicines and Supplements.K2/Spice may interact with other medicines and supplements. Before using K2/Spice, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. K2/Spice is designed to mimic the effects of THC, which can cause harm to a fetus. However, it is not known if or how K2/Spice could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. K2/Spice is designed to mimic the effects of THC, which passes into breast milk and may cause harm to a breastfeeding baby. However, it is not known if K2/Spice passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does K2/Spice interact with foods or drinks?

There are no known interactions between K2/Spice and foods or drinks.

It is unknown if drinking alcohol will affect K2/Spice. But the risk of serious side effects may increase if you drink alcohol while using K2/Spice. It is best to limit the amount of alcohol you drink.

Does K2/Spice interact with medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using K2/Spice.

• Any medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, or medicines for anxiety
• A barbiturate, such as butalbital, phenobarbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
• A benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium and others), or lorazepam (Ativan and others), which is a medicine used for anxiety, muscle spasms, or seizures
• A muscle relaxant, such as carisoprodol (Soma), cyclobenzaprine, metaxalone, or tizanidine (Zanaflex)
• An opioid, such as codeine, fentanyl, morphine, oxycodone, or tramadol, which is a medicine used to treat certain types of pain
• Any other street drug, such as cocaine, heroin, or methamphetamine

The interactions between K2/Spice and medicines are not fully understood. As with most unapproved products, the research on drug interactions with K2/Spice is incomplete. Always check with your health care provider before using K2/Spice with any medicines.

Dosing

What should I do if I accidentally use too much K2/Spice?

If you or someone else has used too much K2/Spice, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

In the U.S., K2/Spice is a controlled substance known to cause serious side effects and health problems. It is best to avoid the use of K2/Spice entirely.