Story highlights
- Teens who use fake weed are more likely to engage in risky behaviors, study says
- "It is very scary, if you've ever seen these kids on it," psychiatrist says
(CNN)The
synthetic cannabinoids often called "fake weed" are a mix of chemicals
sprinkled on what looks like incense and sold in shiny packages, often
to teens and young adults.
It
produces sensations similar to tetrahydrocannabinol (THC), the
psychoactive ingredient in the cannabis plant, yet many users report
more powerful, often dangerous effects.
New
research from the Centers for Disease Control and Prevention says young
people who use fake weed are also more likely to use other drugs or
alcohol, to behave violently and to have high-risk sex, according to a study published Monday in the journal Pediatrics.
To
understand the overall behavior of fake weed users, Heather Clayton,
lead researcher of the new study and a health scientist in the CDC's
Division of Adolescent and School Health, turned to the 2015 Youth Risk
Behavior Survey, a school-based anonymous questionnaire administered to a
nationally representative sample of high school students.
A
total of 15,624 students in grades nine through 12 reported their
behavior in four domains: substance use, injury and violence, mental
health and sexual health.
"We
learned from the 2015 Youth Risk Behavior Survey that nearly one in 10
high school students had used synthetic marijuana at some point in their
lifetime," Clayton said.
Of these
students, nearly all reported that they had also used marijuana at
least once. They were more likely to use marijuana very early in life --
before the age of 13 -- compared with students who had only ever used
marijuana, according to Clayton.
Sexual risk-taking
Almost two-thirds of the surveyed students said they'd never used marijuana or synthetic cannabinoids.
But
nearly a third of the students reported trying or routinely using
marijuana, while about 23% of these students had also tried or used fake
weed.
Digging deeper into the
data, Clayton and her colleagues discovered that students partial to
synthetic cannabinoids were significantly more likely to perform risky
sexual behaviors compared with students who limited themselves to
marijuana.
For instance, compared
with just 2% of nonusing teens and about 5% of marijuana-using teens,
nearly 15% of fake weed-using teens had their first sexual intercourse
before age 13. And about 38% of these same teens had had intercourse
with four or more people, compared with just 3% of the nonusers and 20%
of the students using cannabis.
Violence
was also more prevalent among teens partial to fake weed. A third of
fake weed users had carried a weapon, compared with 12% of nonusers and
about 19% of weed users. Meanwhile, more than half of fake weed users
had been in physical fights and a quarter drove while drinking, compared
with nonusers (15% and 2%, respectively) and weed users (29% and 12%,
respectively).
"The findings
indicate that students who report using synthetic marijuana are possibly
on a very concerning health trajectory, which is particularly serious
given that synthetic marijuana use is relatively common among
adolescents," Clayton said.
Based
on the research, she and her colleagues believe school programs and
health professionals should feature not only marijuana but synthetic
cannabinoids in their prevention strategies.
Depression and other risk factors
Packages
labeled as a safe and "natural" blend of herbs may give a false
impression that the drug is a safe alternative to marijuana. Yet fake
weed has caused rapid pulse, lethargy, nausea, vomiting, agitation,
chest pain, hallucinations, delusions, confusion and dizziness,
according to poison center reports.
The
most severe effects reported include seizures, permanent cardiovascular
damage, liver damage, stroke, psychosis, paranoia, aggression, anxiety
attacks, dependence and death through overdose, suicide or an extreme
negative reaction.
With
so many obvious dangers, Andrew Ninnemann, a doctoral student in the
clinical psychology program at the University of Maryland, designed a separate study, also published Monday in the journal Pediatrics, to understand the risk factors that contribute to a teen using fake weed.
Ninnemann
and his colleagues recruited nearly a thousand students from seven
public schools in Texas to participate in a survey in 2011, with
follow-up questions approximately one year later.
At the start of the survey, most participants were enrolled in the 10th or 11th grades. Ethnically diverse, 31% of the teens were African-American, 29% were white, 28% were Hispanic, and 12% categorized themselves as "other."
At the start of the survey, most participants were enrolled in the 10th or 11th grades. Ethnically diverse, 31% of the teens were African-American, 29% were white, 28% were Hispanic, and 12% categorized themselves as "other."
Analysis
of the data showed that African-American teens and females were less
likely to use fake weed than males and teens of other ethnicities.
Symptoms
of depression, alcohol use, marijuana use and fake weed use predicted
using fake weed one year later. However, teens with symptoms of anxiety
or impulsivity were not likely to report using fake weed later.
The results indicate that using marijuana may increase the risk of fake weed use -- but not vice versa.
"This
suggests that synthetic cannabinoid use should not necessarily be
thought of as a risk factor for eventual marijuana use but instead may
be a risk factor for those adolescents who engage in marijuana use
already," Ninnemann said.
'Unpredictable reactions' to a changing substance
"Teens
who use synthetic cannabinoids, really, it's playing a game of Russian
roulette," said Dr. Robert Glatter, an emergency physician at Lenox Hill
Hospital in New York City.
"Typically,
they become very aggressive and violent in the ER, and often they
require chemical (sedation) if not physical restraint."
The
reaction of each user is "unpredictable," Glatter said. "We've had
people with seizures requiring airway management and intubation. Other
times, they can smoke it and become a little violent, seize once, and
that's it. In other cases, they can become a little violent, a little
agitated, and that's it. They wake up in a few hours."
Mostly,
though, because they are "flailing around" and become violent and
aggressive, the main issue is that they can injure the staff and
themselves.
"Luckily, we haven't
been seeing a whole lot of it in the last six to 12 months. It's kind of
quieted down," Glatter said. "A few years ago, we were seeing several
cases a week." Still, he said, it's likely to pop up again.
"People talk about getting it in bodegas, head shops, gas stations ... or they buy it from a friend."
Users
find it difficult to gauge how much is too much, because once a fake
weed formula is recognized, it will be outlawed, but then the producers
will quickly change the chemical formula to keep one step ahead of the
law.
"This is dangerous and
unpredictable, and it can kill you," Glatter said. "Using marijuana,
which I'm not condoning, is safer. We don't see the violent behavior or
the seizure aspect we see with this drug."
What parents need to know
According
to Dr. Scott Krakower, assistant unit chief for psychiatry at Zucker
Hillside Hospital in Glen Oaks, New York, parents often ask him whether
their teens might be doing permanent damage to their brains.
"It's
a tough question," he said. "There is a possibility you can alter the
neuro circuitry just from ingesting some of these agents. ... There
could be some sustained injury."
It's more likely, he said, that with treatment and help, the brain may be able to recuperate.
Teens using fake weed can become paranoid, on edge, agitated and aggressive toward parents and family members.
"It's
a different kind of psychosis than we might see with other patients.
The psychosis is an agitated psychosis," Krakower said. "They're
violent. They can become aggressive. It is very scary, if you've ever
seen these kids on it.
"And coming
off of it is very, very scary, too. It takes them a few days sometimes
to get rid of the paranoia. Sometimes, they'll be paranoid for like 48,
72 hours."
Krakower said the substance emerges in waves while drug officials and test kits try to keep up with changing formulations.
Usually,
he tells that parents the warning signs for synthetic cannabinoid use
include a child with a history of substance use and drug tests that come
back negative even when the child appears high.
"And
if they are using synthetic agents, that's pretty serious, and they
should definitely seek help from a professional," Krakower said, whether
it's an addiction specialist or even a trusted pediatrician who might
guide them through the crisis. "There's a lot of ways to tackle this."
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